EN ⬇️
Suspension Trauma Syndrome (STS) is a life-threatening event which was defined as the development of presyncope symptoms and loss of consciousness if the human body is held motionless in a vertical position for some time. This syndrome can occur in people who practise activities using harness systems with a dorsal or chest point of attachment as used by height workers and builders of high-rise buildings, towers, bridges, viaducts, marine platforms, power plants.
Suspension time the onset of this syndrome is completely unpredictable, but a 2006 Occupational Safety and Health Administration (OSHA) guideline defined increased mortality to be suspended for more than thirty minutes. Age and gender one of the factors as older patients have poorer cardiac and arterial functions, but gender does not affect risk.
In addition to decrease in cardiac output, there is a release of adrenaline into the bloodstream as a result of the fear and anxiety experienced by the individual who is suspended. Initially, there is an increase in the frequency and intensity of cardiac contractions as a compensatory mechanism in an attempt to maintain cerebral blood flow, which then leads to the presence of pre-syncopal symptoms, such as nausea, dizziness, sweating, confusion, loss of vision, buzzing, and vertigo. This condition is known as distributive shock and includes a decrease in heart rate, blood pressure, and cardiac output.
Previous researches show that hanging from dorsal ring produces a decrease in blood flow creating functional hypovolemia by limiting the physiological movement of the rib cage and diaphragm. In 1985, 46 suspension tests were performed on various types of harnesses for up to 10 minutes. No one lost consciousness, but two individuals with harnesses with dorsal hooks had to stop the test by presenting undetectable blood pressure between five and nine minutes of suspension.
The first series of cases of death due to STS was studied by a research group. The cause of death in ten climbers with no physical injury who were suspended on their own harnesses from 90 minutes up to eight hours. Eight patients were rescued and extricated and survived from 30 minutes to 11 days after their rescue. Eventually, all eight patients died.
A group of French speleology doctors also performed autopsies on patients who died suspended by a harness. This group initially indicated that 10 of the 12 individuals died from hypothermia, but in contradiction to their theory, many of these subjects had lost consciousness very quickly. For this reason, they decided to conduct a study reproducing the same circumstances in a laboratory. The participants were asked to act as if they were unconscious hanging from a harness. The first two participants effectively lost consciousness at seven and thirty minutes, respectively, and the study was stopped. Later on, during a second attempt of the same study but only modifying certain parameters, a participant lost consciousness after six minutes. They concluded that hypothermia was not the cause of death in these patients. STS was the cause of quick deaths. Loss of consciousness may also block the airway, depending on the position of the head.
The most effective measure that can be taken for STS is to have a safe working method and rescue plan against a possible emergency situation. Suspended casualty should wear suitable type of full body harness with trauma straps that will ensure the continuation of blood circulation until the rescue team arrives.
As a rope access team, we do our best to improve our emergency and rescue plans with the rescue drills we carry out in our working fields.
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