© Introduction ‘Suspension Trauma’ –The medical effects of immobilisation in a vertical position The effects are nothing new –Crucifixion is death from suspension trauma It presents an immediate threat of death to anyone immobilised in a vertical position –Hanging still in a harness –Stretcher patients, performers, stuntmen, confined space workers The onset and progress of ST are rapid and unpredictable All those ‘working at height’ must be trained in how to recognise, manage and prevent suspension traumaAll those ‘working at height’ must be trained in how to recognise, manage and prevent suspension trauma

© So what happens? General feelings of unease –Dizzy, sweaty and other signs of shock –Increased pulse and breathing rates Then a sudden drop in pulse & Blood Pressure Instant loss of consciousness If not rescued, death is certain –From suffocation due to a closed airway, or from lack of blood flow and oxygen to the brain.

© How long have you got? Uninjured volunteers felt dizzy in as little as 3 minutes –Typically 5 to 20 minutes Loss of consciousness in as little as 5 minutes –Typically 5 to 30 minutes It is difficult to put a timeline on deaths, however from research it is clear that death can result in as little as 10 minutes - typically between 15 and 40 minutes post-suspension. Anyone immobilised in an upright posture is in immediate danger of death

© OK, so we rescue them! Not so fast! There’s something important to deal with:- The blood that is trapped in the legs may not be in very good condition, and may even kill the person if we let it all pour back into their brain! This is called the ‘reflow syndrome’

© Reflow Syndrome Pooled blood in the legs is ‘stale’ after mins –Drained of oxygen, saturated with CO 2 –Loaded with toxic wastes (from the fat burning process) Re-elevating the legs returns this to the rest of the body in a massive flood –Heart can be stopped –Internal organs (especially the kidneys) can be damaged You have to stop this flood of stale blood – but still keep enough tricking to the brain to keep the person alive! Anyone released from immobile suspension should be kept in a sitting position for at least 30 minutes

© Preventing suspension trauma If you fall accidentally and are suspended: –AVOID using your legs. You don’t want blood sent there. –Lift your knees into a sitting position –Relax as much as possible. Panic makes things worse –If you can, every few minutes swing yourself upside down If you’re trapped and cannot move –Strain your leg muscles as hard as you can every 5 seconds –Breathe slowly and deeply –You’re most urgently needing rescue!

© Emergency action If at all possible, climb out of suspension –Using self-rescue equipment, improvised or otherwise Get into a sitting position straight after the fall –Pass the casualty a work seat or improvised platform All casualties must be ‘immediately rescued’ On-site First Aiders and communications are vital Never work alone! Who’s going to help you?