The Clock Starts When You're at the End of Your Rope

Recently, I ran a fall protection workshop for one of our policyholders. They passed with flying colors when it came to fall prevention, but when it came to fall rescue, they were like most companiesthey weren’t prepared for what to do after a fall. 

When we pushed “Randy” our mannequin equipped with personal fall arrest gear off a work platform 30 feet off the ground, there was silence followed by 40 minutes of failed rescue attempts.

When you’re suspended after a fall, you have a 10-minute survival timer counting down. Randy only needed some epoxy, but for one of us, even in the best case scenario with no injuries, suspension trauma is a concern. Studies show that unconsciousness can happen in less than 10 minutes from hanging motionless.

Suspension trauma, also known as harness hang syndrome (HHS), occurs when the human body is held upright, without movement, over a period of time. In this position, the body cannot overcome the effects of gravity and the pressure of the harness against blood vessels in the legs, and it results in a loss of oxygen to the brain and unconsciousness. If blood flow and oxygen are not restored in time under proper medical care, death will follow.

Most companies rely on 911 and local EMS crews to rescue suspended workers. But it’s likely the wait could be 15, 30 or even 60 minutes. The keys to a successful rescue are identification and action. Remember suspension trauma occurs most quickly when hanging motionless.

OSHA best practices and considerations for suspended workers:

  • Rescue suspended workers as quickly as possible.
  • Be aware that suspended workers are at risk of orthostatic intolerance and suspension trauma. 
  • Be aware of signs and symptoms of orthostatic intolerance. 
  • Be aware that orthostatic intolerance is potentially life threatening. Suspended workers with head injuries or who are unconscious are particularly at risk. 
  • Be aware of factors that can increase the risk of suspension trauma. 
  • Be aware that some authorities advise against moving the rescued workers to a horizontal position too quickly.

At the very least you should evaluate your fall protection program and gear against the probable work scenarios and locations for rescue potential in the event of a fall. Then, don’t forget the most important part of all: training.

Train your staff to:

  • Decide whether their PPE is properly fitted and worn.
  • Understand how suspension trauma occurs and what would increase its risk.
  • Recognize the signs and symptoms.
  • Pump their legs frequently to reduce suspension trauma, if rescue is not prompt. And advise that footholds can be used to alleviate pressure, delay symptoms and provide support for muscle pumping.

These steps should be taken at least annually, but better yet, at the start of a new job where fall protection hazards and proximity of EMS have changed.

Following are some interesting links to facts and articles on suspension trauma.