Page 18 - OHS, June 2024

FALL PROTECTION
What is Suspension Trauma?
Suspension trauma is a life-threatening condition that occurs when the body re- sponds to being in an upright position for a prolonged time with sweating, dizziness, nausea, heart palpitations or loss of con- sciousness among other symptoms. While fall protection equipment aims to prevent the almost certain debilitating or fatal re- sults of falling from heights, the body still assumes some of the forces incurred from the fall. Shock-absorbing elements in lan- yards or SRLs shoulder most of the burden, but the remaining shock suffered is distrib- uted around the victim’s body and can cause a decrease in heart rate, blood pressure and cardiac output. This is a tricky hazard to mitigate because the effects of orthostatic intolerance will vary between workers, and it’s often difficult to determine the rate or in- tensity at which suspension trauma occurs.
The Effects of Suspension Trauma
The body’s upright position while being suspended in a fall arrest harness can block airways and restrict blood flow around the body, creating poor circulation. Typically, the leg straps constrict blood from natu- rally traveling between the upper and lower halves of the body. Blood can start collect- ing in the leg muscles and will become in- creasingly toxic. If this occurs for too long, that toxic blood can enter the body’s main bloodstream once the harness is removed. This can damage the organs to the point of fatality if enough progresses.
Restricted blood flow also greatly in-
creases the chances of developing a blood clot, which has been fatal for some fall vic- tims as the effects appeared sometime after the victim was rescued. Additionally, the heart is put under increased pressure during suspension trauma. Blood pressure can de- crease, and the victim could fall into shock at this point. If blood flow diminishes to a certain extent, it can affect brain activity and the victim can lose consciousness.
Prevent Suspension Trauma
If someone falls, 9-1-1 should be called im- mediately. However, this should not be ex- pected to be the main means of rescuing a fallen worker. OSHA requires that employ- ers prepare and implement fall protection rescue plans for workers who must don fall arrest equipment. The rescue plan should be put into effect as emergency personnel are responding. They must aim to rescue the worker as quickly as possible. It can take as little as a few minutes for the effects of orthostatic intolerance to begin and sus- pension trauma to set in. Depending on the general health of the individual, the victim could lose consciousness, go into cardiac arrest or die. Due to the panic and stress of the situation, fall victims often have dif- ficulty accurately communicating the state of their well-being to first responders. Best practices suggest that an organization’s res- cue plan includes someone dedicated to staying in constant communication with the victim. Emergency medical personnel will benefit from knowing more details about the fall victim and the fall incident
so that they can provide proper treatments and hopefully prevent further permanent damage from occurring.
Proper donning procedure and ensuring the proper fit of a body harness is one of the most effective methods of preventing sus- pension trauma. In order for the connecting device and harness to absorb the most shock possible from the fall, a harness must be properly adjusted to fit each user. Proper leg strap tightness is a significant contributing factor to the severity of suspension trauma. The common rule of thumb for proper ten- sion of leg straps is referred to as “flat hand, notfathand.”Iftheusercanfittheirclenched fist (or, fat hand) under the leg straps, they should tighten the straps until they can only fit their extended palm (or, flat hand) under- neath the leg straps. If the flat hand cannot fit under the straps, loosen until it can. Leg straps that are too tight can cause further injury during the fall. Leg straps should re- main stationary on the leg while the worker walks around while wearing the harness. Any that slip up and down during normal walking movements should be checked for proper tightness. If a user falls in a harness that is too loose, they could potentially be ejected from the harness during the fall. At the very least, their body will jostle while the fall is being arrested and greater fall forces felt by the user can be anticipated. The more fall forces passed onto the body and not ab- sorbed by the fall protection equipment, the greater the risk of injury. It’s also important to note that fall protection equipment must be removed from service after successfully arresting a fall and should not be used again.
Reduce the Effects of
Suspension Trauma
Rescue training is another effective method of preventing suspension trauma after a fall. Besides learning to recognize the signs and symptoms of orthostatic intolerance that can lead to suspension trauma, employees should be trained in self-mitigation meth- ods as well. All body harnesses compliant with the ANSI Z359 standard are equipped with a sub-pelvic strap that can assist with promoting body movement while a victim awaits rescue. The sub-pelvic strap sits di- rectly underneath the buttocks and, if the user is conscious after their fall, can slide down the legs to orient the body in a more “seated” position. This position helps pro- mote circulation and can help delay ortho- static intolerance. Users can also practice
16 Occupational Health & Safety | JUNE 2024
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