Suspension Trauma: A Clinical Review


South Atlantic


Grand Strand Medical Center

Document Type


Publication Date



suspension trauma, suspension syndrome, harness hang syndrome, harness, reflow syndrome, rescue death, orthostatic syndrome, orthostatic intolerance, fall protection


Emergency Medicine | Nervous System Diseases | Trauma


Suspension trauma is a potentially dangerous outcome of the body’s normal physiological response to motionless vertical suspension from a rope. All who use a safety harness are at risk, and the growing need for occupational work at extreme heights in addition to the interest in caving and mountaineering worldwide has led to an increased number of individuals wearing protective harnesses for work and recreation. It has been described as the cause of death in many climbing incidents and has been demonstrated in multiple studies for improvement of employee fall protection.

Although suspension trauma is potentially life-threatening, there is a lack of scientific data to define an exact mechanism of injury, and there is little conclusive evidence about the proper management of victims. This has led to controversy surrounding the topic of postsuspension management. The discussion of suspension trauma has historically been led by nonmedical experts, but the recent push for more evidence-based research has created a better understanding of the condition. Further investigation of the pathophysiological mechanism of suspension trauma and more complete collection of data from individual cases will increase our understanding of the topic and lead to better decision making in the management of victims.

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