2009 HSE Report on Suspension Trauma

A new report from the HSE giving authoritative guidance on Syspension Trauma

In 2002 the UK Health and Safety Executive (HSE) published a review entitled “Harness Suspension: Review and Evaluation of Existing Information”. It was noted in this report that the rescue plan was an essential part of fall protection arrangements. The report quoted and summarised advice extracted from various papers concerning harness suspension and noted that, “some of the advice appears
to conflict”. Nevertheless, although this document was not intended to be a review of
the medical advice for rescue from suspension it has been frequently cited in such a
context and in support of measures that differ from standard UK first aid practice.
Consequently, it was the recognition that authoritative guidance was needed for first
responders, in the workplace setting, to any cases of a fall into harness suspension,
which led to this project being undertaken.

Objectives

The Health and Safety Laboratory (HSL) was asked to review the advice and
guidance available on suspension trauma. This review was used to address the
questions of whether the current information and advice available for treating
suspension trauma casualties was adequate and in line with current practice and
recommendations, and whether there was a need for HSE to produce guidance.
The requirement for this work arose because first aid training organisations and first
aiders were not clear about the correct positioning of rescued casualties in the event
of a harness suspension situation.

Main Findings

There is little scientific published literature regarding the circumstances and
consequences of harness suspension, and none that tests the effect of sitting a
rescued casualty in the semi-recumbent posture that some authors have suggested.

Main Recommendations

- No change should be made to the standard United Kingdom (UK) first aid
guidance for the post rescue 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 harnesses suspension.

- A casualty who is experiencing pre-syncopal?? symptoms 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 rescuers 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. These include light-headedness;
nausea; sensations of flushing; tingling or numbness of the arms or legs;
anxiety; visual disturbance; or a feeling they are about to faint.