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John has been assigned
to make some minor repairs in an elevated work location. Because John’s
employer is conscientious about safety, he has been equipped and trained
to use a fall-arrest harness with a 6-foot shock-absorbing lanyard and
has been told about self-rescue techniques.
After fastening his
lanyard to a secure anchorage, John begins his tasks. Suddenly, a pigeon,
disturbed by John’s work activities, flies out of a small area and
startles John. He steps back suddenly and falls from the platform where
he was working. The shock absorber on his lanyard extends to reduce the
impact forces on his body, although it is still a hard fall, and John
is left dangling in an area where he can’t reach any of the structure
to be able to perform self-rescue. All he can do is yell for help and
wait while the harness binds painfully around his thighs.
The industrial facility
that employs John does not have a trained high angle or confined space
rescue team. The management of the facility had previously decided that
the cost of equipping, training and maintaining an in-house team was prohibitive
and unnecessary since they had a good safety record in the workplace.
The plant has a standing contract for a confined space rescue standby
team during turnarounds but they are not available for response in the
plant except during turnarounds.
Other workers hear
John’s cries for help and decide to call 911 for assistance from
the local fire department. The fire department has a big, shiny rescue
truck but they are only trained and equipped for vehicle crash extrication,
not high angle or confined space rescue..
The fire department
responds and arrives at the site within 10-minutes of the call to 911.
They quickly establish verbal contact with John to assess his condition.
John tells the firefighters that he is not hurt but he can’t get
back to safety without help. The firefighters determine that John is beyond
the reach of the ladders they carry on their truck, he cannot be reached
by crane or manlift and that a rope rescue will be necessary. They call
for mutual aid from a nearby fire department with high angle rescue capabilities
but it will be a 25-minute response before they arrive.
It has been 20-minutes
since John has fallen and been saved by his fall-arrest system. Suddenly,
John stops communicating with the firefighters and hangs limply in his harness.
The mutual aid rescue team is still 20-minutes away.
When the mutual aid
rescue team arrives, they quickly set up a raising system to be able to
release John’s lanyard from its anchor point and then lower him to
the ground. John has no vital signs and CPR is started during the trip
to the hospital. Unfortunately, the hospital personnel are unable to restore
John’s heartbeat and he is pronounced dead.
What Happened?
29 CFR 1910.66 Powered
Platforms for Building Maintenance, Section (e)1, Care and
Use says when vertical lifelines are used, each employee shall be provided
with a separate lifeline and the employer shall provide for the prompt
rescue of employees in the event of a fall or shall assure the self? rescue
capability of employees.
John’s employers
had equipped John with a fall-arrest system and trained him in self-rescue
as required by OSHA. He was uninjured by his fall but he died before he
could be rescued.
Motionless or unconscious
suspension in strap harnesses for even a very short time, sets up a blood
venous pooling effect which becomes dangerous if rescue methods do not
address this effect. Oxygen flow into the respiratory tract plus slight
elevation of the legs is vitally important for the rescue of fallen workers.
Speedy rescue techniques are vital.
Workers in pre-fall
training should be told to keep body parts moving frequently in a post-fall
wait for rescue; The term "Prompt rescue availability" means
"immediate prompt relief of suspension"; Rescuers need special
training for understanding suspended worker physiology
Harness Testing
At the request of
OSHA, the United States Air Force’s Aeronautical Equipment Laboratory
and the Aeromedical Laboratory at Wright-Patterson Air Force Base conducted
a research program aimed at demonstrating the relative effectiveness of
various types of fall protection harnesses.2
The objectives of
the test program were:
- To determine the
post-fall suspension capabilities of three types of harnesses; the body
belt, chest harness and full-body harness
- To assess the
physiological effects of prolonged motionless suspension. Motionless
suspension was selected as the most crucial test to simulate the state
of an individual who might be unconscious or injured prior to or as
a result of a fall.
The test subject
sample consisted of 13 volunteers who passed an extensive medical screening
before the tests. The subjects were gently raised off the floor while
wearing the test harness until their feet could not touch the floor for
support. No corrective movements or strap adjustments were permitted once
the subject was suspended. The subjects were suspended until their subjective
tolerance was reached or until symptoms of hypotension (low blood pressure)
or syncope (fainting) developed, which warranted a medical decision to
terminate the test.
The measurements
taken included an electrocardiogram, blood pressure, respiratory rate,
test duration and subjective comments. Each harness was fitted snugly
to the subject in accordance with the manufacturer’s instructions,
but not to the point where the range of extremity motion or torso movement
were restricted.
The two tables that follow are the results of the testing program.
| Table
1: Summary of Suspension-Duration Statistics Body Belt Chest Harness
Full-Body Harness |
| #
of Tests |
13
13 13 |
| Range
(Minutes) |
0.35
to 4.76 0.62 to 13.13 5.08 to 30.12 |
| Median
(Minutes) |
1.32
5.30 14.23 |
| Mean
(Minutes) |
1.63
6.08 14.38 |
| Standard
Deviation |
1.25
3.35 8.01 |
| Table
2: Comparison of Physician Versus Subject Decisions to Terminate the
Test |
| Type
of Decision |
Body
Belt Chest Harness Full-Body Harness |
| Medical |
3
9 11 |
| Voluntary |
10
4 2 |
One case of syncope
(loss of consciousness) occurred in a subject suspended in a full-body
harness. The syncope occurred while the subject was being lowered from
the suspension. The subject had requested termination of the suspension
because of symptoms of feeling flushed. The subject was unconscious for
approximately 30 seconds, and recovered quickly without any medically
adverse effects when placed in the supine position. The electrocardiogram
revealed a significant bradycardia in which the heart rate decreased to
approximately 30 beats per minute. The bradycardia persisted for approximately
20 seconds before returning to a normal sinus rhythm and rate.
In almost all instances
the heart rate and respiratory rate increased while the subject was suspended
in a harness. The magnitude of the increase in heart rate and respiratory
rate was variable among subjects and harness types. Cardiac dysrhythmias
that were observed included tachycardia and premature ventricular contractions
as well as bradycardia.
WARNING! A worker
who has suffered a fall and is suspended in his harness is a true medical
emergency. Just because they are hanging in a harness doesn’t mean
you “have all day” to perform the rescue. Rescue has to be planned,
practiced, and performed quickly and effectively or the victim may very
well die before the “rescue” finally occurs.
1 U.S. Department
of Labor, Occupational Safety and Health Administration (US DOL/OSHA)
200 Constitution Avenue NW. Washington, DC 20210.
2 Fall Arrest and
Post? Fall Suspension, (AFAMRL?TR?84?021), Air Force Aerospace Medical
Research Laboratory, Wright? Patterson AFB, Dayton, Ohio: 1984
This article was
published in the April 2000 edition of BIC Magazine and is posted here
by permission of the author.
Mike Dunn, President
Emergency Response Training, Inc. 1-888-639-4600
PO Box 305 www.ertrescue.com
Port Allen, LA 70767-1305
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