“ANSI Z359 as well as OSHA 1926.502(d)(20) require employers to provide the prompt rescue of employees in the event of a fall, or assure that employees are able to perform self-rescue.”

What is suspension trauma?

Suspension Trauma (also known as orthostatic intolerance) has been identified by OSHA as a workplace hazard for those using Personal Fall Arrest Systems (PFAS) who may be suspended from their harness for a period of time following a fall. More and more employers are becoming aware of this workplace hazard and are taking appropriate steps to protect their employees. 

The range of understanding on the cause of suspension trauma, as well as how to protect against it, is limited – and it has been revised over the years to include updated information as shown here. The development of suspension trauma varies from individual to individual and its onset can be difficult to predict. However, it is important to be aware of the Suspension Trauma  hazard and be prepared to take action as needed. Employers need to be aware that this syndrome is potentially life threatening.

Our revised Suspension Trauma Safety Poster is a tool to raise awareness of this potential hazard. It illustrates the pathological effects that a suspended worker may experience. We encourage you to share it with others who may work-at-height and/or use PFAS. Rescuers also need to be aware of this information and precautionary measures. Roco offers Rescue from Fall Protection training to educate rescuers who may respond to suspended workers.

Briefly, we will review the signs and symptoms of suspension trauma as well as factors that can influence the onset. We will also mention several options to prevent its occurrence as well as what precautions to take in treatment for suspension trauma. Suspended workers with head injuries or who are unconscious are particularly at risk (according to OSHA Bulletin 03-24-2004, updated 2011). As always, it is very important to follow your local treatment protocols.

What are signs and symptoms of suspension trauma?

Common signs and symptoms include light-headedness, heart palpitations, trembling, fatigue, nausea, dizziness, headache, sweating, weakness or fainting. Factors that influence the potential for suspension trauma as well as the speed of onset include the following:

• Unconsciousness, fainting or immobility;
• Underlying physical conditions including any pre-existing respiratory or cardiac conditions;
• Worker’s ability to handle stress and anxiety;
• Harness selection, fit, and adjustment;
• Traumatic injuries that may have occurred during or before the fall; and,
• Knowledge and the use of equipment or techniques to delay the onset of suspension trauma such as temporary leg stirrups or simply “bicycling the legs.”

What can be done to prevent suspension trauma?

• Follow manufacturer guidelines on harness use and proper fit.
• Preparation of a Fall Hazard Assessment, including a plan for self-rescue or assisted rescue as needed.
• Leg movement or bicycling of the legs while suspended.
• Use of a “step-up” device to relieve pressure. Example: MSA makes a device that attaches to the harness to help take pressure off the legs. (MSA Suspension Trauma Safety Step) 
• Timely availability of a properly trained rescue service, such as an in-house team or a contracted rescue team prepared for suspended worker rescue.

What are the latest treatment opinions?

The following information is from “Evidence-Based Versus Myth-Based Treatment of Suspension Syndrome” by Roger B. Mortimer, MD and Ken Zafren, MD, published May 30, 2020.

For many years, the theory has been that a worker with the potential of suspension trauma should be placed in a certain position for a certain amount of time following rescue. The theory was that if a worker remained standing or sitting, the toxic blood would be introduced back into central blood flow, at a lower rate, minimizing risk of cardiac arrest – similar to a tourniquet being released too quickly on an extremity, so the right side of the heart would not be overloaded.

However, this theory hasn’t proven entirely true. According to the referenced article, the worker should not be treated any differently than any other patient that presents with signs and symptoms of shock. Simply put, if the patient is displaying “shock-like” symptoms, assess and manage the patient’s airway, breathing, and circulation. Place the patient in the supine position (flat on back), and rapidly transport to the nearest hospital with adequate services.

Notice: It is always important to follow local treatment protocols.

In summary

Suspension trauma is a hazard to be considered (and prepared for) by employers with workers using PFAS. A worker suspended from their fall protection harness must be treated and rescued in a very timely manner – or be prepared for self-rescue when viable. The use of a Fall Hazard Survey is highly recommended – as well as the preparation of a Rescue from Fall Protection Rescue Preplan (samples referenced below). Rescue personnel must also be trained, prepared and equipped for Rescue from Fall Protection operations.

