In this article, we’ll cover:
Arresting a fall is only the moment you stop the drop. What happens next is a race: the worker may be hurt, disoriented, or completely unable to help themselves, and prolonged suspension introduces serious physiological risk. OSHA’s standards reinforce that reality by requiring employers to provide for prompt rescue because time and access are what determine outcomes when someone is hanging in a harness. Because of this, we understand the importance of educating and preparing those who engage in fall arrest systems on the proper practices and policies of an efficient rescue plan.
Misconception #1: “The fall arrest system worked, so the worker is okay.”
Fall protection equipment prevents workers from impacting the lower level. It is a vital and important part of worker safety, but fall arrest systems that leave workers hanging vertically in a harness pose their own risks after the fall. The worker is still at risk of suffering from:
The latter of the risks, paired with prolonged time hanging in an upright position, can be the cause of a time-sensitive medical emergency we call suspension trauma that leads to further serious medical issues and even death. We will cover more on suspension trauma later in this article.
Misconception #2: “Provided with the right equipment, the worker can rescue themselves.”
After a fall, the suspended worker may be suffering from the events that preceded the fall as well as symptoms of the fall arrest. It is important to acknowledge what caused the worker to fall in the first place, as in most cases, it is preceded by another health issue such as pain, hypoglycemia, injury, fatigue, hypothermia, or fear.
Combined, these events may cause the worker to be:
Having self-rescue equipment available in the event that the worker is conscious and well can be a great start; however, the potential reality of the fallen worker being immobilized is the core of why the rest of the crew should be a foundation of a rescue plan.
Misconception #3: “Calling 911 is a rescue plan.”
Calling 911 is an important part of a rescue plan but should never be the entirety of it. In real jobsites, EMS response time varies, site access can be complicated, and responders may not be able to reach a suspended worker quickly without your team’s help. By the time they arrive, the fallen worker could have already suffered severely from hanging in the harness. A quick, self-sufficient rescue is the key, and emergency responders can assess the situation and health of the fallen worker when they arrive.
Definition
Suspension trauma, often discussed with orthostatic intolerance, occurs when a person is upright and still for too long, causing the pooling of blood in the lower extremities which in turn reduces the flow of oxygenated blood to vital organs including the heart, kidneys, and brain. Prolonged suspension causes unconsciousness and eventual cardiac arrest.
How it occurs in fall protection equipment
The harness is designed to distribute force away from vital organs in the event of a fall and to maintain the spine in a vertical position to best absorb the forces of a fall. It is effectively designed for fall arrest events, but ironically that same design becomes the cause of another life-threatening situation if the worker is not retrieved quickly.
After a fall arrest, the worker is typically left upright in the harness, and blood will begin to pool in the legs. If they are not actively moving their legs, the “muscle pump” that helps circulate blood in upright positions is reduced further enhancing the issue. The onset of suspension trauma can take place in as little as 5 minutes.
Ways to help (but not replace rescue)
There are measures that can help buy time while rescue is underway:
These are helpful tools that can delay the onset of suspension trauma symptoms, but relief straps also should not replace rescue. They support the rescue plan, but the goal is still to get the worker on the ground as soon as possible.
If suspension trauma risk teaches us anything, it’s this: The most effective rescue plan is the one you never have to perform. That is why passive protection and travel restraint solutions should always be the first conversation before anyone selects a harness or writes a rescue plan. In instances where those solutions aren’t possible, the real work begins in ensuring that your rescue plan thoroughly answers the following questions:
Who rescues? With what equipment? From where? Using what method? In what time frame? And what happens next?
With those questions in mind, let’s tackle the basic necessities of a plan.
1. Be self-sufficient: your company provides the equipment and capability
A strong plan assumes your crew is the first reliable line of response:
2. Calling 911
When working with EMS workers, it is important to know:
While EMS is on their way, your crew should be working on step 3.
3. The rescue: reduce risk while moving fast
Workers should be ready for:
4. Filling out an incident report
There should be designations for:
Done right, an incident report becomes a prevention tool that strengthens the next job.
5. Remove deployed equipment from service
This is both a safety must and a place where standards strongly reinforce best practice OSHA 1910.140(c)(17). Components of a fall arrest system such as a harness or lanyard are often designed to stop one fall and are no longer safe to use after that fall occurs and anchors subjected to the fall will need to be recertified before they are put back into use.
Don’t wait until the day a worker is hanging in a harness to find out your plan was only a concept. The most effective fall safety program starts upstream with passive or travel restraint solutions whenever the work allows but when fall arrest is unavoidable, your rescue plan has to be fast, practiced and truly executable.
If you haven’t walked the site with rescue in mind, staged the right equipment, assigned roles, and ran a drill, now is the time. Review your plan with your competent person, and if you want a second set of eyes, bring Diversified Fall Protection in to help you reduce exposure, identify additional hazards, and give you a foundation to build a rescue plan your crew can perform under pressure. Because when seconds matter, the plan that gets used is the plan that saves a life.