EDITORIAL – Medical Implications of Suspension

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All users of personal fall protection systems and others involved with work at height should be aware of the following precautions that might need to be taken in the event of a casualty being in a suspended position.

1.  The longer the casualty is suspended, the greater the chances are of symptoms developing of a pre-existing medical condition, injuries sustained during the fall, or of Orthostatic Intolerance. The symptoms of Orthostatic Intolerance are often nausea or light-headedness.  These occur when a person’s body cannot compensate for the drop in blood pressure caused by the force of gravity because the person is in an upright position. The symptoms are relieved when the person is reclining.  An injured person hanging in a harness awaiting rescue should be removed from upright suspension as quickly as is reasonably possible.  This is particularly important for a casualty who is a motionless.

2.  To alleviate the symptoms of Orthostatic Intolerance, a conscious casualty should be encouraged to exercise their legs gently to stimulate circulation of blood and raise the blood pressure.

Note: manufacturers provide various types of equipment to reduce the effects of harness suspension for a fallen person. These items are only effective if the casualty is still able to employ them. They are not a substitute to rescue provision.

3.  Regarding position of the casualty:

  • during rescue, a position with the lower limbs slightly elevated may be preferable
  • if prolonged suspension has occurred, or if in doubt as to the condition of the person who has fallen, alert medical agencies immediately, following an incident, the casualty should be:
  • removed from the suspended position to the nearest point of safety
  • assessed by a qualified first aider who should carry out the standard ABC’s of first aid

Users of personal fall protection equipment should be aware of symptoms which can occur as a result of prolonged suspension.  Staff will require training in rescue techniques or alternatively it may be necessary to create a specially trained rescue team on site to be available at short notice.