Orthostatic Shock Harness Suspension Trauma
Harness suspension trauma, also referred to as orthostatic shock, affects people suspended in a body harness for a prolonged period while working at heights, or while suspended in a harness device.
Occupations that require harnesses for safe work practice must be aware of the signs and symptoms of suspension trauma and correct them as quickly as possible.
Suspension trauma not treated immediately will quickly result in a loss of consciousness or, if prolonged, may result in death.
This is believed to occur from low blood pressure due to the pooling of blood in the legs combined with increased activity in the nervous system that slows the heart’s vagal tone.
The Australian and New Zealand Committee on Resuscitation (A.N.Z.C.O.R.) makes the following summary recommendations for First Aid Harness Suspension Trauma.
· Send for an ambulance
· Rescue the person and place them in a lying position as soon as it is safe to do so.
Sign And Symptoms of Suspension Trauma
The signs and symptoms of suspension trauma are the same as shock. Harness suspension trauma should be considered where a harness has suspended the person and they are exhibiting any of the following conditions:
• Feeling dizzy or like fainting with light-headedness
• Breathlessness with increasing difficulty in breathing
• Looking pale and ashen
• Nausea or feeling queasy with the desire to vomit
• Low blood pressure
• Loss of responsiveness in an unconscious state
Harness Suspension Trauma Management
• Call for an ambulance.
• If safe to do so, lower the person to the ground and free the person from the harness A.S.A.P.
• If they are not responding, manage as per D.R.S.A.B.C.D. protocol.
• Rest the responding person in a position of comfort, ideally lying down in the recovery position if no injuries prevent and provide reassurance and warmth to counter shock onset.
• Loosen clothing and completely remove the harness and any restrictive P.P.E.
• Look for and manage any associated injuries, particularly in someone who may have fallen or been electrocuted.
• Monitor level of conscious response and breathing at frequent intervals and immediately begin C.P.R. if they stop breathing and become unconscious and unresponsive without a pulse.
What Is Harness Suspension Syndrome
Harness suspension trauma occurs when a body is suspended motionless in an upright, vertical position, such as while awaiting rescue after an arrested fall in a harness from height.
Suspension Syndrome is when a suspended person is rendered unconscious due to orthostasis without traumatic injury.
Syncope is a sudden loss of consciousness due to a rapid drop in blood pressure.
As a result, harness suspension in a fall-arrest device or harness, unconsciousness and death can occur in less than 30 minutes, making immediate First Aid critical in saving their life.
Suspension trauma is a rapid sequence of events that begins with venous blood pooling in the legs and lower extremities due to a motionless, vertical orientation that significantly reduces the amount of blood returned to the heart.
The onset of trauma may begin with the person experiencing hot flashes, sweating, numbness in the legs, dizziness, nausea, low blood pressure, confusion and an irregular or slowing heart rate.
They may drop tools and become clumsy or fumble with tools prior to the onset of trauma, and this should be looked for in workers who work at heights as a precursor to impending harness trauma.
If not treated at this stage by returning them to the ground and removing the harness, it may quickly lead to a loss of consciousness as the body tries to achieve a horizontal position and return blood to the upper extremities.
A person confined in a harness will lose consciousness resulting in an inability to protect their airways or move their legs to promote active blood flow. The harness compression from the body’s dead weight has a tourniquet effect on the straps on the legs, further limiting blood flow to the upper body.
Death may occur after 10 minutes and before 30 minutes due to hypovolemic shock leading to cardiac arrest or brain damage from lack of blood to the brain during the suspension. Post-rescue complications and crush injuries may lead to renal system failure as the kidneys shut down.
When you cut the victim down and immediately alleviate the pressure, you put the kidneys at a massive risk of entering renal failure. If the pressure is released in one hit, the returning blood pressure to areas that have been deprived is significant, similar to going from a trickle to a tsunami instantly. When combined with the toxicity risks of deoxygenation, the two factors can be deadly.
Given a quick rescue can make all the difference in the outcome of suspension trauma, industry rescue kits specifically designed for rapidly rescuing a suspended casualty from a fall arrest system are available for purchase online from multiple sources. They are recommended as additional First Aid equipment for any job site or location with staff members working at heights under suspension.
First Aid For Life
First Aid skills, once learned, are a skill you retain for life. While technology advances and protocols change, the basics are the same globally. When applied correctly, it allows you to potentially save a life at worst and prevent a situation from escalating into a medical emergency at best.
FACE is an accredited R.T.O. specialising in providing First Aid courses Australia-wide.
Please drop by our FACE Home page to find a venue and course near you. Need a little motivation to gain your certification? Peruse our FACE Blog page for a range of topics, and take our First Aid Quiz to test your general First Aid knowledge.