The first thing fall-protection trainers ask when they go to a jobsite is, "What will you do if someone falls and is left suspended in their harness at height?" The immediate response is almost always, "Call 911." This answer is okay if the fire department has the equipment and the training, but not all firefighters have the ability to perform an at-height rescue.
According to a study published in the Journal of Occupational and Environmental Hygiene, the median time required for a fire crew to complete a confined-space rescue ranged from 48 to 123 minutes. When hazardous materials were present, the median range increased to 70 to 173 minutes.
The American National Standards Institute (ANSI) recommends a fall victim be rescued in less than six minutes. Even the quickest emergency response team might not be able to arrive that fast—much less safely complete the rescue.
Prompt Rescue is Critical
If a worker falls and his fall protection gear saves him, it is too early to breathe a sigh of relief. A worker may have fallen because of a medical condition or because he was struck by a dropped object.
He may also have collided with a structure during his fall. Without prompt rescue, the worker is at a greater risk of sustaining medical complications.
Suspension trauma, also known as harness-induced pathology, harness hang syndrome (HHS) or orthostatic intolerance, occurs after a fallen worker is suspended for too long in his harness and the harness straps restrict his blood flow, causing blood to pool in his legs.
This reduces the flow of oxygenated blood to his heart, brain and kidneys. Although every individual reacts differently, research indicates that suspension of a worker in a fall-arrest device may result in unconsciousness, followed by death. There are many factors that affect the onset of suspension trauma, including the following:
- The health of the individual and any pre-existing medical conditions—For example, if a worker has a pre-existing cardiac condition, he could be at greater risk of suspension trauma.
- The type and fit of the harness—An ergonomically designed and properly fitted harness may help alleviate pressure on the femoral veins and arteries.
- Immobility—If the worker is not able to move his legs, he is at greater risk for suspension trauma.
- Age—The elderly are most at risk due to less responsive arteries and veins and a less robust heart.
- Dehydration and exhaustion—Both of these conditions increase the chance and speed of suspension trauma occurring.
With that said, determining exactly who will be affected by suspension trauma is impossible to know. This means that every suspended worker should be rescued as if he is going to have complications—hence ANSI/OSHA's prompt rescue guidelines.
The Importance of Self-Rescue
If you are an at-height worker who has suffered a fall, you don't want to worry about how long it might take for others to get you down safely. If you work alone, you definitely don't want to be stuck wondering how long it will take before someone finds you and then alerts those responsible for your rescue. That's why self-rescue is an important part of any fall protection program. In fact, self-rescue is an easy but often overlooked means of rescue.
A wide variety of self-rescue equipment can easily be incorporated into a fall arrest system and used to complete the entire rescue. If a person working at height has properly selected and used his or her fall protection equipment, 90 percent of workers will be able to perform a self-rescue. Self-rescue should include the following steps:
- Climbing back up to the level from which he fell.
- Returning to the floor or ground to be evaluated for possible medical attention per OSHA.
- Removing all components of fall arrest system impacted by the fall event from service and documenting the components with name, date and activity at time of fall and giving the equipment to management.
Self-rescue devices attach to your safety harness and allow you to lower yourself to the ground or raise yourself to your starting position.
Because a self-rescue device is your number one resource to turn to in the event of a fall, make sure it gives you a smart, efficient escape that minimizes risk to you and your coworkers, as a rescue can be just as dangerous for the rescuer as it is for those needing rescue.
Your Rescue Plan
Companies that have not reviewed or revised their rescue plans recently should take action now. To help expedite the process, free rescue plan templates specifically designed to help you comply with OSHA and ANSI guidelines are available at http://ow.ly/Vy5UU.
All rescue plans should address what should happen immediately after a fall has occurred, and outline a strategy or procedure for safely retrieving a person who has fallen from an elevated work surface and is suspended in a full-body harness.
They should also be individualized to all locations where personnel are employed to work at height. In situations where a rescue can be planned and anticipated, the best approach is almost always the simplest. The four basics of rescue are:
- Keep it simple.
- Keep it safe.
- Do not use knots.
- Do not use knives.
When developing a rescue plan, the first things to consider are:
- If a fall occurs, where will the worker be located after the fall?
- Can a rescuer safely access the worker's anchor point?
- Are there safe anchors available for the rescuer and the rescue system?
- What resources are already available? Are there aerial lifts or cranes with personnel baskets on the site?
Next, address the hierarchy of the rescue plan, which should be mapped out in the following order:
- Self-rescue—The first and best approach to rescue is always self-rescue. If a worker is suspended and uninjured and can climb down or up by grabbing onto an existing structure, that is ideal.
- Assisted self-rescue—The second best approach is assisted self-rescue, which is an intermediary step that is used when a fall victim cannot reach a nearby structure. In this scenario, a worker deploys suspension trauma straps or steps on a ladder to help reduce suspension trauma while others work to retrieve him.
- Mechanically aided rescue—The next best approach is a mechanically aided rescue, which employs an aerial lift or a crane with a personnel basket or specialty rescue equipment to retrieve a suspended worker who has fallen.
- Pick-off rescue—The final approach to rescue, which should only be used by highly skilled rescue personnel, is a pick-off rescue. This is a technically challenging method that involves rappelling down to a fall victim, hooking up to him, then rappelling down together to help lower the victim to safety.
Safety is a culture that must be engrained in how employees work every day. Too often, companies only invest in proper fall protection equipment and training after a tragic event occurs.
Although most companies now recognize the hazards of working at height, the next step is for them to realize that rescue plans are part of the same equation—to be addressed before an incident, not after, so that workers are kept safe at all times.