Beware "Orthostatic Incompetence"
Volume 23, No.2
Recently I read an article on a phenomenon known to some as "orthostatic incompetence." Although fall protection researchers have recognized this situation for decades, I hadn't experienced this, nor even heard of it before. As I read through the article, I realized that "orthostatic incompetence" is a common problem. For instance, if one has ever served in the military and had to stand at attention for hours on hours, or has been a member of a high school or church choir, you have probably witnessed someone "passing out" or fainting, then falling to the floor. This is orthostatic incompetence. Military trainers and choir teachers have learned over the years to inform their students to always stand with their knees slightly bent and not to lock their knees. This action causes leg muscles to work at maintaining an upright posture. Another name for this phenomenon is called suspension trauma.
Orthostatic incompetence happens when the legs are immobile with the person in an upright position. Gravity drains the blood into the lower legs, which can store a large amount of blood. Eventually, enough blood pools in the legs so that it reduces the return blood flow to the right chamber of the heart. This reduced flow usually causes the oxygenated blood flow to the brain to slow down, and eventually the person faints. The victim falls to the floor, lying horizontally. This equals the blood flow out to the heart, brain and lungs, and the victim wakes up, unaware of what has taken place.
Because of the changes OSHA has mandated in the way we do things at our work sites, suspension trauma has become more prevalent, simply because we use the body harness when ever we get six feet off the ground or enter a confined space. Electrical and telephone pole climbers, rock climbers, cavers, deer hunters in elevated stands and window washers all use these body harnesses to protect themselves from falls. In suspension trauma, the initial steps to orthostatic incompetence take place; however when the person in the harness faints, they remain in an upright position with the harness still compressing the veins in the legs, which continues reducing the blood flow to the heart, lung and brain. Death has been known to take place within 15 minutes.
There are several steps that can prevent suspension trauma from occurring. Obviously, being aware of your surroundings and taking time to be safe is the first step. If and when the unexpected happens though, a simple second step is to move your legs. Lifting your legs up and down, pushing off solid structures or? bending your legs at the knees will help alleviate the problem of suspension trauma. If the person in the harness is unconscious, rescue must be very quick. However, it is important not to just get the victim on the ground and out of the harness, for this can cause an abrupt increase in blood flow to the right chamber of the heart and cause problems. The recommended procedure takes up to 30-40 minutes, moving the patient from a kneeling position to sitting, then to a supine position, which allows the blood flow to even out. For all you older EMT's still in actron out there, it's similar to the removal procedure of the MAST Trousers used in trauma situations.
Suspension trauma is a REAL, and dan-gerous situation that is somewhat unknown to most. Being aware of this phenomenon and making others aware could save lives.?????????????????????????????????????????????????????????????????? ????
Reference: "Will Your Safety Harness Kill You?"? by Bill Weems and Phil Bishop