Another name for Suspension Trauma
Harness Hang Syndrome
Time onset of symptoms for suspension trauma
As little as 3 minutes
Average between 5-20 minutes.
This practice during ancient Roman times likely led to suspension trauma death?
Crucifixion
Classification of hypotension contributing to suspension trauma
Orthostatic hypotension
The 2 primary goals of Suspension Trauma rescue
To return oxygen supply to the brain and other vital organs while preventing Reflow Syndrome.
These harnesses are designed for prolonged support
Front attached harnesses
6 signs and symptoms of low flow states
SOB
Tachycardia
Diaphoresis
Nausea
Pallor
Dizziness
The proper way to mix a bicarb infusion
What is:
1L D5W bag
Withdraw 150ml of D5W
3 amps
Two categories of blood flow contributing to suspension trauma
Low flow
No flow
Treatment should/can be initiated when?
PRIOR to
DURING and
AFTER patient movement,
These higher risk harnesses create pressure on what areas of the body?
Femoral Triangle
These events often precede the fall (in the harness) that precedes suspension trauma
Trauma, hypoglycemia, fatigue, hypothermia, or fear
causing the individual to fall
You should have a high index of suspicion of this common, well understood hematological condition that can occur with suspension trauma
Blood Clots
DVTs
PEs
Toxic byproducts that can reach dangerous levels within a short period of time in suspension trauma
K+
Lactic acid
CO2
In the unconscious patient, prior to pick off or release, consider this treatment
Bilateral Tourniquets
Populations at risk for suspension trauma
rescuers working in a harness
industry employees working in a harness
climbers/cavers in a harness
patients being extricated in a harness
A high index of suspicion for developing this if they have been suspended for a prolonged period and are experiencing any symptoms of extremity LOW or NO flow states
Reflow syndrome
Following a suspension trauma, the victim should be moved to a hospital with these capabilities
Dialysis
The usual cause of cardiac arrest in a suspended victim who you witnessed to go unconscious
Hypoxic arrest
These 4 movements help prevent suspension trauma and reflow syndrome
Seated position
Cycling of legs
Push offs
Use of prusik
5 risk factors for developing suspension trauma
Inability to move the legs
Hypothermia
Pre-existing heart disease and lung disease
Dehydration
Blood loss
Reflow syndrome causes this
Trapped blood be allowed to flow back rapidly to the rest of the body
The presence of the K+, Lactic acid, CO2 in this blood can cause multisystem organ disfunction
Limb then heart then brain circulation compromise
The progression of suspension trauma
Prolonged limb immobilization or limb strangulation causes this
Tourniquet effect
Greater than 20% circulating volume can be confined to the lower limb that is vertically immobilized
The 5 treatment options for minimizing reflow syndrome in an unstable patient
Bilateral TK
IVF
CaCl
Bicarb
Ventolin