RTHOSTATIC INTOLERANCE
(i.e. Suspension Trauma, Harness Induced Pathology and Harness Hang Syndrome)
Orthostatic Intolerance: the development of symptoms such as light-headedness, palpitations, tremulousness, poor concentration, fatigue, nausea, dizziness, headache, sweating, weakness and occasional fainting during upright standing. When motionless in an upright position blood can accumulate in the veins due to gravity and failure of the venous pump, called “venous pooling,” and cause orthostatic intolerance. When a person is standing or in a vertical position and they lose consciousness, he or she will fall into a horizontal position. This position will self-correct this venous pooling, as the legs are now at the same level as the heart and brain with a rapid return to consciousness. This pathology becomes a serious concern when remaining suspended upright and unconscious. Because this cannot be corrected by falling to a horizontal position, the body continues to be hypo-perfused as brain injury and cardiac arrest become a real possibility, because the body is suffering from regional hypoxia.
Rescue personnel must be aware of this danger to a suspended victim (and themselves) and make every effort to get them to the ground (horizontal) as quickly as possible!
• If a patient must be raised or lowered in a vertical orientation, attempt to minimize
the time suspended in this orientation. Elevate their legs if warning signs develop.
• Having a conscious patient do leg contractions can assist with circulation in their
legs.
• Suspension trauma has resulted in the death of relatively uninjured casualties,
depending on the subject and their harness type, while suspended upright for as little as 10-30 minutes.