Suspension Trauma (Suspension Syndrome): Symptoms, Risks and How to Prevent It

What Is Suspension Trauma (Suspension Syndrome)?

Full-body safety harnesses used for working at height are among the most important personal protective equipment (PPE) designed to help protect workers in the event of a fall. However, stopping a fall does not mean that the danger has completely disappeared. If a worker remains suspended and motionless in a safety harness for an extended period, a serious physiological condition known as Suspension Trauma, also referred to as Suspension Syndrome, may develop. Symptoms can begin within minutes in some individuals, making a rapid and effective rescue plan essential.

Suspension trauma is an important risk for workers operating at height, particularly in construction, energy, telecommunications, steel construction, wind turbines, solar power plants, and industrial maintenance.

How Does Suspension Trauma Occur?

A fall arrest system can protect a worker from hitting the ground during a fall. However, if the person remains suspended in an upright and motionless position in a safety harness, gravity can cause blood to pool in the lower extremities. This may reduce blood circulation to the brain and other vital organs, potentially leading to symptoms such as dizziness, faintness, and loss of consciousness.

The severity of the risk depends on several factors, including the individual's condition, the length of time they remain suspended, their physical condition after the fall, and how quickly the rescue operation is carried out. There is no fixed time period at which suspension trauma symptoms will occur; in some people, symptoms may develop within minutes.

Who Is at Risk of Suspension Trauma?

Workers who perform the following types of work may be exposed to an increased risk of suspension trauma:

Construction sites
Roofing work
Telecommunications towers and poles
Power transmission lines
Wind turbines
Solar power plants
Steel construction and installation
Industrial maintenance
Refineries
Ports and shipyards
Rope access work

Any worker who uses a fall arrest system and may remain suspended after a fall should be considered when developing a suitable rescue strategy.

What Are the Symptoms of Suspension Trauma?

Symptoms of suspension trauma can vary from person to person.

Common symptoms may include:

Dizziness
Feeling faint or light-headed
Cold sweating
Nausea
Pale skin
Blurred vision
A feeling of difficulty breathing
Confusion
Loss of consciousness

A person showing symptoms after being suspended in a safety harness should be rescued safely as quickly as possible using an appropriate emergency rescue procedure.

Why Is Suspension Trauma Dangerous?

Even when a fall arrest system successfully prevents a worker from hitting the ground, remaining suspended for an extended period can itself create a serious hazard.

For this reason, a proper working-at-height safety plan should address more than simply preventing or arresting a fall. It should also include:

Post-fall rescue procedures
Emergency response organization
Worker training
Rescue equipment and preparation

As part of good working-at-height safety practice, workers should avoid working alone whenever possible, and an appropriate rescue plan should be established before work begins.

How Can Suspension Trauma Be Prevented?

Although the risk cannot always be completely eliminated, the following measures can significantly reduce the potential consequences of suspension trauma:

Prepare a rescue plan before starting work.
Use a properly selected full-body safety harness.
Choose an appropriate fall arrest system for the task.
Ensure that workers are properly trained in fall protection and rescue procedures.
Avoid working alone at height.
Keep suitable rescue equipment readily available at the worksite.
Ensure that a suspended worker can be rescued safely and as quickly as reasonably possible.
Inspect fall protection equipment regularly and use it according to the manufacturer's instructions.

Effective fall protection is not limited to wearing a safety harness. It requires proper planning, equipment selection, training, supervision, and emergency preparedness.

Why Is a Rescue Plan Essential?

Many workplaces provide fall protection equipment but fail to adequately prepare for what happens after a fall.

A comprehensive working-at-height safety system should include four essential stages:

Risk assessment
Correct PPE and fall protection equipment selection
Training
Emergency response and rescue planning

A work-at-height operation without an appropriate rescue plan can still involve serious risks, even when suitable fall protection equipment is being used.

A rescue plan should be developed before work begins and should consider the work environment, access routes, available rescue equipment, trained personnel, communication procedures, and foreseeable emergency scenarios.

What Should Be Done After a Fall?

After a fall has been arrested, the situation should be treated as an emergency. The suspended worker should not be left unattended, and a planned rescue procedure should be initiated as soon as it is safe to do so.

Rescue operations must be performed by appropriately trained and competent personnel using suitable equipment and procedures. Emergency responders should also be informed about the circumstances of the incident and the worker's condition.

The exact rescue procedure should be determined through a site-specific risk assessment and emergency plan. Workers should not attempt improvised rescue methods that could expose them or the suspended person to additional hazards.

The Importance of Training in Fall Protection

Proper training is one of the most important elements of working-at-height safety.

Workers using full-body safety harnesses and fall arrest systems should understand:

How to correctly wear and adjust a safety harness
How fall arrest equipment works
The limitations of the equipment
How to recognize potential suspension trauma symptoms
What to do immediately after a fall
How to communicate during an emergency
The importance of the site-specific rescue plan

Regular practical training and rescue drills can help workers respond more effectively during an actual emergency.

Conclusion

Suspension Trauma, also known as Suspension Syndrome, is a serious risk that can occur when a person remains suspended and motionless in a safety harness after a fall. Although a fall arrest system can prevent a worker from hitting the ground, the emergency does not end when the fall is arrested.

Safe working at height requires more than simply stopping a fall. Proper fall protection equipment, worker training, risk assessment, regular inspections, rescue equipment, and a well-prepared emergency rescue plan are all essential components of an effective safety system.

By selecting the appropriate equipment, training workers properly, conducting regular rescue drills, and preparing a site-specific rescue plan in advance, organizations can improve worker safety and be better prepared to respond to emergencies involving falls from height and suspension.