Suspension Trauma: The Danger of Fall Arrest Systems
Arresting a fall is not the last step to fall safety. A plan for rescuing suspended workers is essential.
Two workers are conducting maintenance on a bridge when one loses his footing and falls. His fall protection gear kicks in and arrests his fall almost as soon as it starts. His life has been saved – but he's not out of harm's way yet.
This worker is still suspended in his fall protection harness, waiting for help. He's at risk for serious health issues, loss of consciousness, and even death.
Fall arrest systems are often seen as the ultimate lifesaver for workers at heights. A worker's fall protection harness may keep them from hitting the ground, but they're not in the clear yet.
Suspension trauma is often overlooked as a serious risk for workers at height. This is why OSHA requires employers to provide prompt rescue for those who experience a fall. For complete information about Fall Protection OSHA Violations, check out this post.
Suspension Trauma: What Happens When You're Left Hanging?
Suspension trauma occurs due to an extended period of orthostatic intolerance. What does this mean? OSHA defines it as:
“the development of symptoms such as light-headedness, palpitations, tremulousness, poor concentration, fatigue, nausea, dizziness, headache, sweating, weakness and occasionally fainting during upright standing.”
Immobility can cause venous pooling. This means that blood pools in the legs and reduces the amount of blood circulating in the rest of the body. Someone who is standing will lose consciousness and fall to a horizontal position. This way, the heart, legs, and brain are on the same plane and the body can normalize blood flow.
When a worker is suspended in a fall harness, the body has no way of going horizontal. The blood keeps pooling and cannot flow properly. This is suspension trauma. And unless the worker is rescued promptly, venous pooling and orthostatic intolerance occurs. This may result in serious damage to the brain, kidneys, and other organs.
Symptoms to Watch For
Suspension trauma is relatively rare, but fallen workers awaiting rescue should be closely monitored for suspension trauma symptoms.
Common symptoms include:
- Hot flashes
- Unusually low heart rate or blood pressure
- Increased heart rate
- Loss of vision
Who Is Affected?
In short, anyone who uses a fall protection harness is at risk.
Passive fall protection systems are used for suspension in cases of emergency. Occupations that use these systems include:
- Window washers
- Construction workers
- Crane operators
- Bridge workers
Suspension trauma can affect any worker left hanging after a fall, but there are several factors that can exacerbate the condition. Pay particular attention to the following:
- Fit and positioning of the fall harness
- Environmental conditions
- Shock and other injuries resulting from the fall
- Psychological state of the worker
- Physical health of the worker
Proactivity Prevents Further Injury
In an ideal world, you would never have to deal with suspension trauma. By taking proactive steps, employers can ensure workers remain safe after a fall. They can also cut the risk of further injury.
What does this entail?
Companies with workers who use fall protection need to institute practices that prevent prolonged suspension. Workers should be thoroughly trained on how to recognize orthostatic intolerance, and they should also know the factors that can increase their risk of it, and what they can to do avoid it. It’s not always easy, but suspended workers awaiting rescue can take some action to guard against injury. Preventative steps for suspended workers include:
- Adopting a sitting position
- Moving into a horizontal position as much as possible
- Using legs to push off from a hard surface, keeping the muscles active
- Pumping legs frequently to maintain blood flow and prevent venous pooling
Harness manufacturers have also come up with a simple solution to help protect workers. Their solution is: trauma straps. This form of PPE consists of a pair of straps contained in pouches, which attach to the hips of the harness. (Need more insight on fall protection harnesses? Check out this helpful blog post, The Ultimate Guide to Choosing the Right Fall Harness.)
A suspended worker can deploy the straps and brace their weight against them. This enables the worker to stand up in the harness, allowing the use of a worker's leg muscles. It takes weight off of the arteries and restores proper blood circulation until rescue occurs. (Want to see trauma straps in action? This video will give you a better understanding of how to install and use suspension relief stirrups in the event of a fall: Reliance SRS Suspension Relief Stirrup: Install and Product Use Demo.)
It is possible to use different techniques to prevent injury during suspension. However, suspended workers should be consistently monitored for signs of orthostatic intolerance. They should also receive an evaluation by a healthcare professional after rescue. It’s not uncommon for the suspension to cause delayed internal effects. Among these are kidney failure, which can be difficult to identify at the site.
What's one of the most significant things employers can to do prevent further injury to suspended workers? Have a rescue plan in place that can immediately be put into action. Let's look at what that means.
|Free Download: Construction Fall Safety Checklist|
Rescue Plans to the Rescue
Regulations say that companies must have a plan in place for the prompt rescue of a suspended worker. But what does "prompt" mean?
OSHA warns that suspension in a fall arrest device can result in unconsciousness, followed by death, in less than 30 minutes. But 30 minutes is a long time to be left hanging. In reality, symptoms of suspension trauma can start after just a few minutes. Studies have even found that loss of consciousness can occur in as little as seven minutes.
