hanging syndrome?

[MessedUpMike]

I hope I got that spelled right. It's my understanding that by spending more than a half hour at a time on rope you can cut off the circulation to the legs which can result in medical complications. I've rappelled and works off of ropes before, I'm sure in some circumstances I've been hanging for more than a 1/2 hour at a time with no ill effects. Is this a condition impacted by the type of harness worn? Is the a resource where I can find more information on this?

[NZcaver]

messedupmike said:

I hope I got that spelled right. It's my understanding that by spending more than a half hour at a time on rope you can cut off the circulation to the legs which can result in medical complications. I've rappelled and works off of ropes before, I'm sure in some circumstances I've been hanging for more than a 1/2 hour at a time with no ill effects. Is this a condition impacted by the type of harness worn? Is the a resource where I can find more information on this?

You may be thinking of Harness Hang Syndrome. This is most relevant if you were to lose consciousness while on rope, but can also apply to conscious and immobile subjects too. If you want to find out more, try looking here and/or doing a Google search.

[Brad Tipton]

Here is a link that is Suspension Trauma specific. Below the link is a comment on the material on the site from Dr. Wharton who is the CHCRS team doctor and a head physician at Erlanger.

www.suspensiontrauma.info


In general this is a very basic and quite good article. I tend to doubt the few minutes they mention ("could die in ten minutes"} but otherwise it gives good basic advice that can be understood by the non-medical person. It is good advice, but as usual the situation, time of hanging, and medical ability at the scene are important.

There seemed to be an inordinate attention placed on keeping the patient upright, but that position would slow the pooled blood somewhat. If there were no bicarbonate available, that would be the only way you could help a person with this problem. We should do this unless we have reasons not to do so. Monitoring the respiratory rate will give you an indication of acidosis. If you breath faster, you are trying to get rid of CO2 (an acid) because of other acids in the blood (lactic acid from the byproducts of anaerobic metabolism) or else you were on
rope long enough to get a blood clot (probably would die in that case). The pulse would also be an indicator if it were over 100 that an insult was occurring.

In most patients that have suspected suspension trauma, giving 1-2 amps of IV bicarbonate would make good sense. That amount of bicarb would not do much to a normal person and would greatly benefit someone who had damage enough to cause an elevated acid and potassium. The types of patients to be cautious with such as those with history of congestive heart failure, etc would not normally be in any of these situations. I wrote that company and asked for any articles relating to advanced treatment of this.

Bottom line. Basic treatment without medical personnel would be sitting up and getting to a medical facility rapidly. For others with suspected suspension trauma, oxygen and IV bicarb would be reasonable until they can get to a medical center for testing. That is what we did on that last rescue where the cavers were hanging for several hours. Seemed to work well. The novice caver had not moved much and had some muscle damage. He was admitted for a couple of days to "flush out" the bad materials (CPK, lactate, etc).

David

[gillip]

Another good article on harness hang:
www.hse.gov.uk/research/crr_pdf/2002/crr02451.pdf
Harness hang syndrome is caused by a lack of circulation in the legs. The type of harness could certainly have some effect in how long it takes to experience harness hang, but inactivity while suspended by your harness is the most significant factor. While active, you will have circulation in your legs unless your harness' leg loops are extremely tight.