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Harness trauma


dtgorton

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Just to start a new thread that I hope might generate some interest: when rescuing a suspended casualty and having safely brought them to the ground for treatment, at what point, if any, should the harness be removed?

 

I have heard a few theories on this:

1) get it off as soon as practicable in order to restore blood flow to the legs

2) leave it on as sudden release of "stagnant" fluids & secreted poisons in the legs could cause heart failure

3) walk away leaving it to the paramedics

 

Has anyone got a definitive answer?

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I have the medical study for this if anyone wants it - from my other interest as a climber/SPA instructor.

I subscribe to the crash helmet theory; leave it on just in case it's holding something else together. However, I will check this in my training manuals and with my local mountain rescue when I next bump into them.

 

http://www.remotemedics.co.uk/downloads/SuspensionTrauma.pdf

 

Offers specific guidance on treatment. I cannot vouch for either the website or the treatment but it seems reasonable to me.

 

Any use?

 

Ken

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While we use harnesses where appropriate I've yet to dangle about in one, so you'll understand my ignorance. So, then: To what extent will the action of lowering the casualty answer the question for you? I mean, once s/he touches ground, their weight will no longer be supported by the harness and the straps that previously constrained them should "relax," allowing blood flow to improve... Won't it? Which is not an argument for leaving them dangling a foot off the ground until the paramedics arrive!

 

Having just completed the refresher for the St John's FAW certificate, the latest idea re a trapped/crushed casualty is that you don't remove the trapping object if they've been like that for 15 minutes (was 10 mins last time I did the refresher) or, of course, if you don't know how long they've been trapped.

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Depends on the victim's state!

If the victim is consious then bring down to sitting position, monitor breathing and pulse til medics arrive.

If UNconsious check pulse and breathing and if required lower to a more horizontal position to start basic life saving CPM etc. Keeping the feet down is best though doing CPM on an upright patient is impossible.

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Major point of note-- Call an ambulance as soon as the fall occurs six minutes is enough for the onset of suspension trauma Describe it as a Crushing Trapping accident as the term suspension trauma hasn't yet permeated the ambulance service. All suspension trauma victims are injured and NEED A&E Supervision for some hours as there are possible delayed complications which require dialysis.

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Apologies for not realising this topic had already been covered in some depth previously! Many thanks for the helpful posts, particularly liked Ken's PDF which will end up gracing the crew room noticeboard (provided you're not charging royalties/copyright fees??).

 

For anyone who wants to look at the doc on the HSE site, here's the link. It is 116 pages long but an interesting, if sobering, read.

 

Thanks again.

 

Dave G

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