Suspension trauma: Every minute counts

If a worker wearing fall protection falls and is left suspended in the air too long, he or she may develop suspension trauma. OSHA defines suspension trauma, also known as orthostatic intolerance, as “the development of symptoms such as light-headedness, palpitations, tremulousness, poor concentration ... and occasionally fainting” while suspended in a sedentary position.

Suspension trauma can lead to death when gravity and lack of movement cause blood to pool into the legs of a suspended worker. OSHA notes that if a worker’s legs are immobile due to vertical hanging, blood will not effectively pump back to the heart. As blood accumulates in the legs, veins can expand, reducing the amount of blood in circulation. The body reacts by speeding up the heart rate in an attempt to maintain blood flow to the brain.

If a worker is left suspended for too long, lack of blood flow to the brain may cause fainting, organ and renal failure, and potentially death. OSHA states that suspension in a fall-arrest device can result in unconsciousness, followed by death, in less than 30 minutes.

To help prevent suspension trauma, OSHA recommends:

• Rescue suspended workers as soon as possible.
• Know the signs and symptoms of orthostatic intolerance and that it is life-threatening. Suspended workers with head injuries or who are unconscious are particularly at risk.

Additionally, OSHA notes that rescue procedures should include the following contingency-based actions:

• If self-rescue is not possible, or if rescue cannot be performed right away, the suspended worker should be trained to pump his or her legs frequently to activate muscles to reduce the risk of venous blood pooling.
• The suspended worker should continuously be monitored for signs and symptoms of suspension trauma.
• Ensure the worker receives standard trauma resuscitation once rescued.
• If the rescued worker is unconscious, keep his or her air passages open and provide first aid.
• Monitor the worker and ensure he or she is evaluated by a health care professional.