Abstract

Fall harnesses have become much more prevalent for those that work at heights. Safety harnesses and fall arrest systems are commonly used by the construction industry, mountain climbers and other recreational activities where fall risks are a concern. Through the efforts of occupational health and safety legislation, job site safety programming and workplace harm reduction culture, there is a growing understanding of how and when to don these safety devices and the potential perils associated with their use. However, there is a paucity of information within the healthcare community in how to clinically manage a patient who has suffered a pattern of injury that can arise from these devices - known as suspension trauma. This condition may also be termed as harness-induced pathology, orthostatic shock while suspended and harness hang syndrome. This article helps to increase awareness and understanding of what suspension trauma is and how to pragmatically manage this condition from both a prehospital and emergency department perspective.

Highlights

  • Key Takeaways Early recognition/rescue—If suspension trauma is suspected it will be critically important to maintain these patients in the highest Fowler’s position for no less than 30 minutes or until the suspension trauma is proven otherwise

  • Monitor and anticipate suspension trauma complications—Placing the patient on a cardiac monitor and gaining IV access will be instrumental in both identifying potential cardiac dysrhythmia and providing an effective route for medication delivery

  • Safety harnesses and fall arrest systems are commonly used by the construction industry, mountain climbers and other recreational activities where fall risks are a concern

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Summary

Introduction

Key Takeaways Early recognition/rescue—If suspension trauma is suspected it will be critically important to maintain these patients in the highest Fowler’s position for no less than 30 minutes or until the suspension trauma is proven otherwise. Known as orthostatic incompetence, relates to the physiological effects of decreased cerebral perfusion due to blood pooling in the lower extremities (Raynovich et al, 2009).

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