Additional Resources

• OSHA Fall Protection Plan Template
• Roco Fall Hazard Survey Template 
• Roco Rescue from Fall Protection (Suspended Worker) Preplan Template
• Roco Rescue from Fall Protection Training Course

Manufactured exclusively for Roco Rescue by CMC.

The new Roco Urban ATOM™ Rescue Harness is the perfect solution for the urban rescuer – designed for vertical and confined space rescue, or an occasional trip to the backcountry. Customized by Roco Rescue, this new full-body harness is based on the technologically advanced ATOM™ harness by CMC. It delivers on performance without compromising comfort and safety. 

• Roco Urban ATOM™ Rescue Harness
• Roco Urban ATOM™ ASCENT Rescue Harness (Complete with Chest Ascender)

Built for long days on rope, the Roco Urban ATOM™ Rescue Harness offers full adjustability along with a modern ergonomic design. Dual-density padding with stitched rolled edges provides unparalleled comfort. Aluminum D-rings reduce overall weight, while small Cobra buckles at the chest and legs make for easy donning and doffing. Rigid gear loops and tool tethers provide unrivaled versatility. The high center of gravity gives rescuers a balanced ride.

The Roco Urban ATOM™ ASCENT Rescue Harness increases the rescuer’s vertical capabilities with the addition of a Climbing Technology chest ascender and chest ascender kit.

Key Features:

• Manufactured in the USA to North American Standards.

• UL Certified to relevant ANSI, CSA and NFPA standards as a Class III Life Safety Harness.

• Improved architecture molds to the user for a lightweight, low-profile fit.

• Ergonomic design for maximum comfort and support.

• Y-back construction and bridged front lift.

• Constructed with polyester webbing.

• Multiple accessory attachment points provide ample space for stowing and organizing hardware and tools.

• Gear loop over-braid is based on a 32-carrier polyester, rope sheath design that delivers a familiar texture and functional robustness.

Place Your Order Today!

• Roco Urban ATOM™ Rescue Harness 
• Roco UrbanATOM™ ASCENT Rescue Harness (Complete with Chest Ascender)
  
  

I love flashlights and pocketknives. Always have. One of the high points of my youth was when my dad finally trusted me enough to carry a pocketknife. From that moment on, the left pocket of my 501’s had a two AA cell Mini Mag in it while the right pocket had an Old Timer three blade. My dad died when I was seventeen, and one of the treasures I have of his is his Old Timer three blade. His influence in pocket tools has carried on over the ensuing decades.

As I sit and write this, the left front pocket of my Truewerk T1 pants holds the spectacular Surefire Stiletto Pro. The right pocket is blessed to hold my retirement gift from my Technical Rescue Team at Nampa (ID) Fire Department. They pitched in and gifted me the incredible Chris Reeve’s Sebenza. The Stiletto and the Sebenza make a wonderful pair.

The Surefire Stiletto Pro has made more than one TSA Agent grin from ear to ear. With 1000 Lumens of rechargeable power, it goes everywhere with me. Its long sleek look regularly gets it pulled from the Xray belt, usually resulting in the grin.

It gets used multiple times every day and as the days get shorter and colder, its workload increases. The value of a good light cannot be understated.

At the Roco Training Center in Baton Rouge, LA, we host students from all over the world. From novice rescuers to some of the world’s best, they trust their lives to the best rescue equipment in the business – Petzl, CMC, SMC, PMI, Harkin, Paratech, Sterling and many more. When we need to risk our own well-being for the benefit of others, the one request we all have is “give us the best equipment and we will do the rest.”

While students are provided with a shiny cache of the best rescue gear available, personal gear is their responsibility. We see a variety of helmets, gloves and boots. Most are good…. some a little questionable. Where we continue to see big deficiencies is in lighting, both pocket and helmet-mounted.

Like so much in the rescue industry right now, lighting kit is better than ever. My original Mini Mag light was a whopping 5-8 lumens. My current helmet light, new Petzl Aria 2R is 600 lumens of white light, uses either the Petzl Core rechargeable pack or three AAA batteries, and offers night modes in red, green or blue light. I make sure it is on my helmet when I head to the airport, because its light weight and ease of use has it pulling double duty on those early morning and evening hikes in the hills with the dog. Good lights will always have a place in my personal rescue kit.