This shows why it’s so important for workers to be rescued as soon as possible after a fall. According to ANSI's Fall Protection Code, rescue is to occur within six minutes. With clear rescue procedures in place, this is achievable.
Write down your rescue plans and make them accessible to all employees. Train every individual involved in the rescue, and conduct mock-rescue simulations. It may seem like a lot of effort. But, when an emergency strikes, you'll be glad your crew was prepared to handle it calmly and efficiently.
Rescuing an incapacitated worker can be more complex. It may require mechanical equipment like an aerial lift or extension ladder (check out this post to find out when you need a fall harness in an aerial lift). In some cases, the rescuer must go to the incapacitated worker to pick them off the structure from which they're hanging. This is the least desirable type of rescue, but it must be planned for.
What should you do once the worker has been recovered? There is no consensus. Some medical professionals suggest positioning the worker in a sitting position with the upper body supported. This should take place for at least 30 minutes before the worker can lie horizontally. The seated position prevents blood from rushing to the heart too quickly. Blood reaching the heart at too high a pace may cause ischemic heart failure or other injuries.
Others recommend supine positioning with the torso facing up. This is especially useful if there are other injuries.
Either way, a healthcare professional should monitor the work for a reasonable period of time. This is to ensure there are no further or lasting ill effects from the experience.
Don't Leave Safety up to Chance
You should now understand the seriousness of suspension trauma. Given a condition this intense, employers must face the challenge of training their workers on how to use their PPE. Blindly trusting your PPE can put everyone at risk of injury, or worse.
Employers and workers must work together to construct and implement efficient rescue plans. The fall harness is a critical lifeline. But the end goal isn’t just to catch you when you fall – it’s to get you safely back on your feet.
Check out the rest of our content about Personal Protective Equipment here.
More from AD Safety Network
- When should you consider using custom molded earplugs?
- At what height do falls become deadly?
- Who should be responsible for rescuing fallen workers?
- What kind of training do loading dock workers need?
- How often should I inspect a loading dock?
- How is wind chill calculated?
- What is the difference between occupational safety and process safety?
- Why should rubber insulating gloves be tested?
- What happens if I tie off at the foot level with a personal SRL?
- Why is testing with a NAIL4PET accredited lab important?
- What kind of face protection do I need when using a chainsaw?
- What is the permissible exposure limit (PEL) for silica?
- What is silica and why is it hazardous?
- What is 'Table 1' and why is it so important?
- Video Q&A - What is a safety policy?
- What kind of fire extinguisher is best for your work site?
- How do I choose the right respirator and mask for working with silica?
- Can I wear fall protection equipment over my rainwear or winter gear?
- When do I need a cage ladder?
- What types of gloves protect your hands from hazardous chemicals?
- How come I still got hurt while wearing flame-resistant clothing?
- What dangers do workers face when working outside in the winter?
- How do I win over my most reluctant employees?
- What kinds of jobs should use disposable safety gloves?
- Is it true that safety shouldn't be a top priority?
- When are employers allowed to conduct drug and alcohol tests on their employees?
- How can I get employees more involved in the risk assessment plan?
- What are some of the indirect costs of workplace accidents?
- How often do fire extinguishers need to be inspected?
- What is the best way to store rubber safety gloves?
- How much voltage protection is needed for safety gloves used in electrical work?
- What is the difference between a safety valve and a release valve?
- When do workers have the right to refuse to work?
- What is the most overlooked item when designing Lockout/Tagout (LOTO) procedures?
- What are some of the misconceptions about heat stress and what should we do to address them?
- What tools should I tether when working at heights?
- What types of gas should I watch out for when working in a confined space?
- How do you create a culture of safety in your workplace?
- What is the difference between industrial safety and industrial hygiene?
- Is it important to get PPE assessments by trained professionals?
- What is a fault tree analysis?
- What kind of respirator cartridge should I use?
- What are the safety benefits of a whistleblower program?
- What type of safety record-keeping and recording should we be doing?
- What makes a hi-vis safety vest ANSI compliant?
- Why is it important to have air sampling done to determine my PELs?
- What is the life expectancy of fall protection equipment?
- What are some basic fall protection rules that each of my workers need to understand?
- How much clearance do I need to safely use a Leading Edge SRL?
- What is the difference between an acute hazard and a chronic hazard?
- What’s the difference between a bump test, a calibration check, and a full calibration?
- Is there any legislation regulating lone worker safety I should know about before hiring?
- What kind of fire extinguisher and accessories should be kept on hand on a factory floor?
- What can companies do to reduce their lost time injury frequency rates?
- Video Q&A - What's your safety network like?
- Video Q&A - What are the 3 levels of safety?
- Video Q&A - How do you treat a near miss?
- Does body weight affect falls differently?
- What ages are most affected by falls?
- Why do workers take risks?
- What Is the Difference Between OHSAS 18001 and 18002?
- What is the difference between lost time injury and medical treatment case?
- What is the difference between occupational health and safety and workplace health and safety?
- What is the difference between occupational health and occupational safety?
- What is the difference between a lost time injury and a disabling injury?