Fall protection programmes tend to stop at the moment of arrest. The harness held, the absorber deployed, the worker is alive and hanging. Job done.
It is not. A person suspended motionless in a harness is in a medical emergency that gets worse the longer it lasts, and the plan for the next few minutes has to exist before anyone goes up.
What happens while a person hangs
Suspension trauma — also called orthostatic intolerance or harness hang syndrome — happens because of how the human circulatory system works when you stand still.
Blood return from the legs depends heavily on the leg muscles contracting as you move. A person hanging motionless in a harness cannot use those muscles, and the harness straps add pressure at the thighs. Blood pools in the legs. The volume returning to the heart falls, and with it the blood supply to the brain.
The result can be faintness, nausea, breathlessness, sweating and loss of consciousness. This can develop within minutes, and it can affect a completely uninjured person who did nothing worse than hang there. An unconscious worker slumped in a harness is in a far more serious position again, because they cannot move at all and their airway may be compromised.
Why “call 999” is not a plan
Emergency services are essential, but response time is measured in tens of minutes, and they may then need specialist height-rescue capability to reach the casualty at all. That timeline does not fit the physiology.
The regulations in most jurisdictions place the duty on the employer to plan for prompt rescue by their own arrangements. A plan that depends entirely on an external service arriving in time is usually not a plan at all.
What a workable plan contains
1. Who performs the rescue, and are they on site right now? Named, trained people — not “whoever is around”. If the trained person goes home at four, the plan expires at four.
2. Equipment that is present and reachable. A rescue kit locked in an office two buildings away is not available. Descent and rescue equipment must be at the work location, and the people using it must have practised with the specific kit.
3. A method matched to the situation. Reaching a casualty suspended mid-facade is a different problem from one hanging just below a leading edge. Options include a rescue or descent device to lower the casualty to a safe level, a lifting device to raise them enough to unload the harness, or a MEWP where access allows.
4. A target time, and evidence you can meet it. Set a target measured in minutes, then actually rehearse it. The first rehearsal almost always reveals that something takes far longer than assumed.
5. What happens after the casualty is down. Anyone who has been suspended should be assessed by medical professionals even if they appear completely fine. Report the incident, quarantine every piece of equipment involved, and do not return any of it to service — the harness has arrested a fall and is finished.
Reduce the hang time in the first place
Rescue is the last line. Two things reduce how long anyone hangs:
- Never let anyone work alone at height. If nobody sees the fall, the clock starts when someone eventually notices.
- Suspension trauma relief straps. Small loops stowed on the harness that a conscious worker deploys to stand in, letting the leg muscles work and relieving thigh pressure. They are inexpensive, add almost no weight, and buy time. They are not a substitute for rescue — they extend the window in which rescue can succeed.
The test
If a worker fell right now, on this site, at this hour — who goes, with what, and how long until the casualty is on the ground?
If the answer takes more than a few seconds to give, the plan needs work before the next shift starts.
This article describes general principles and is not medical or regulatory advice. Rescue planning must be carried out by competent persons against the regulations applying to your site, and rescue techniques must be trained and rehearsed with the specific equipment in use.
