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When an employee is suspended in a fall arrest harness, they are at risk of suspension trauma and need to be rescued right away. While the harness stopped the fall, it’s holding the worker in a vertical position with the legs dangling. Suspension trauma occurs as the blood pools in the legs, reducing blood circulation and depriving the brain of oxygen. This can result in serious injury to the worker. Death can occur in less than 30 minutes. Suspension trauma includes these symptoms:
Do your employees know what to do if they are suspended in a fall arrest harness? Do your employees know how to rescue a coworker that's suspended in a fall arrest harness? What your employees need to know about being suspended in a fall arrest harnessWhile coworkers immediately begin the emergency response, the trapped worker can actually help in their rescue by keeping their blood circulating. One way to do this is to deploy the foot straps. Once deployed, workers stand on the foot straps to keep the harness from cutting off blood flow to and from their legs. The improved circulation provides more time for rescue procedures. Other things workers should know when suspended in a fall arrest harness are:
Not all fall arrest harnesses come with foot straps, but foot straps can be purchased separately.
When a fall occurs, call 9-1-1 right away. One person makes the call while the other workers immediately begin rescue procedures according to your fall protection plan. Remember, the rescue must be quick to prevent the suspended worker from losing consciousness. Maintain regular communication and encourage the worker to continue moving the legs. Ask if they're experiencing any symptoms such as faintness, dizziness, nausea, paleness, or narrowing of vision. Depending on the height of the building, you can use stepladders as long as they extend from the ground to the roof of the building. If someone falls and is suspended in the harness, coworkers can move the ladder to a position where the worker can access it and make their way to safety. For taller buildings, an aerial lift can be used to retrieve a worker. You can also mount a flexible safety ladder to the top of the building and throw it to a suspended worker, who can then grab hold of it and climb to safety. After completing the rescue, follow these steps until emergency crews arrive:
What to cover at your safety meeting about suspension traumaTalk to your employees about suspension trauma, and address any concerns they might have about working from heights:
Reinforce that time is of the essence and how regular movement and use of the foot straps can provide more time for the rescue operation. You might also consider holding a safety demonstration at your worksite and practice your emergency response plan. When working at heights, employees are at a greater risk for serious or fatal injury. The additional steps you take to prepare for a fall can literally be the difference between life and death. Investing in a quality harness and the foot straps along with the time to conduct safety demonstrations, makes a statement to your employees that you are serious about their safety.
Often, employers believe their job is complete if they can keep their workers safe from an impact injury during a fall event. Unfortunately, according to the Occupational Safety and Health Administration (OSHA), timely rescue and post-fall suspension trauma are often ignored when employers are building a fall protection plan. To the employee waiting for rescue, suspension trauma is a real and very serious threat. Greater knowledge of what suspension trauma is and how it affects the body is needed to develop a plan to control the hazards it presents. What Is Suspension Trauma?Suspension trauma, also referred to as orthostatic intolerance, is a natural human reaction to being upright and immobile and can be caused by a situation when a person is forced to stay upright without standing. The use of a personal fall arrest system during a fall event can be the cause of this situation. During a fall event, several things occur that can lead to suspension trauma. Because the worker is suspended in an upright position with his/her legs hanging, blood begins to accumulate in the legs. This is commonly called venous pooling (the accumulation of too much blood in the veins) which reduces the flow of oxygenated blood to the heart and brain. Additionally, in a post-fall suspension event, the leg straps on a worker’s safety harness can exert pressure on veins in the legs, compressing them and further reducing blood flow back to the heart. When venous pooling happens to someone in a standing position, he or she loses consciousness, faints and falls to the ground, resulting in the head (brain), heart and legs on the same level and normalized blood flow. Unfortunately, during a fall event, the harness keeps the worker upright. The worker faints but cannot collapse and circulation isn’t restored. Under the most ideal circumstances, when a rescue plan is in place, suspension trauma should always be treated as an emergency situation because, according to the Emergency Medicine Journal, it can become fatal in less than 30 minutes. Suspension Trauma Warning SignsIt is important to know the warning signs associated with suspension trauma. They include faintness, breathlessness, sweating, paleness, hot flashes, increased heart rate, nausea, dizziness, unusually low heart rate, unusually low blood pressure and loss of vision. Taking Steps to Reduce the Potential for Suspension TraumaSuspended workers awaiting rescue can take some action to guard against injury. Preventative steps for suspended workers include:
One of the primary ways to slow the progression of suspension trauma is to stand up. When standing, the leg muscles must contract to provide support and maintain balance and these actions also put pressure on the veins. This pressure, along with a series of one-way valves in the veins, helps blood get to the heart and reduces the amount of blood pooling in the legs. How Does a Worker Stand While Hanging in a Harness?A worker can stand in a harness by employing suspension trauma relief straps. Suspension trauma relief straps typically come packaged in two pouches that attach to each side of a harness. During a fall event, the worker can deploy the trauma relief straps - creating a loop that the worker can put his feet into and press against to simulate standing up.
Picture this... 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 ForSuspension trauma is relatively rare, but fallen workers awaiting rescue should be closely monitored for suspension trauma symptoms. Common symptoms include:
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:
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:
Proactivity Prevents Further InjuryIn 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:
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.
Rescue Plans to the RescueRegulations 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 ChanceYou 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.
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