Advice for first-aiders responding to harness suspension incidents

September 2008

Following completion of an evidence based review of published medical literature, HSE has clarified guidance on the first aid management of a person falling into suspension in a harness who may develop 'suspension trauma'. 

The key recommendations are:

  • No change should be made to the standard first aid guidance for the post recovery of a semi-conscious or unconscious person in a horizontal position, even if the subject of prior harness suspension.
  • No change should be made to the standard UK first aid guidance of ABC management, even if the subject of prior harness suspension.
  • A casualty who is experiencing pre-syncopal symptoms or who is unconscious whilst suspended in a harness should be rescued as soon as is safely possible.
  • If the rescuer is unable to immediately release a conscious casualty from a suspended position, elevation of the legs by the casualty or rescuer where safely possible may prolong tolerance of suspension.
  • First responders to persons in harness suspension should be able to recognise the symptoms of pre-syncope. These include light headedness; nausea; sensations of flushing; tingling or numbness of the arms or legs; anxiety; visual disturbance; or a feeling they are about to faint. (Motionless head up suspension can lead to pre-syncope in most normal subjects within 1 hour and in a fifth within 10 minutes.)

A report and the full list of recommendations will be published shortly on HSE's website.

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Updated 2020-10-02