Suspension trauma (ST) is a risk for everyone using a fall arrest system - one which is often overlooked by users as well as the owners of the system. A few simple instructions can reduce the risk that users will suffer from suspension trauma after a fall arrest.

To illustrate this, it’s important to cover all the appropriate actions that a user should perform in case of a fall, by means of the following scenario.

Imagine two glaziers whose job is to replace the windows of the third floor of an office building from the outside. They need to work while standing on a small ledge without edge protection.

An overhead lifeline is installed to the overhanging roof structure in order to protect workers on the ledge.

The glaziers are trained in the use of a fall arrest system, and are supplied with all the required personal protective equipment (PPE): a safety harness, a fall arrest device with integrated energy absorption and some karabiners.

They perform a pre-use check on all PPE, in accordance with the instructions in the manuals of their equipment. They put on their helmets and don their harnesses, ensuring a snug fit. They check each other’s harnesses.

If you think the two glaziers are now ready to use the fall arrest system, you’re wrong.

Yes, they are using the system correctly. Yes, the system should arrest their fall before they hit the ground. But then what?

Sometimes, the emphasis that is put on preventing or arresting falls leads to the false impression that the danger is over when a fall is arrested. Nothing could be further from the truth.

What happens when a fall is arrested?

Say that at some point during the window replacement, one of the glazier trips or missteps and falls off the edge. The fall arrest system activates. The fall is arrested and the shock on the glazier’s body is limited thanks to his fall arrest device.

But then what? He’s now dangling in his harness several metres above the ground and is probably unable to stop himself from panicking. He was just exposed to a major shock and a collision may have knocked him unconscious.


Harness suspension trauma

Hanging in a harness is better than a falling three floors to the ground, but make no mistake: the glazier will be far from fine. His blood circulation will be disrupted because the leg straps of his harness will be squeezing the veins in his groins. This impedes blood flow back to his brains and the vital organs his torso. This underestimated danger is known as harness suspension trauma.

The symptoms of ST may become noticeable in a matter of minutes: the glazier may become lightheaded and/or nauseous, his limbs may start to feel tingly or numb, he may feel like he’s about to faint, he may experience visual disturbances. ST could lead to unconsciousness and even death if he’s not rescued in time, due to oxygen deprivation of the brain and other vital organs.

Harness relief straps

Harnesses can be equipped with a relief strap – an extra strap (or two), attached to the harness near the user’s hips. The user deploys this solution when suspended in his harness, and places his feet on the relief strap. This allows him to stretch his legs so that his blood circulation is not impeded.

When it comes to preventing ST, the importance of using a relief strap cannot be stressed enough. It is undoubtedly the simplest way to prevent permanent, long-term injuries when working with a fall arrest system. The use of a relief strap drastically improves the condition of a user suspended in a harness, and thereby increases the chance that a user is rescued before losing consciousness.

How proper instructions can save lives

Let’s see what would happen when the glazier is properly prepared for a potential fall:

  • The PPE did exactly what it should do, as the glazier has ensured by inspecting it before use. His helmet prevented him from being knocked out by an impact. So here he is, shocked, but alive and conscious.
  • The glazier is aware of the danger: ST. He knows exactly what to do. He deploys the relief straps to relieve the pressure on his groin. This keeps his blood circulating so that ST doesn’t set in.
  • In accordance with the instructions he’s been given, he hasn’t left the sight of his co-worker who has witnessed the fall and who knows exactly who to call for help. The emergency response officer on duty is made aware of the situation promptly. If there is no trained emergency response officer onsite, then the fire department should be notified by calling the local emergency number.

In this scenario, it is very likely that the glazier will be rescued before sustaining serious injuries from harness suspension trauma.

Rescue plan

If you’re responsible for the safety of people working with a fall arrest system, it’s your duty to ensure that workers use the system properly. Giving clear instructions on how to prevent harness suspension trauma is also part of this duty.

From there, you should have a rescue plan in place, which defines how workers hanging in a harness should be rescued.