For many rescuers, a single helmet light will suffice. As a young firefighter, I learned quickly that lesser quality gear cannot be counted on in our business. Because of that I personally adopted that old military adage of “One is None and Two is One.” One on the helmet and one in the pocket has been my personal rescue lighting system for almost 30 years.

There are many quality helmet lights on the market, from some of the $30 lights you can pick up at your local hardware store to $500 light reactive headlamps that lower the light output when it turns to face you. The Petzl lights have served me well over the years. From the current Aria R2 to the Swift RL Pro I wore for years at work, to the workhorse Tikka series, they have a great line up. I have also had great luck with some of the sport climbing lamps. I run into more than one Black Diamond lights in drawers around the house. The Fenix line of lights has performed well for me, as have Nightcore lights, although I have more experience with both of their handhelds. The Surefire Stiletto I now carry replaced the Fenix PD series in my left pocket.

My long-time teaching light was the venerable Zebralight H31. I ended up with the Zebralight after a student took a liking to the Spyderco Endura pocketknife I was carrying at the time. A trade offer was made, and the H31 ended up riding on my helmet for many years. Powered by a single CR123 battery and putting out a very usable 200 lumens on high, it quickly became my go to Confined Space light. The 90-degree standup light could easily be pulled from its helmet strap and stood up to illuminate a wide area for patient packaging or rigging. It was an option I came to greatly appreciate. I really like the CR123 battery system. They last forever in storage, and I trust them more than most rechargeable systems.

So, what should we look for in a quality rescue lighting system?

• Brightness and Adjustability – Evaluating your needs will help determine what best suits you. Do you work on a back country team that hikes to the scene, or do you work mostly inside tanks or vaults? One situation may require big light (1000 lumens +) while for the other, 200 lumens might be suitable. Having adjustability allows the user to better choose a light that will work for both situations.
  
  
• Beam Type – Do I need a spot type beam, a flood beam, or an adjustable beam? For me, the spot beam fills my needs better than the flood. I use helmet mounted lights outside a lot, and the flood beams do not provide the distance I want. Your needs may be different.
  
  
• Battery Type and Life – Rechargeable or disposable? Ten years ago, this was an easy choice. Rechargeable lights were a short-term solution at best. It was a regular occurrence to find dead rechargeable batteries when you most needed them. That has changed. My Surefire Stiletto Pro’s rechargeable battery is long lasting. I plug it in before bed on occasion and am confident that it will perform at my use level (moderate to heavy) for three weeks to a month. It is incredible. That said, I treat my pocket lights different from my helmet lights. For a light that is not in my hand every day (i.e., my helmet light), I prefer a system that uses either disposable batteries that are readily available or rechargeable systems that can be backed up by disposables.
  
  
• Durability and Compliance – Most name manufacturers have strong records for durability. A quick Google search will get you pages of reviews. I often use forums such as com to research lights. An IPX rating may be desirable if working in wet or dusty conditions. If you are required to have an intrinsically safe light due to work hazards, you will need to choose one of the many lights that meets those standards.
   
• Weight, Comfort and Mounting Options – Cavers often use large, expensive lights that will run for days. They run with them for a reason. Does a member of an Urban Technical Rescue Team need a light that big? You get to decide. For me, I have decided that I want the smallest light that will provide adjustable brightness of at least 500 lumens with a medium or low setting that will last at least two hours. Are there mounting options available for my helmet? Is the light strap strong enough and secure enough or does my helmet manufacturer make a light mount? The military is dialed in on light mounting and some of the most reliable lights available are weapon-mounted lights such as Surefire, Streamlight and InForce that can easily be mounted on a rescue helmet mounted Picatinny Rail section.
  
  
• Modes and Features – Red lights are fantastic for close up work. Confined spaces can be challenging for bright lights and a red-light option can help to solve that problem. Ease of use is also a concern. Can I easily, using a gloved hand, turn on my light, move through the different modes and shut it off without distracting myself from the rescue task at hand? If you can’t, perhaps it isn’t the right light for you.
  
