Suspension trauma is a serious and potentially life-threatening condition. Understanding its causes and dangers is essential for anyone working at heights.

Suspension trauma, also known as ‘orthostatic shock while suspended’ or ‘harness hang syndrome’, is a serious condition that is particularly relevant to those working at heights, such as construction workers, climbers, and rescue personnel. Let’s talk about what suspension trauma is, how it is caused, the dangers it presents and how it can be prevented.

Suspension trauma occurs when a person is immobilised in an upright position while suspended in a harness. This immobility can lead to a rapid onset of physiological symptoms due to the pooling of blood in the legs, which restricts circulation and reduces blood flow returning to the heart. If not addressed promptly, suspension trauma can lead to serious consequences, including unconsciousness and even death.

Suspension trauma is primarily caused by prolonged immobility in a suspended position. Here are the key factors contributing to this condition:

Venous Pooling
When a person is suspended vertically, gravity causes blood to pool in the legs. Unlike standing or moving, where muscle activity helps pump blood back to the heart, being immobile in a harness allows blood to accumulate in the lower extremities.

Harness Pressure
The harness exerts pressure on the legs and groin, further restricting blood flow. This pressure can impede the circulation in the veins, exacerbating venous pooling and increasing the risk of orthostatic shock.

Lack of Movement
Movement is crucial for maintaining blood circulation. When suspended, the inability to move the legs means that the muscles cannot assist in pumping blood back to the heart, leading to a drop in blood pressure and reduced blood flow to vital organs.

Position of Suspension
The position in which a person is suspended also plays a role. A fully upright position is more likely to cause venous pooling and orthostatic shock than a more reclined position.

Suspension trauma is not just uncomfortable; it is potentially life-threatening. The dangers associated with this condition include:

Loss of Consciousness
The pooling of blood in the legs reduces the amount of blood returning to the heart and subsequently to the brain. This can cause dizziness, light-headedness and eventually loss of consciousness.

Reduced Oxygen Supply
As blood circulation slows, the delivery of oxygen to vital organs is compromised. This can lead to hypoxia (low oxygen levels) and organ failure.

Cardiac Arrest
In severe cases, the lack of blood flow and oxygen can cause cardiac arrest, a condition where the heart stops pumping blood effectively, leading to death if not immediately treated.

Compartment Syndrome
Prolonged suspension can lead to compartment syndrome, a condition where increased pressure within the muscles restricts blood flow, causing severe pain and muscle damage.

Prevention is the key to mitigating the risks associated with suspension trauma, and one of the most effective measures is the use of anti-trauma straps to maintain good blood circulation in the legs and prevent the pooling of blood. Here's how they work and why they are crucial:

Anti-trauma straps are integrated into or attached to a harness, usually at the waist or thigh regions as these positions allow easy access and deployment. In the event of suspension following a fall, the straps can be deployed to create a loop or step that the suspended person can stand on. By doing so, they can shift their weight and move their legs, helping to stimulate blood flow and reduce venous pooling.

Anti-trauma straps often come with adjustable lengths to accommodate different body sizes and harness configurations. Workers should adjust the straps to ensure they are neither too tight nor too loose, allowing for quick deployment when needed.

In the event of a fall, the worker will be suspended in their harness. The first step is to locate the anti-trauma straps, which are typically stored in pouches attached to the harness. Immediately after a fall, the worker should pull the straps out of the pouches and connect the ends to form a loop or step.

Once deployed, the worker steps into the loop created by the anti-trauma straps. This loop acts as a foot support, allowing the worker to transfer their weight from the harness to the strap. This standing position helps to reduce venous pooling in the legs and prevent the onset of suspension trauma.

The suspended worker also needs to maintain some movement in their legs. They can do this by shifting their weight from one leg to the other or moving their legs periodically to keep blood circulating. The anti-trauma straps enable these movements by providing stable support.

With the anti-trauma straps in place, the worker can safely wait for rescue. The straps extend the amount of time they can remain suspended without significant risk, giving rescue teams a better chance to perform a safe and efficient recovery.

1. Improved Circulation

By allowing the user to stand and move their legs, anti-trauma straps help maintain blood flow, reducing the risk of orthostatic shock.

2. Reduced Pressure

Standing on the straps alleviates pressure from the harness on the legs and groin, further aiding in better circulation.

3. Increased Comfort

Anti-trauma straps provide a more comfortable suspension experience, reducing the physical and psychological stress associated with being suspended.

4. Time Extension

These straps can significantly extend the time a person can be safely suspended, giving rescue teams a larger window to perform a safe recovery.

While anti-trauma straps are an effective preventive measure, their proper use and deployment require training. Workers should be trained on how to deploy and use the straps correctly and the importance of maintaining movement while suspended.

1. Correct Harness Fitting

First and foremost, the worker must ensure that their full-body harness is correctly fitted. The harness should be snug but comfortable, with all straps properly adjusted and secured.

2. Positioning the Straps

Once the harness is properly fitted, the anti-trauma straps should be positioned according to the manufacturer's instructions. Typically, they are stowed in a compact, easily accessible manner around the waist or thighs.

3. Visibility and Accessibility

Ensure that the straps are visible and accessible. In the event of a fall, the worker must be able to locate and deploy the straps quickly without any obstruction.

Regular inspection of harnesses and anti-trauma straps is essential, as maintaining the equipment in good working condition can prevent failures that could otherwise contribute to suspension trauma.

Having an emergency response plan in place is also critical. Workers should be trained to recognise the signs of suspension trauma and know how to respond effectively. Quick rescue operations are vital in preventing the severe consequences of prolonged suspension.

Our anti-trauma straps perfectly complement other fall arrest products in our PPE range, designed to keep you safe wherever you are and whatever you are doing on a construction site.

If you can’t find what you’re looking for or need more assistance, contact us on 020 8311 1144 or sales@cmt.co.uk.