As  first aid instructors, we discuss shock with our class as a core component of learning about the symptoms of a casualty. So, it came as a surprise to me that I had never learned about a specialized type of shock entitled Suspension Trauma. this form of shock , also known as Orthostatic Incompetence, develops rapidly when a worker is suspended in a full body harness after taking a fall from a roof.  Prevention of this Trauma is taught in Fall Protections Classes.

The industrial full body harness is designed to make the worker end up in an upright position once the lanyard is deployed. If the worker is suspended upright, the arrest force of an accelerating fall will hopefully travel up the spine in a vertical path, causing less damage to the workers body. Unfortunately, after the worker has become motionless, even if they are breathing, their legs end up dangling, creating a blood circulation issue.

The restricted blood circulation can change from discomfort into injury or death, due to the immobile legs and the restriction of the leg straps.  This leads to pressure on the leg veins, compressing them and slowing down return blood circulation to the heart.  At first, the worker will attempt to shake his legs to increase circulation and attempt to swing over to the side of the building and put his legs up against the wall.

Pushing forcefully with the legs away from a solid wall by positioning ones body in a slightly leg high position or horizontal position might help. Another method is to stand up on a support strap to put ones feet in, such as a suspension trauma strap or step up strap. Unfortunately, the harness design, attachment points used or injuries to the worker from the fall might prevent these actions from being successful.

If he is not successful, and he goes unconscious, he might have about 15 minutes to live. The kidneys, brain and other organs become starved for oxygen, that would normally be carried by blood flow. After about 5 minutes of blood deprivation to these organs, people normally go unconscious and as a result, stop shaking their legs to promote circulation.

This is why it is essential to develop a proper fall protection rescue plan for a worker suffering from suspension trauma. It is essential to carry it out carefully or the rescued worker might die anyway.  Often post rescue deaths are caused by the heart’s inability to tolerate the blood flow to the right side of the heart from the abrupt increase in blood flow once a harness is removed.

There are several methods used to treat the worker who has been lowered to the ground following a fall. Several schools of thought have been developed concerning treatment of the casualty until advanced life support arrives.