YourCaptor
Cute Girl Connoisseur
- Joined
- Jun 17, 2007
- Posts
- 4,550
Info on HHS, harness hang syndrome, aka orthostatic intolerance, aka suspension trauma
Original article found in the ICD-10-CM
Original article found in the ICD-10-CM
While in a sedentary position, blood can accumulate in the veins, which is commonly called "venous pooling," and cause orthostatic intolerance
In the veins, blood normally is moved back to the heart through one-way valves using the normal muscular action associated with limb movement. If the legs are immobile, then these "muscle pumps" do not operate effectively, and blood can accumulate. Since veins can expand, a large volume of blood may accumulate in the veins.
Venous pooling typically occurs in the legs due to the force of gravity and a lack of movement.
Orthostatic intolerance may be defined as "the development of symptoms such as light-headedness, palpitations, tremulousness, poor concentration, fatigue, nausea, dizziness, headache, sweating, weakness and occasionally fainting during upright standing"
An accumulation of blood in the legs reduces the amount of blood in circulation. The body reacts to this reduction by speeding up the heart rate and in an attempt to maintain sufficient blood flow to the brain. If the blood supply is significantly reduced, this reaction will not be effective. The body will abruptly slow the heart rate and blood pressure will diminish in the arteries. During severe venous pooling, the reduction in quantity and/or quality (oxygen content) of blood flowing to the brain causes fainting. This reduction also can have an effect on other vital organs, such as the kidneys [3]. The kidneys are very sensitive to blood oxygen, and renal failure can occur with excessive venous pooling. If these conditions continue, they potentially may be fatal.
venous pooling and orthostatic intolerance could result in serious or fatal injury, as the brain, kidneys, and other organs are deprived of oxygen
Moving the worker quickly into a horizontal position - a natural reaction - is likely to cause a large volume of deoxygenated blood to move to the heart, if the worker had been suspended for an extended period. The heart may be unable to cope with the abrupt increase in blood flow, causing cardiac arrest
Research indicates that suspension in a fall arrest device can result in unconsciousness, followed by death, in less than 30 minutes
Rescue procedures should include the following contingency based actions:
- If self-rescue is impossible, or if rescue cannot be performed promptly, the worker should be trained to "pump" his/her legs frequently to activate the muscles and reduce the risk of venous pooling. Footholds can be used to alleviate pressure, delay symptoms, and provide support for "muscle pumping."
- Continuous monitoring of the suspended worker for signs and symptoms of orthostatic intolerance and suspension trauma.
- Ensuring that a worker receives standard trauma resuscitation1 once rescued. Some authorities recommend that the patient be transported with the upper body raised.
- If the worker is unconscious, keeping the worker’s air passages open and obtain first aid.
- Monitoring the worker after rescue, and ensuring that the worker is evaluated by a health-care professional. The worker should be hospitalized when appropriate. Possible delayed effects, such as kidney failure, which is not unusual in these cases, are difficult to assess on the scene.