When working at height, dangers are everywhere. Just a wrong step can mean dangling several meters above the ground in a harness. Luckily saved from the fall, but swift rescue is necessary to decrease the hazards that can occur to the human body.
We assume responsible employers have a fall protection- and rescue plan in place and your colleagues know the emergency procedures by heart. Waiting to be rescued, the harness begins to pinch a little, which brings us to the post fall arrest effects.
What happens after a fall
When suspended in a harness the blood flow of the human body is disrupted. The longer a person hangs in suspension the worse the effects can become. This is what is known as harness suspension trauma (HST), or orthostatic intolerance. It will happen to everyone hanging in a harness after their fall has been arrested, no matter how healthy you are, you are at risk. The exposure of harness suspension trauma can be limited with additional trauma relief straps attached to the harness. This still means rescue needs to be happening really soon.
Don’t leave me hanging
If you are not moving while hanging in suspension you can start to experience the first signs of shock after only 3 – 20 minutes. A few minutes after you will faint, followed quickly by the brain shutting. This is the situation where a fallen worker is still conscious, however it can also happen that a worker is knocked unconscious during the fall.
Our bodies contain veins and arteries that help transfer the blood throughout our body and to our vital organs. Our brain needs blood and oxygen to function. When suspended in a harness gravity pulls on the blood and the harness constricts the arteries and veins in the groin area. This causes the blood to pool in the legs. The brain senses it receives less and less blood and oxygen, and starts to give off warning signals. Your pulse and breathing quicken, you might feel light-headed, sick, sweaty, anxious or get a tingling/numb feeling.
Unfortunately this rescue plan from our brains won’t help when hanging in suspension. After all the blood is still being pumped to the legs and constriction still blocks blood circulation. As a last resort the brain will try to force you to fall over by fainting, because when you are lying down the blood will flow again. In a harness this won’t work, but the brain lets you faint anyway. This is when the situation gets really serious and can have deadly results. First, fainting in an upright position means you can block your airway, which can result in suffocation. Secondly, because you haven’t fallen over the brain cannot ‘restart’ your body.
Tips for providing first aid after a fall arrest
Next to providing a quick, but safe, rescue, the rescue plan should also address the way the rescued worker will be handled to treat (post-) rescue injuries. We put together some tips for first aid after a fall arrest.
- Assess the situation and ensure you are in not putting yourself at risk
- Talk to the worker in suspension, keep them calm and try to determine their condition. Continuously monitor them for signs of suspension trauma as long as they hang in their harness.
- Alert emergency services.
- Get the suspension trauma victim to the ground but ensure all rescue efforts are executed safely, and that rescuers are not at risk of falling themselves.
- Loosen or remove the harness
- Once rescued place the worker in a position of comfort, preferably a supine or W-position (The Australian Resuscitation Council and HSE UK state that there appears to be no evidence to support the claim that workers have to be kept in a seated position for about 30 minutes post rescue to ensure stale blood wouldn’t rush back to the vital organs.)
- If you suspect the worker has a back injury use a KED board for stabilization.
- Assess injuries, airway and cardiac status, or let medical services do this.
- Ensure that the rescued worker receives standard trauma resuscitation.
- Ensure that workers are evaluated by a health-care professional. Get unconscious or long exposed workers to the hospital.