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After the Fall Event — Preventing Suspension Trauma

Quick Tips #385

Often, safety managers believe that their job is complete if they can keep their workers from an impact injury during a fall event at work. Unfortunately, post-fall suspension trauma and timely rescue are often ignored when employers are building a fall protection plan. While waiting for rescue after a fall-related event, suspension trauma is a real threat.

What is Suspension Trauma?

Suspension trauma can be caused by any situation where a worker is forced to stay upright without the ability to use his legs or move. The use of a personal fall arrest system during a fall event can be the cause of this situation. Even under the most ideal circumstances, when a rescue plan is in place suspension trauma should always be treated as an emergency situation because it can become fatal in less than 30 minutes.

During a fall event, several things occur that can lead to suspension trauma. Because the worker issuspended in an upright posture with legs hanging, blood begins to pool in the legs. The safety harness straps can exert pressure on leg veins, compressing them and reducing blood flow back to the heart. If circulation is impeded enough, the heart rate will likely abruptly slow, reducing oxygen to the brain. Under normal circumstances, fainting and collapsing to the ground would occur, positioning the head, heart and legs at the same level, thus returning blood flow and oxygen to vital organs. Unfortunately, during a fall event, the harness keeps the worker upright. The worker faints but cannot collapse and circulation isn’t restored.

Taking Steps to Reduce the Potential for Suspension Trauma

One of the ways to slow the progression of suspension trauma is to stand up. Under normal circumstances, when a worker is standing, the leg muscles must contract to provide support and maintain balance, which puts pressure on the veins. This pressure, along with a series of one-way valves in the veins, helps blood get to the heart and reduces the amount of blood pooling in the legs.

Preparedness is Key

Too often, a worker is saved by his personal fall arrest system, only to succumb to suspension trauma while waiting for rescue. Everyone who works at heights should be fully trained in fall prevention and protection procedures. Those procedures should also include provisions for rescue in the event a fall does occur. Taking a few minutes to familiarize yourself with suspension trauma relief straps by adjusting them and practicing with them could mean the difference between life and death.

How Does a Worker Stand While Hanging in a Harness?

A worker can stand in a harness by employing suspension trauma relief straps. Suspension trauma relief straps typically come packaged in two pouches that attach to each side of a harness. During a fall event, the worker can deploy the trauma relief straps - creating a loop that the worker can put his feet into and press against to simulate standing up. This allows the legs muscles to contract and can relieve pressure from the leg straps to help improve circulation.

For more information on fall protection equipment and the associated standards, check out these Grainger Quick Tips:

#130 Fall Protection Equipment
#131 Construction Fall Protection, Subpart M
#347 ANSI Z359: A New Lift to Fall Protection Standards


Sources of Information

1. Bill Weems and Phil Bishop. Will Your Safety Harness Kill You?, Occupational Health & Safety. March, 2003.
2. Dr. Caroline Lee and Dr. Keith M Porter, Suspension Trauma, Emergency Medicine Journal, January 2007.
3. Paul Seddon, Harness Suspension: Review and Evaluation of Existing Information. Health and Safety
Executive. Research report 451 2002.
4. OSHA, Safety and Health Information Bulletin, 03-24-2004, updated 2011

Rev. 9/2013

Find even more information you can use to help make informed decisions about the regulatory issues you face in your workplace every day. View all Quick Tips Technical Resources at

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Please Note:
The content in this newsletter is intended for general information purposes only. This publication is not a substitute for review of the applicable government regulations and standards, and should not be construed as legal advice or opinion. Readers with specific compliance questions should refer to the cited regulation or consult with an attorney.

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