  
• Cost – Buy the best you can afford. I say that for the purpose of reliability and durability, not lumens. There are many great suitable lumen lights out there for less than $50. Find one that works for your budget.

A quality lighting system is as important to your personal rescue kit as the harness you wear and the descent control device you choose. Take the time to choose the lighting system that suits your needs for the type of rescue that you do.

Brad Warr is a Senior Chief Instructor for Roco Rescue. He joined Roco Rescue in 2003 and currently teaches a wide variety of technical rescue classes including rope rescue, confined space rescue, trench rescue, and structural collapse. He is also a member of Roco’s Contracted Safety & Rescue Teams (CSRT), providing standby rescue services for plants, refineries and other industrial facilities. Brad became a firefighter for the Nampa (ID) Fire Department in 1998 and was promoted to Captain in 2006. He retired earlier this year. His responsibilities included training the department’s Heavy & Technical Rescue Team. Before joining the fire department, Brad worked as an Emergency Response Technician for a large manufacturer in Boise, where he was responsible for OSHA compliance, emergency medical response, confined space/rope rescue response and hazardous materials response.

Product Links:

Knife Photo:

Chris Reeves Sebanza  (silver knife)- Sebenza 31 Plain Drop Point – Chris Reeve Knives 

Amtac Blades Northman X (black knife) - The NorthmanX • Amtac Blades

Surefire Stilleto Pro - Stiletto Pro - SureFire

Helmet Photo:

White Helmet - VERTEX® VENT - Helmets | Petzl USA

White Helmet light - ARIA® 2 RGB - Versatile-headlamps | Petzl USA

Red Helmet - KASK SuperPlasma HD Helmet ANSI Head Protection | CMC PRO

Red Helmet light - H600c Mk IV 18650 XHP50.2 4000K High CRI Headlamp-H600c Mk I (zebralight.com)

Lights Photo:

Back row left – Fenix PD35 - Fenix PD35 V3.0 Flashlight - 1700 Lumens - Fenix Lighting

Back row middle – Maglight 3D - Maglite 3-Cell D LED Flashlight

Back row left – Klarus XT - XT Series - KLARUS Lighting Technology Co.,Ltd

Middle Row left – Petzl Aria2R - ARIA® 2R - Headlamps | Petzl USA

Middle Row center – Petzl Pixa 3 - PIXA® 3 (HAZLOC) - ATEX---HAZLOC-headlamps | Petzl USA

Middle Row right -  Petzl Aria 2 - ARIA® 2 RGB - Versatile-headlamps | Petzl USA

Additional Resources:

• Service Life Guidelines for Rescue Gear

• Roco Rescue Open Enrollment Training

Check out our latest video from Challenge

Check out the video from our 2023 Roco Rescue Challenge which marked our 30th anniversary of the event. Teams from both industrial and municipal sectors participated in the two-day scenario-based event which focused on confined space and high angle rope rescue in industrial settings. Scores are given and trophies awarded, but Rescue Challenge is really a learning event, with skill-building and improving being the ultimate objectives.

If you missed this year’s Rescue Challenge, join us next year on October 16-17, 2024, at the Roco Training Center in Baton Rouge. Every year our instructors devise new “surprise obstacles” to challenge teams with hurdles never before tackled.

Rescue Challenge is an outstanding motivational event for rescue teams – from new rescuers to more seasoned veterans.

Is your team ready for the CHALLENGE 2024? 

(And, if not, our instructors can get them ready!)

A How-To Guide for Selecting a Rescue Service

In the first article in this series, we provided a high-level overview of NFPA 350 Guide for Safe Confined Space Entry and Work. We discussed the expanded roles on a confined space entry team with the inclusion of positions such as the Ventilation Specialist, Gas Tester, Standby Worker, etc. We also delved into the standard’s tiered response time and capability requirements for rescue, based on the hazards of the space.

In this article, we will focus on the rescue section of the standard. It provides broad coverage of the topic and if you have not read the standard, we highly recommend that you do so. It takes the “safe” part of its title very seriously, not only as it pertains to rescue, but across the board in everything related to confined space entry.

This article will focus on what the standard has to say about how an organization should select a rescue services provider if they are not going to perform rescue with in-house personnel. Roco Rescue thinks this of particular importance because there are many companies on the market that offer rescue services for confined space entry, and with any open market, there are vast differences in the quality of services they provide.

