Fall arrest systems, including safety straps, harnesses, and cables can cause suspension trauma, or orthostatic intolerance, if a worker remains suspended while waiting to be rescued after a fall-related incident. Extended periods of immobility and suspension can lead to unconsciousness and the pooling of blood. In severe cases, the condition can lead to death.
Understanding Suspension Trauma
Formally referred to as orthostatic intolerance, suspension trauma occurs when an individual is immobilized and held in an upright position. As a person is suspended, blood flow is restricted throughout the body. Venous pooling within the veins can reduce the amount of blood reaching the heart and brain. This can cause the individual to lose consciousness, resulting in the inability to respond to the commands of first responders when they arrive on the scene. When an individual passes out, it leads to a condition that can only be reversed once the individual is returned to a horizontal position and blood flow to the heart, brain, and other organs is restored. In such situations, if the individual is not placed on a horizontal surface within 30 minutes the condition can lead to a wrongful death.
Recognizing Symptoms of Suspension Trauma
Suspension trauma can occur during a sudden fall, or to workers who are suspended as part of their job such as window washers, linemen, etc. Symptoms of suspension trauma can include loss of breath, dizziness, excessive sweating, significantly diminished heart rate, loss of vision, and paleness.
Factors that can impact the degree of risk include fatigue, injuries sustained during the fall, shock, existing cardiovascular or respiratory diseases, blood loss, and both cold and hot weather which can quickly cause hypothermia or heatstroke as blood flow and respiration decreases.
Training and Safety
OSHA requires employers to provide employees with adequate training in self-rescue as well as appropriate personal protective equipment that is designed to prevent suspension trauma injuries. This includes safety harnesses and training employees how to “pump” their legs to alleviate venous pooling, and methods of using alternative footholds including safety straps to serve as a temporary footing.
Employers are also required to take all reasonable steps to rescue an employee who has become suspended. This includes contacting first responders and attempting to rescue the individual. Following a rescue, employers are required to monitor the individual for signs of kidney failure, brain damage, heart damage, and other symptoms of distress.