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The requirement of a rescue plan

By: Steve Mcginty

You might be standing outside the front door of an employee's home, hands clammy, and also a cold sweat on your brow, a metallic taste inside your mouth. You're feeling so nervous that you might vomit or even faint. Precisely why do you feel this way? Imagine as an employer how you might feel if you were going to explain to a family the reason why their loved one, a member of your workforce has died after falling from height. Precisely why did this have to happen? You realise that you overlooked, or perhaps didn't get around to the task of planning for rescue and emergencies, which could have saved that employees life. Planning for rescue and emergencies in regard to work at height is greater than a monetary issue; now it is a legal and moral duty for all business employers. The Working at Height Regulations 2005 and BS8437:2005. 4 (1) & (2) says: "Every employer shall ensure that all work at height includes planning for emergences and rescue." My intention is actually to provide food for thought, ideas for the future and possibly some solutions to your immediate issues. The advantages of a rescue plan Even in work places of the most safety conscious employer's accidents occur, therefore a rescue plan is a vital part of working at height and really should be managed using a working at height method statement and risk assessment, and should include training and practice. The lack of any type of post-fall rescue plan not merely puts the victim at risk, but also puts rescuers in harms way. Unplanned attempts at rescue often result in secondary and tertiary injuries or deaths. CRITICAL PHASES OF A RESCUE. There are 4-phases of a rescue, each phase presents unique safety challenges and has to be considered individually. As with all safety issues, increasing safety in one area can compromise safety in others. Rescue operations are carried out under extreme pressure, whatever training your employees have had or are yet to have, will determine how they react as each phase develops. PHASE 1- Before the fall The key issue of fall protection prior to a fall is compliance. If a harness is too uncomfortable, or interferes too much with carrying out the work being done, operatives may not use the equipment or may modify it (illegally) to make it more tolerable. A poorly fitted harness can result in severe injuries following a fall making rescue more difficult. PHASE 2- Fall Arrest The whole concept of fall protection is that operatives who fall will be stopped by a shock absorbing tethering system. Unfortunately, the posture of the falling operative is unpredictable. Depending on the harness attachment point and the position of the operative's body at fall arrest, different harness attachments offer different advantages. An attachment near the shoulders means that any drag from the lanyard will serve to position the operative's body in an upright position so the forces are distributed from head to foot. The head is somewhat protected if the legs and body precede it in the fall, but this offers some disadvantages after the fall arrest is completed. PHASE 3 - Suspension Many safety professionals naturally assume that once a fall has been arrested then the fall protection system has successfully completed its job. Unfortunately, this is not the case. An operative suspended in an upright position with the legs dangling in a harness of any type is subject to suspension trauma and orthostatic intolerance. Fall victims can slow the onset of suspension trauma by pushing down vigorously with the legs, by positioning their body in a slight leg-high position or, by standing up. Harness design and fall injuries may prevent these actions. PHASE 4 - Post-fall rescue Rescue must come rapidly to minimise the dangers of suspension trauma. The circumstances together with the lanyard attachment point will determine the possibility of self-rescue. In situations where self-rescue is not possible, operatives must be supervised at all times. Regardless of whether an operative can self-rescue or must rely on others, time is of the essence because an operative may lose consciousness in only a few minutes. For conscious casualties we recommend (where possible) that those suspended keep their legs moving to keep the blood pumping and reduce the risk of venous pooling, whilst deploying a self recovery rescue system. For unconscious casualties we recommend using a raising or lowering system to facilitate the rescue of an unconscious casualty, ideally the equipment chosen will allow the rescue to be carried out in less than five minutes. Toxic Shock - Suspension Trauma - Orthostatic Intolerance Unless the operative is rescued promptly using established safe procedures, suspension trauma caused by orthostatic intolerance could occur and result in serious or fatal injury as the brain, kidneys and other organs are deprived of oxygen. Most users of fall protection equipment are unaware of the hazard of suspension trauma. Venous pooling - The need to faint and fall over Death from suspension trauma is caused by orthostatic intolerance and is the result of venous pooling. This can occur any time a person is required to stand still for prolonged periods and may be worsened by heat and dehydration. Major blood vessels pass through the muscles in the legs. The movement of these muscles assists circulation by squeezing the blood back up towards the heart. If the muscles stop moving, gravity pulls the blood down into the legs and reduces blood flow to vital organs First Aid Procedures Following completion of 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: a) 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. b) No change should be made to the standard first aid guidance of ABC management, even if the subject of prior harness suspension. c) 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. d) 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. e) First responders to persons in harness suspension should be able to recognise the symptoms of pre-synsope. For further guidance contact your first aid training provider There are many other things to consider when planning for rescue, these include: • How will you know someone has fallen? • What communication systems are in place, how will your employee call for help? • Who do your other employees call when an incident occurs? • Incident Information, what information does the emergency services require? • How safe will the rescuers be, before, during and post incident? • How will the rescuers get to the casualty? • Can you rescue in under 5 minutes, is there adequate equipment available? • What if the casualty has additional injuries? • Other considerations such as: Ø Language barriers Ø Adverse weather Ø Working alone Should you create a rescue plan that's very well thought out and sufficiently detailed to cover the majority of, if not all situations, obtain proper training, and practice it frequently. It is extremely improbable that you'll ever need to inform an employee's family of the death of a loved one, or give an account to the HSE that explains why you did not have a plan in place, when it is today a legal necessity to do so.

Steve is a senior trainer with Leading Edge Safety Leading Edge has developed rescue training courses and rescue safety equipment which are suitable for all industry sectors and workplaces. For more information please visit Rescue Training and Equipment