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Suspension Trauma in Fall Protection

Working at heights is an integral part of various industries, but it comes with its fair share of risks. One such risk that often goes unnoticed is suspension trauma, also known as orthostatic intolerance or orthostatic shock. Fall protection is crucial in preventing accidents, but what happens when a worker is suspended in a safety harness after a fall? In this comprehensive guide, we’ll dig into the world of suspension trauma (also known as suspension syndrome) in the workplace, discussing rescue plans, OSHA regulations, the prolonged effects of suspension trauma, and what products safety professionals are using to minimize the effects. 

Rescue Plans for Working at Heights

It’s essential to understand the importance of having a well-thought-out rescue plan for workers operating at heights. The Occupational Safety and Health Administration (OSHA) provides guidelines and regulations to ensure the safety of workers engaged in such activities. Falls can still occur despite the best safety measures in place, which is why it is crucial for employers to have a well-defined rescue plan in accordance with OSHA’s 1926.502(d)(20) requirement. This regulation mandates that employers provide prompt rescue and medical assistance to workers in the event of a fall, emphasizing the importance of a comprehensive safety strategy that covers both fall prevention and rescue procedures. The OSHA “Safety and Health Information Bulletin” emphasizes the necessity of prompt rescue measures in case a fall occurs. The key elements of a rescue plan should include: 

  1. Training: Workers should be trained in rescue procedures specific to their work environment. This includes understanding how to use rescue equipment and perform self-rescue if necessary.
  2. Response Time: The rescue plan should stipulate a maximum acceptable time for rescuers to reach a suspended worker. Delays can exacerbate suspension trauma, so rapid response is critical.
  3. Communication: Effective communication between the worker at height and ground personnel is vital. This includes relaying information about the worker’s condition and any medical issues that may arise during the rescue.

READ MORE: OSHA – Suspension Trauma/Orthostatic Intolerance 

Fall Protection for Suspended Falls

OSHA sets strict standards for fall protection systems to minimize the risk of falls and the potential for suspension trauma. Fall protection for suspended falls primarily involves the proper use of personal protective equipment (PPE) such as a fall arrest harness, lanyards, and self-retracting lifelines. These safety measures are designed to arrest a fall and prevent the worker from hitting the ground. 

READ MORE: OSHA – Personal Protective Equipment 

Suspension Trauma: Understanding Orthostatic Intolerance

Suspension trauma also referred to as orthostatic intolerance, is a medical condition that occurs when a person is in motionless vertical suspension in a harness for an extended period, usually after a fall. This condition arises due to the body’s inability to circulate blood adequately when in an upright position, leading to a range of potentially life-threatening symptoms. 

As outlined by the National Institutes of Health’s PubMed Central, suspension trauma can result in decreased blood flow to the brain, causing light headedness, fainting, dizziness, and nausea. It can also lead to serious complications, including muscle damage, kidney failure, and cardiac arrest.

READ MORE: PubMed Central – Suspension Trauma  

What to Do When Suspension Happens

In the event of a fall, workers must be aware of the potential for suspension trauma and take immediate action to mitigate the risks. Trauma relief straps, also known as suspension trauma relief straps, play a crucial role in addressing this issue. These straps are designed to relieve pressure on the legs and reduce the risk of orthostatic intolerance during harness suspension. 

To use trauma relief straps effectively: 

  1. Secure the relief straps to the front of the harness before ascending to height.
  2. In the event of a fall, pull the straps down beneath the thighs to distribute pressure.
  3. This action helps maintain blood flow to the lower extremities and reduces the risk of suspension trauma.

Prolonged Suspension Trauma and Its Effects

Prolonged suspension in a harness can have severe consequences for a worker’s health. The article published in PubMed Central titled “Prolonged Suspension Trauma in a Worker Rescued Using an Industrial Ascender” highlights the potentially life-threatening nature of extended suspension. The serious injury caused by prolonged suspension trauma may include: 

Leg Circulation

Suspension trauma can initiate a cascade of health problems, with its effects often beginning in the legs. When a person is suspended in a harness or by ropes for an extended period, the straps can impede the return of blood from the legs to the heart in the femoral arteries. This impediment disrupts the natural muscle venous pump, which normally assists in pushing blood back to the heart against gravity. As a result, blood pools in the lower extremities, causing a lack of oxygen and nutrients in the leg muscles, an effect known as venous pooling. Over time, this stagnant blood can become toxic and highly acidic due to the buildup of metabolic waste products, leading to muscle tissue damage, a condition referred to as Rhabdomyolysis. Even more severe systemic health issues, can potentially occure potentially damaging the kidneys and other vital organs.

Heart Circulation

Suspension trauma not only affects the legs but also has profound implications for heart health and overall circulation. As blood pools in the lower extremities due to the straps impeding blood return, the body can experience heightened anxiety and the onset of shock. In response to this crisis, the heart rate increases as it attempts to compensate for the decreased blood flow to vital organs. This increased workload on the heart can lead to increased blood pressure, cardiac irritability, or even circulatory collapse, where the heart’s electrical impulses become erratic and potentially life-threatening.

Brain Circulation

Suspension trauma poses a grave threat to brain circulation, as it can result in a cascade of life-threatening events. With blood pooling in the legs and a disrupted circulatory system, the brain may experience diminished blood flow, which can have severe consequences. Additionally, if the individual’s airway becomes blocked or compromised during suspension, oxygen supply to the brain is further restricted, increasing the risk of cardiac arrest or irreversible brain damage. In the most critical cases, suspension trauma can ultimately lead to death, underscoring the urgent need for prompt rescue and appropriate measures to restore blood flow and ensure the safety and well-being of those at risk.

READ MORE: PubMed Central – Suspension Trauma: A Clinical Review 

How Long Can You Hang from a Harness?

The duration a person can hang from a harness without experiencing suspension trauma varies from individual to individual. Factors such as age, fitness level, and pre-existing medical conditions can influence this time. However, it’s generally recommended not to exceed 15-30 minutes of suspension in a harness. Beyond this timeframe, the risk of orthostatic intolerance significantly increases.

READ MORE: PubMed Central – Fatal and Non-fatal Injuries Due to Suspension Trauma Syndrome 

How long can you hang in a harness

OSHA Guidelines and Best Practices

To ensure the safety of workers at heights, it’s crucial to adhere to OSHA regulations and best practices. Here are some key OSHA guidelines related to fall protection and suspension trauma: 

  1. Regular Training: OSHA mandates regular training for workers engaged in activities involving fall hazards. Training should cover the proper use of PPE, rescue procedures, and awareness of suspension trauma.
  2. Rescue Plans: Employers must have comprehensive rescue plans in place, specifying procedures for prompt rescue and the use of trauma relief straps when necessary.
  3. Inspect and Maintain Equipment: Regularly inspect and maintain fall protection equipment to ensure it is in good working condition. Defective equipment can lead to accidents and suspension trauma.
  4. Emergency Response: In the event of a fall, employers must have a well-coordinated emergency response plan in place to minimize suspension time and provide first aid measures if needed.

RESOURCES: Malta Dynamics – OSHA Survival Guide 

Suspension trauma (Orthostatic Intolerance) is a serious risk associated with working at heights. Understanding the condition, using trauma relief straps, and adhering to OSHA regulations are vital steps in mitigating this risk. It is crucial for employers and workers to prioritize safety, ensuring that rescue plans are in place and fall protection equipment is properly maintained. By following these guidelines and staying informed about suspension trauma, we can create safer working environments for those who operate at heights, reducing the risk of prolonged effects and potential life-threatening complications. 

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