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Risk Advisor – Suspension Trauma

By April 25, 2024April 30th, 2024Business Insurance, Construction

The risk of serious injury or death doesn’t end after a construction worker’s fall has been arrested. Although personal protective equipment (PPE) may prevent ground impacts, it may leave workers vulnerable to suspension trauma—also known as orthostatic intolerance or harness hang syndrome—which can lead to serious injury or death. It is crucial for those in the construction industry to be familiar with the signs and symptoms of suspension trauma as well as how to help prevent its negative outcomes.

How Suspension Trauma Occurs

Fall PPE typically includes a harness and lanyard attached to an anchor point. If this type of system arrests a fall, the worker is often left suspended in an upright position, with their legs dangling and partially immobile. This vertical orientation, combined with the lack of leg muscle contractions and pressure on the individual’s veins from their harness, can result in blood pooling in the lower extremities. With reduced circulation, the brain and vital organs may be deprived of oxygenated blood, which can lead to unconsciousness, organ damage or death in a matter of minutes.

Suspension Trauma Prevention

Given the severity of outcomes, reacting quickly and utilizing suspension trauma prevention strategies and equipment is essential, including:

• Trauma relief straps

These devices are attached to safety harnesses and can be deployed after a fall is arrested. When uncoiled, they make a loop that workers can press their legs against and simulate standing. This results in leg muscle contractions and pressure relief, which can improve blood circulation.

• Fall rescue plans

Comprehensive fall rescue plans are a job site necessity, and they should include detailed procedures for reacting swiftly after a fall. For example, plans should outline steps for a prompt rescue, including through selfrescue or assisted rescue. They should also address both
when the suspended worker can assist rescue workers and when the suspended worker cannot assist in their rescue (e.g., due to a lack of equipment or unconsciousness). Furthermore, plans should describe the types and amount of rescue equipment available, how and when to use it, and
their locations. Additionally, the plans should include contact information for key personnel, authorized rescuers, safety managers, nearby hospitals, first responders and OSHA.

• Training

Ensuring workers regularly participate in and understand training about suspension trauma is a vital safety measure. Training should cover various topics, including what suspension trauma is, how it occurs and how to recognize it. It should also discuss the risks associated
with suspension trauma, the importance of rescuing workers as quickly as possible and factors that increase workers’ risks of experiencing suspension trauma (e.g., environmental conditions and if a worker suffers an injury during the fall). Moreover, these sessions should cover how to identify fall hazards at a job site, proper use of fall PPE, fall rescue plans and how to reduce risks when suspended while wearing fall PPE (e.g., pumping legs to improve circulation and utilizing trauma relief straps). Additionally, training can provide rescuers with information on how to keep an unconscious worker’s airway open and treat and monitor the person after a rescue since the effects of the event may not be immediately detectable.


Suspension trauma presents a serious risk that threatens workers’ health and safety. Following OSHA regulations, reacting quickly and utilizing suspension trauma prevention equipment and techniques are crucial for a safe working environment. For additional risk management resources, contact us today.

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