Suspension Trauma update

Advice for first aiders responding to harness suspension incidents


Following completion of an evidence based review of published medical literature, HSE has clarified guidance on the first aid management of a person falling into suspension in a harness who may develop 'suspension trauma'.

The key recommendations are:

No change should be made to the standard first aid guidance for the post recovery of a semi-conscious or unconscious person in a horizontal position, even if the subject of prior harness suspension.

No change should be made to the standard UK first aid guidance of ABC management, even if the subject of prior harness suspension. A casualty who is experiencing pre-syncopal symptoms or who is unconscious whilst suspended in a harness should be rescued as soon as is safely possible.

If the rescuer is unable to immediately release a conscious casualty from a suspended position, elevation of the legs by the casualty or rescuer where safely possible may prolong tolerance of suspension.

First responders to persons in harness suspension should be able to recognise the symptoms of pre-syncope. These include light headedness; nausea; sensations of flushing; tingling or numbness of the arms or legs; anxiety; visual disturbance; or a feeling they are about to faint. (Motionless head up suspension can lead to pre-syncope in most normal subjects within 1 hour and in a fifth within 10 minutes.)