Suspension trauma: After the fall

Imagine this scenario: A construction worker is replacing shingles on the roof of a two-story house 20 feet above ground. He loses his footing and slips, falling off the roof. He’s wearing a fall-arrest system, and as a result is saved from death.

But he’s not out of danger yet.

This worker could potentially experience orthostatic intolerance – also commonly referred to as suspension trauma.

What is it?

OSHA describes suspension trauma as “the development of symptoms such as light-headedness, poor concentration, palpitations, tremulousness, fatigue, nausea, dizziness, headache, sweating, weakness and occasionally fainting during upright standing.”

After a fall, a worker may remain suspended in his or her harness before being rescued. Depending on how long the worker remains suspended, the sustained immobility can lead to unconsciousness and even death. This is because of “venous pooling,” a condition that occurs when a person’s legs are immobile and blood pools in the legs, reducing the amount of blood circulating in the body.

OSHA notes that the body reacts to venous pooling by speeding up the heart rate in an attempt to maintain sufficient blood flow to the brain. If a person’s blood supply is significantly reduced, this won’t be effective and the body will then “abruptly slow the heart rate and blood pressure will diminish in the arteries.” In severe cases of venous pooling, a person may faint or experience kidney failure, which can be fatal.

Move fast

Speed is crucial after a worker experiences a fall. Suspension in a fall-arrest device can result in unconsciousness and death in less than 30 minutes. According to OSHA, workers who wear fall-arrest devices or who may perform rescue activities should know:

• How to determine whether their personal protective equipment is properly worn and fitted
• How suspension trauma may occur, as well as its signs and symptoms
• How to use appropriate rescue procedures and methods to diminish risk while suspended

For more information on suspension trauma, go to www.osha.gov/dts/shib/shib032404.pdf.