UKH

Forgive me for the harrowing topic, but is anyone aware of any British climbers/access workers dying as a result of suspension syndrome?

I'm afraid I can't answer your question, but thanks for bringing this up as I've never heard of it before.

I don't know the figures but we covered this on my last outdoor first aid course for the first time. Sobering. Quite likely to be a problem for hung up cavers doing SRT.

I haven't heard much about it recently.  (Er..  and no is the answer to your question in my case anyway.)

There was a flurry of 'awareness raising' around the issue that started getting on for 20 years ago now, and probably ended up slightly exaggerating the dangers of what is, to be fair, quite a serious issue that had previously been largely ignored.  In the end it developed some of the characteristics of a 'moral panic', with some first-aid trainers and the like getting a tad carried away for a while there.

The HSE did a meta-study and published a report that's worth a read.  It put some of the more sensational stuff that was online at the time into perspective.  Here's a link in case you've not seen it: https://www.hse.gov.uk/research/rrpdf/rr708.pdf

Thanks! That's very helpful!

As a paramedic in an area where a lot of climbing takes place I asked about this and very few staff had any idea. I chased it up with the HCPC not much help also spoke with the HSE and got told to look at the paper mentioned in a previous post dated 2009.I have read various versions of treatment all conflicting each other. When I worked in the States we were taught a lot more about it. Seems not very high on the list in UK.

There's heaps of studies about it and a search on ncbi or google scholar will throw plenty more stuff to look at.

This has a good brief sum up and links to several of them https://www.wemjournal.org/article/S1080-6032(20)30070-3/fulltext

Yes, a lot of anxiety was generated (and conflatio with crush injuries) and actions were recomended or planned which probably increased the risk to the suspendee. Certainly in a caving context getting someone out of a hostile environment is important, and overstated risks of mobilisation can interfere with good judgement. (Wet casualty in draughty site with continued exposure to running water (which might contain cobbles) in a confined space, with pple talking about leaving person (who will certainly become a casualaty by the end of this) horizontal for varying amounts of time.....

I recall a CRO member talking about a caver passing due to being suspended on the rope. The CRO hold all their call out rescue info so you may find something by looking through their history.

The only CRO fatality I know of (as opposed to general caver fatality) was a rescuer suspended on the rope at Rowten Pot during a rescue. I think the actual cause of death was drowning (or hypothermia or a combination?) while stuck under the waterfall. I never heard of any suspension issues in my time caving. I think there are other things to worry about when caving or climbing.

I'd not heard about this until a recent St John's first aid course. There was some discussion about it, where the instructor said it wasn't an issue with climbing harnesses as they are designed for sitting in, but that it is an issue for rope access harnesses. It wasn't explained terribly well though.

One thing that you could get due to the reduced blood flow is DVT (aka "economy class syndrome"), which if it then "escapes" and becomes a pulmonary embolism can kill you.  From first hand experience I can confirm that it's rather nasty, though it wasn't hanging in a harness that caused it for me.

Thanks for that one it backs up my thoughts and what I was trained in previously. There is limited to nil training for this I know in prehospital {ambulance} settings in our area. Intrested if other ambulance services have taken up on it. Not even mentioned in clinical guidelines. 

The particular suspension point used and the type of harness are factors.
Suspension from the dorsal point of a full body harness results in a fairly serious risk of suffocation for an unconscious victim for certain makes (and fit) of harness (more recent petzl harnesses address this issue to a certain extent). For that type of harness I doubt that suspension trauma is really much of an issue in the absence of other factors.
For fall arrest style harnesses, hanging from the dorsal pick creates a pretty drastic pinch/pressure point in the upper thigh which I could imagine causing suspension trauma, though I've not heard of it happen. 
In general, I suspect that suspension trauma has been a little overemphasized when compared to other risks.

I recall from health and safety courses in the past that suspension trauma was mostly a risk with unconscious people and that that with people above to move, even the slightest wriggle was sufficient to mitigate the risks.

Dorsal attachment fall arrest were identified as compounding the issue.

I had a feeling it was Ireby Fell, but like you say other factors like hypothermia may have sadly contributed rather than suspension syndrome.

It is a widely misunderstood and poorly taught subject not helped by the term 'suspension syndrome'. This means that it is often overlooked in reporting where it may be a contributory factor in cases leading to loss of consciousness and morbidity / mortality.
Having recently written the updated STN guidelines for management and spent a while reviewing the published literature, if seen as a spectrum of disease (from pre-syncopal sx to cardiac arrest) it probably occurs not infrequently at the mild end although isolated suspension as a sole cause of major mortality seems rare.

Agree with the above that risk factors; loss of consciousness, immobility, dorsal attachment, ventral attachment with hyper-extension at pelvis, concomitant trauma all worsen outcome. Treatment - get to ground or if unable look at supporting mechanisms to lesson the above.

Sex Swing??

I suspect it's more of a work/industrial issue where the person with the experience to help may not be on site or is the one hanging on the lanyard (I presume roped access work is done in teams/pairs?). In the more regulated work environment timely but 'improvised' rescues are maybe less likely than for climbing and caving scenarios where there's almost always more than one skilled and equipped person present. Also for both climbing and caving the trauma associated with what most commonly causes one to become immobile on a rope (falls, head injuries and water) probably kill faster than simply hanging on the rope so I doubt suspension trauma complications make it onto many if any death certificates.

OP: no, I've never heard of a case.

jk

Should have known someone would have a dirty mind!

No, was (probably) caused by blunt trauma to the knee.

Doesn't mean it's always the case of course, but in the UK it's been a legal requirement to have a rescue plan and the means to carry it out in place since the 2005 'Work at Height Regulations' came in.

So theoretically at least there shouldn't be work happening if no one who can carry out a rescue is on site, and if they're in a position to potentially need rescuing themselves there should be at least one other.

Sensible.

Even so: the time to raise the alarm, find the plan, find the trained person, check out the rescue equipment, all of which may require trips across the site, it adds up whereas for climbing and caving there is typically someone able to help already at the other end of the rope.

jk

Apologies in advance for replying with non-UK examples of which you may be aware. There was a guided client who died in USA (1960s or 70s Yosemite probably), Abseiling with Swami round waist only, he couldn't release his prusik backup knot, Also Rainer was said to have quickly asphyxiated hanging wirh the rope around his diaphragm in the tragedy involving Kurz and others on the Eiger. 

 Suspension. Syncope seems to be the buzz word for it in the UK. Probably more terms used as well.👍

slipped from the travers into a gully rather than SRT incident

As far as the actual evidence internationally  there has never been a case of a healthy person loosing their life from hanging in a harness. 
it’s a wonderful anecdotal story and the idea is great and highly circulated in the ticket sales industry but in reality we’ve over 2,000,000 hrs worked in rope access and no deaths. If someone’s immobile in a harness chances are there’s a bigger problem I would suggest than metabolite buildup.