For safety managers who determined to ensure that they select a quality rescue provider, NFPA 350 provides an excellent framework for making that decision. If the safety manager rigorously applies the guidelines for auditing rescue programs contained in NFPA 350, they can rest assured that they are making an informed decision when selecting a Confined Space Rescue Service.

The need to evaluate rescue service providers is not new or limited to NFPA 350. OSHA 1910.146 requires employers to “evaluate a prospective rescuer's ability to respond to a rescue summons in a timely manner, considering the hazard(s) identified.” They shall “evaluate a prospective rescue service's ability, in terms of proficiency with rescue-related tasks and equipment, [and] to function appropriately while rescuing entrants from the particular permit space or types of permit spaces identified.” Further, employers shall “select a rescue team or service from those evaluated that has the capability to reach the victim(s) within a time frame that is appropriate for the permit space hazard(s) identified, [and] is equipped for and proficient in performing the needed rescue services.”

The mandate for due diligence is there, but the standard is a bit vague and subject to broad interpretation. NFPA 350 on the other hand, does a really good job of filling in the voids and eliminating gray areas.

The first thing NFPA 350 requires is that the rescue provider ”should meet all requirements of the technician level confined space rescue chapter in NFPA 1670” Standard on Operations and Training for Technical Search and Rescue Incidents. Technician level training from a reputable company is a significant investment in both time and money. This will effectively eliminate companies that want to simply have someone standing by at a tripod winch and consider them the “rescuer.”

The mandate for due diligence is there, but the standard is a bit vague and subject to broad interpretation. NFPA 350 on the other hand, does a really good job of filling in the voids and eliminating gray areas.

For those services that meet that first requirement, this is where the standard really gets interesting. The standard then calls for an audit of the prospective rescue provider by a designated person or team. Those conducting the audit should be “persons trained in or familiar with rescue operations and medical provisions at a level commensurate with the recommendations of this guide [NFPA 350] for rescue team members.” What the standard basically says is that the person or team conducting the audit should know what they are looking at from a rescue perspective.

The audit recommended by NFPA 350 is thorough. It should include, but is not limited to, an evaluation of the rescue service’s:

In addition to the audit of plans and records, NFPA 350 recommends that the prospective provider submit to a performance evaluation and declares that it is the “principal means of deciding who is qualified among a group of prospective rescue service providers.”

The performance evaluation suggested by NFPA 350 goes far beyond knot tying and equipment usage. The evaluation should involve simulated rescues with manikins removed from actual representative spaces. Further, the teams being evaluated should be the actual teams that will be on standby in all staffing combinations. The standard acknowledges that “this may require multiple evaluations to ensure that all team member compositions will provide the appropriate capability for confined space rescue.”

Once a rescue service is selected, the evaluation does not stop there. The standard calls for annual evaluations, or whenever there are changes to operations or regulatory requirements.

In addition to evaluating rescue capabilities, the performance evaluation should also take into account patient care. The prospective service should demonstrate their ability to address both life-threatening and non-life-threatening conditions and maintain effective treatment until the patient is turned over to definitive care providers.

Once a rescue service is selected, the evaluation does not stop there. The standard calls for annual evaluations, or whenever there are changes to operations or regulatory requirements.

Following NFPA 350’s guidelines is the surefire way to select a rescue services provider. Are these requirements rigorous? You bet. To borrow a saying, this method separates the wheat from the chaff. At the end of the day, it ensures that should an emergency occur, your confined space rescue provider will give the injured entrant the best chance possible for a positive outcome.

NFPA 350 serves as a comprehensive guide for safe practices related to confined space entry, work, and rescue. It provides procedures and best practices for safely entering and working in confined spaces. It also includes guidelines for confined space rescue operations, which are critical for the safety of entrants.It provides a dependable template for selecting a qualified rescue service. Everyone involved in confined space operations should consider NFPA 350 a “must-have” resource.

Additional Resources

• To order a copy of the NFPA 350, Guide for Safe Confined Space Entry and Work (2022)
• Roco Confined Space Types Chart
• Read Part 1 of What Does NFPA Have to Say about Confined Spaces?