Suspension Trauma is the topic of this weeks Toolbox Talk. After a worker falls and is caught by his fall protection harness, the danger is not over.  The fallen worker’s blood circulation is restricted, causing a condition known as suspension trauma. In the fall protection industry, there is a continuing debate on the level of risk from suspension trauma. While there is limited scientific research directly focused on suspension trauma, there is sufficient knowledge of the body’s physiology to illustrate that this condition can be fatal.

What is Suspension Trauma?

Suspension trauma happens when a fallen worker is suspended in a harness with legs hanging. While arteries near the fronts of the legs continue pumping blood, the harness straps act like tourniquets on the veins in the backs of the legs and prevent used (deoxygenated) blood from returning to the heart. If circulation is impeded enough, the heart rate will abruptly slow and reduce oxygen to the brain.

Immediate steps to reduce the risk of suspension trauma.

The best way to slow the progression of suspension trauma is to stand. When a worker stans, the leg muscles must contract, which puts pressure on the veins. This pressure, along with a series of one-way valves within the veins, helps blood return to the heart and reduces the amount of blood pooling in the legs.

A fallen worker can stand in one of several ways:

  • Suspension trauma relief straps – A trauma relief strap can be used to create a loop that the worker steps into and presses against to stand up. Relief straps are typically packaged in two pouches that attach to each side of a harness. However, relief straps are not a common tool used with safety harnesses in South Africa.
  • Onsite work equipment – The onsite rescue team may be able to bring a ladder, an aerial lift, or other equipment for the suspended worker to stand on.
  • Structural member – The onsite rescue team may be able to pull the suspended worker over a structural member, a lower level, or ground.

Whether or not the suspended worker has lost consciousness, the rescue team must be careful in handling the victim. Post-recuse death is caused by the heart’s inability to tolerate the abrupt flow of carbon dioxide-saturated blood from the legs. Do not put a rescue worker in a horizontal position – conscious or not.

After the fall

  • move the legs in the harness and try to push against any footholds, such as relief straps.
  • Try to get your legs as high as possible and your head as close to horizontal as possible.
  •  If suspended upright, emergency measures must be taken to remove the worker from suspension or move the fallen worker into a horizontal posture or at least to a sitting position prior to the rescue.
  • Rescuers to be aware of the post-rescue death, which may happen if the victim is moved too rapidly to a horizontal position.
  • Rescuers must be aware of the first aid measures to prevent suspension trauma.

Download the full Toolbox Talk document on Suspension Trauma below: