SUSPENSIONTRAUMARecognition,preventionandtreatmentforFirstResponders©2005www.SuspensionTrauma.info©2005www.suspensiontrauma.infoIntroduction•‘SuspensionTrauma’–Themedicaleffectsofimmobilisationinaverticalposition–Medicaltermis‘OrthostaticIncompetence’•Theeffectsarenothingnew–Crucifixionisdeathfromsuspensiontrauma•Itpresentsanimmediatethreatofdeathtoanyoneimmobilisedinaverticalposition–Hangingstillinanindustrial,theatricalorsportharness–Stretcherpatients,performers,stuntmen,confinedspaceworkers•Theonsetandprogressarerapidandunpredictable•Allthose‘workingatheight’mustbetrainedinhowtorecognise,manageandpreventsuspensiontrauma©2005www.suspensiontrauma.infoImmobileisimportant!•Suspensiontraumacanonlyaffectsomeonewhoisimmobile–specificallynotusingtheirlegmusclestoanygreatextent•Itdoesnotnormallyaffectpeoplewhowearaharnessbutwhoare:-–Activelymovingabout(climbing,caving,etc)–Suspendedforonlyaminuteortwo(parachutists)•Thedangeriswhensomeoneisunabletomove,orforgetstobother!©2005www.suspensiontrauma.infoWhomaybeatrisk?•The‘classicgroup’arepeoplewhowearharnesses–Sportclimbers,cavers,parachutists,parascenders,etc–Industrialclimbers–Confinedspaceworkersloweredusingaharnessandwinch–Theatricalandcircusperformers,stuntmenandartists•Thereareotherwaystobe‘immobilised’–Rescuestretchers,spineboardsandsplints–Personalpursuitsinvolvingbondageorconfinement–Becomingstuckinaconfinedspace©2005www.suspensiontrauma.infoSowhathappens?•Generalfeelingsofunease–Dizzy,sweatyandothersignsofshock–Increasedpulseandbreathingrates•Thenasuddendropinpulse&BP•Instantlossofconsciousness•Ifnotrescued,deathiscertain–Fromsuffocationduetoaclosedairway,orfromlackofbloodflowandoxygentothebrain.©2005www.suspensiontrauma.infoAlittlebiology…•Humansarenotdesignedtostandupright–Ourcirculatorysystemwasbuiltforlifeonallfours–Volumeofbloodvesselsismuchgreaterthanthatoftheblood•So,whenwestanduprightwehaveaproblem–Gravitypullsyourbloodintoyourlegs–Yourheartisapositive-pressurepump–itcannotsuck!–Theonlywaytogetthebloodbackoutofthelegsistopumpitusinganothermethod.Luckily,we’veevolvedone!©2005www.suspensiontrauma.infoMuscularpumps•Theveinsinyourlegsareentwinedwithintheskeletalmuscles,andwhenyoumoveyourlegs,thesemusclessqueezetheveins,pushingthebloodoutoftheway•Wehaveone-wayvalvesintheseveins,soeachsqueezecanpumpthebloodashortdistancetowardstheheart•Providingyouarewalkingaround,thisprocessmakesa‘heartineachleg’–andit’sveryeffective!–Tryit–takeyoursocksoffandstandstill–lookatyourfeetandyou’llseetheveinsallstandingoutandtheskinred.–Nowwalkaroundinalittlecircleandlookagain–theveinsareemptyandflat,andtheskingoespale.Pumpinginaction!©2005www.suspensiontrauma.infoButwhatifwe’renotpumping?•Ifthemusclesarenotpumpingthebloodupwards,itpoolsinyourlegs–Youcan‘lose’severalpintsandgointoshock•Yourbraintries‘shock’forawhile,butofcourseitdoesn’thelp–bloodisstillstuckinyourlegs.•Afterafewminutes,itgoesforthelast-ditchmethodIfIfaint,Ifallover.Igetthebloodback.•Itassumesyoumustfallover.Ifyoustayupright:-–Yourbrainhasnooxygensupply–Yourairwayisatrisk–Youwillprobablydiewithin10minutes©2005www.suspensiontrauma.infoHowlonghaveyougot?•Uninjuredvolunteersfeltdizzyinaslittleas3minutes–Typically5to20minutes•Lossofconsciousnessinaslittleas5minutes–Typically5to30minute...
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