Harness Suspension Stress: Narrowing the Focus

James Marc Beverly, Jenna White, Erin Beverly, Trisha VanDusseldorp, McCormick Jeremy McCormick, Micah Zuhl, Jason Williams, Christine Mermier

Abstract


Harness Suspension Stress (HSS) is defined as the physiological stress resulting from hanging motionless in a harness for a length of time. HSS may produce pain in the legs, numbness, syncope, and has been the subject of debate without much clinical data to support the physiologic explanation for these clinical features. HSS has been reported loosely in peer-reviewed literature. Further, one's predisposition of developing HSS, or subsequent medical ramifications requiring therapy has not been well evaluated. Our knowledge of HSS to this point has been derived mostly from expert opinion and case reports over the last 50 years. A rise in manufacturer development of fall protection equipment, including the use of harnesses, has resulted in increased regulative preventative measures, rescue techniques, and postulations for medical care. Other syndromes have been associated with the effects of HSS, but the constellation of symptoms reported for HSS are inconsistent with any other set of well- established existing medical syndromes, leaving a gap in understanding of the overall etiology and pathogenesis of HSS. This review aims to examine possible factors that may help qualify or quantify a series of measurable signs or symptoms that may establish HSS as its own syndrome, or if pre-dispositional factors may play a role that could be of clinical or practical use.


Keywords


Harness stress syndrome, hang syndrome, climbing, orthostatic intolerance, safety harness

Full Text:

PDF

References


Seddon, P. Harness suspension: review and evaluation of existing information. In: Health and Safety Executive-Contract Research Report. 451/2002.

(NAEMT), N.A.E.M.T., PHTLS Basic and Advanced Prehospital Trauma Life Support Fifth Edition: Section 1. 3rd ed. St. Louis, MO: Mosby; 2003.

United States Department of Labor. Suspension Trauma/Orthostatic Intolerance. [Internet] 2011 [cited 2015 April, 3]; Available from: https://http://www.osha.gov/dts/shib/shib032404.html.

Amphoux, M. Physiological constraints and design of individual fall protection equipment. Annals of the Technical Institute for Construction and Public Works, 1982a. Paper No. 401, French-English Translation. (Paper No. 401).

Retief, F, Cilliers, L. The history and pathology of crucifixion. S Afr Med J 2003. 93(12): 938-41.

Retief, F, and Cilliers. Christ’s crucifixion as a medico-historical event. Acta Theol, 2005 26(2): 294-309. http://dx.doi.org/10.4314/actat.v26i2.52582.

Bergeron, JW. The crucifixion of Jesus: review of hypothesized mechanisms of death and implications of shock and trauma-induced coagulopathy. J Forensic Leg Med, 2012. 19(3): p. 113-16. doi: 10.1016/j.jflm.2011.06.001

Baumann, R. Unpublished report.: Wright-Patterson Air Force Base, OH. 1968 May.

Nelson BA. Climbing harnesses: how long can you safely hang in your harness. Off Belay; 1979:10–12.

Pasquier, M, Yersin, B, Vallotton, L, Carron, PN. Clinical Update: Suspension trauma. Wilderness and Environmental Med. 2010; 22(2): 167-71. DOI: 10.1016/j.wem.2010.12.006.

Orzech M.A., Goodwin, D.M., Brinkley J.W, Salerno MD, Seaworth J., Test Program to Evaluate Human Response to Prolonged Motionless Suspension in Three Types of Fall Protection Harnesses., O. Wright-Patterson Air Force Base, Harry G Armstrong Aerospace Medical Research Laboratory. 1-36, 1987.

Lee C, Porter KM., Suspension trauma. Emerg Med J, 2007. 24(4): p. 237-8. doi: 10.1136/emj.2007.046391.

Roggla G, Moser B, Roggla M. Suspension trauma. Emerg Med J., 2008. 25(1): 59.

Turner NL, Wassell JT, Whisler R, Zweiner J. Suspension tolerance in a full-body safety harness, and a prototype harness accessory. J Occup Environ Hyg, 2008. 5(4): p. 227-31. doi: 10.1080/15459620801894386.

Raynovich, W. Dangerous suspension: understanding suspension syndrome & prehospital treatment for those at risk., in JEMS Magazine. [Internet] 2009. [cited 4 Feb 2017] http://www.jems.com/articles/print/volume-34/issue-8/patient-care/dangerous-suspension-understan.html.

