Fall Rescue & Suspension Trauma
A harness that stops your fall is only half the job. A worker hanging in a harness needs to be rescued quickly. Hanging still can cause a dangerous condition called suspension trauma, and the worker may also be hurt from the fall. “Call 911 and wait” is not a rescue plan.
- Construction
- General Industry
Suspension trauma
When you hang still in a harness, the leg straps squeeze the veins in your legs and gravity pulls blood into them. Less blood returns to your heart and brain. This is called suspension trauma or orthostatic intolerance. It can lead to fainting and, if not relieved, can become life-threatening, sometimes in well under an hour. A worker who is unconscious or injured can’t move their legs, so they’re at the highest risk.
Warning signs: faintness, dizziness, nausea, sweating, pale skin, numb legs, shortness of breath, blurred vision.
If you’re the one hanging
- Stay calm and call for help, using your phone or radio if you can reach it.
- Deploy your trauma relief straps if your harness has them, and stand in the loops.
- Pump your legs and keep them moving. Push against any nearby structure with your feet.
- If you can safely reach a ladder, beam or platform to take your weight, do it, but don’t unclip.
Types of rescue
| Type | How it works | Example |
|---|---|---|
| Self-rescue | The fallen worker gets themselves to safety | Climbing back to a platform; a self-rescue device that lowers the worker |
| Assisted rescue | Coworkers reach the worker with equipment staged on site | An aerial lift or ladder; a pre-rigged rescue kit that lifts or lowers the worker from the anchor |
| Technical rescue | Trained rescue team with rope systems | Towers, bridges, confined spaces, high-rise facades |
The rescue plan
Employers must provide for prompt rescue of workers after a fall, or make sure workers can rescue themselves. “Prompt” means fast enough to prevent harm, so many safety programs aim to reach a fallen worker within a few minutes. Before work starts, the plan should answer:
- How will we reach the worker? (Ladder, aerial lift, rescue kit, self-rescue device)
- Who is trained and on site to do it, on every shift?
- What equipment is staged and ready, and has it been inspected?
- How do we call 911, what’s the site address, and can rescuers reach this location?
- Do we rely on the local fire department? Have they confirmed they can do high-angle rescue in time?
- When did we last practice it?
Practice the rescue. A plan nobody has tried usually fails the first time.
Danger: Don’t put yourself at risk during a rescue. Use your own fall protection, and never climb onto a damaged structure or into a lift that may be unstable.
After the rescue
- Call 911. Everyone who was suspended should be checked by medical personnel, even if they feel fine.
- Check breathing and consciousness. Give first aid for injuries and be ready for CPR. See First Aid Basics.
- Older training said to keep a rescued worker sitting up. Current medical guidance generally says to treat them like any other patient. Follow the 911 dispatcher and EMS.
- Tell EMS how long the worker was suspended.
- Remove all the fall arrest equipment involved from service.
- Report the incident and review what happened. See Reporting Incidents.
Standards & references
- 29 CFR 1926.502(d)(20): Prompt rescue
- 29 CFR 1910.140(c)(21): Prompt rescue (general industry)
- OSHA Safety and Health Information Bulletin: Suspension trauma / orthostatic intolerance
- ANSI/ASSP Z359.2: Managed fall protection programs (rescue procedures)
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