‘Suspension Trauma’ first aid advice

Advice for first-aiders responding to harness suspension incidents.

harness-injuryIn 2008 the Health and Safety Executive produced an evidence based review of published medical literature, which clarified guidance on the first aid management of a person falling into suspension in a harness who may develop ‘suspension trauma’.
The key recommendations are:

  • No change should be made to the standard first aid guidance for the post recovery of a semi-conscious or unconscious person in a horizontal position, even if the subject of prior harness suspension.
  • No change should be made to the standard UK first aid guidance of ABC management, even if the subject of prior harness suspension.
  • A casualty who is experiencing pre-syncopal symptoms (dizziness, lightheadedness, blurry or narrowed vision, (Tunnel Vision), nausea (feeling sick) and / or vomiting (being sick), headache, sweating, heart palpitations (faster, heavier, or irregular heartbeat felt by the person) or who is unconscious whilst suspended in a harness should be rescued as soon as is safely possible.
  • If the rescuer is unable to immediately release a conscious casualty from a suspended position, elevation of the legs by the casualty or rescuer where safely possible may prolong tolerance of suspension.
  • First responders to persons in harness suspension should be able to recognise the symptoms of pre-syncope (Motionless head up suspension can lead to pre-syncope in most normal subjects within 1 hour and in a fifth within 10 minutes).

A report and the full list of recommendations will be published shortly on HSE’s website. Notification of publication will appear on HSE’s Falls from Height news page.

“The term “suspension trauma” is one that has developed as a parlance amongst many who work in the fall protection industry and training sector.  It is used to describe the situation of a person falling into suspension in a harness and then becoming unconscious. In this scenario the loss of consciousness is not due to any physical injury, but rather, it is thought that orthostasis, motionless vertical suspension, is responsible. “Trauma” is therefore an inappropriate term which may be better replaced by the descriptive term “syncope” which is the sudden transient loss of consciousness with spontaneous recovery, as may occur with a simple faint.” – HSE 2008

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