Roco Rescue. Suspension trauma explained. [cited 2015, June 9]; Available from: http://www.rocorescue.com/roco-rescue-blog/suspension_trauma_dangers.

Gotcha suspension loop. Guardian fall protection, Kent, WA. [Internet] Leg up suspension trauma straps. [cited 4 Feb 2017]; Available from http://guardianfall.com/performance-safety-products/rescue-escape-and-descent/product/gotcha-suspension-loop.

Wolner JT, Betcher TP, inventors. Suspension trauma relief strap assembly for use with a full body harness. . 2009 April 3, 2015]; United States patent US 2 20150060196 A1 2014 Nov 6.

Jobe, MT. Compartment syndromes and Volkmann contracture. In: Canale ST, Beaty, JH editors. Campbell's Operative Orthopaedics, Philadelphia, PA: Mosby; 2012. Chap 74.

Stracciolini, A, Hammerberg, EM. Acute compartment syndrome of the extremities. [Internet] 2016 May 13 [cited 2016 June 15]. Available from: https://www.nlm.nih.gov/bsd/uniform_requirements.html.

Sung JH., Mastri AR, and Segal E. Pathology of Shy-Drager Syndrome. J Neuropathol Exp Neurol, 1979. July; 38(4): 353-68.

Sasaki H. Emi M, Iijima H, Ito N, Sato H, Yabe I, Kato T, Utsumi J, Matsubara K. Copy number loss of (src homology 2 domain containing)- transforming protein 2 (SHC2) gene: discordant loss in monozygotic twins and frequent loss in patients with multiple system atrophy. Mol Brain, 2011 Jun 10;4:24. doi: 10.1186/1756-6606-4-2.

Mortimer RB. Risks and management of prolonged suspension in an Alpine harness.

Wilderness Environ Med., 2011 Mar;22(1):77-86. doi: 10.1016/j.wem.2010.10.008. Epub 2010 Oct 30.

Hyatt KH, Jacobson LB, Schneider VS. Comparison of 70 degrees tilt, LBNP, and passive standing as measures of orthostatic tolerance. Aviat Space Environ Med, 1975 Jun;46(6):801-8.

Grubb BP. Neurocardiogenic syncope and related disorders of orthostatic intolerance. Circulation, 2005 Jun 7;111(22):2997-3006.

Grubb BP. Clinical practice. Neurocardiogenic syncope. New Engl J Med, 2005 Mar 10;352(10):1004-10.

Burton AC. On the physical equilibrium of small blood vessels. Am J Physiol 1951 Feb;164(2):319-29.

Morillo CA, Ellenbogen KA, Fernando Pava L. Pathophysiologic basis for vasodepressor syncope. Cardiol clin, 1997 May;15(2):233-49.

Bywaters EG, Beall D. Crush injuries with impairment of renal function. Br Med J, 1941 Mar 22;1(4185):427-32.

Adisesh A, Robinson.L, Codling A, Harris-Roberts J, Lee C, Porter K. Evidence-based review of the current guidance on first aid measures for suspension trauma. Health and Safety Executive, Research Report 708,: Birmingham, UK; 2009.

Weems, B. Will your safety harness kill you? [Internet] 2003 [cited 4 Feb, 2017]; Available from: http://www.elcosh.org/document/1662/d000568/Will%2BYour%2BSafety%2BH arness%2BKill%2BYou%3F.html?show_text=1.

American College of Surgeons. Advanced Trauma Life Support Student Course Manual. 9th ed. 2012, Chicago: ACS.

International Rope Access Trade Industry. WASA Report 2013. IRATA Work and Safety Analysis. [Internet] 2013. April 20, 2015.]; Available from: http://www.irata.org/pdf_word/WASA%20Report%202013.pdf.

Wood N. Suspension trauma: A lethal cascade of events. [Internet] 11 June 2012. [cited 4 Feb, 2017]; Available from http://www.fallsafety.com/wp-content/uploads/2013/03/NormanWoodsSuspensionTraumaALethalCascadeOfEvents.pdf.




DOI: https://doi.org/10.12922/jshp.v5i1.103

Refbacks

  • There are currently no refbacks.


 

 JSHP is hosted by the Mary and Jeff Bell Library, at Texas A&M University- Corpus Christi.