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Read this...
http://www.google.co.uk/...LvFK1TEaHUPU9yO3x5pg

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Fixed

Good find Paul,

We covered this in the BASE specific 1st aid course a few of us did a few years back.

It is worth remembering that paramedics are not necessarily trained in this area and will more than likely put you on a stretcher or trolly and possibly put your life at risk!

DO NOT LET THEM LIE YOU FLAT

A powerpoint presentation? ick! For those that don't have powerpoint (or a different ppt viewer), here's a html version:

http://webcache.googleusercontent.com/...mp;ct=clnk&gl=uk

There was a discussion on this a while back on basejumper.org...

http://www.basejumper.org/forums/technical-discussion/6506-one-more-top-tip?limit=6&start=6

(ps, don't know if this'll be a 'clicky link' or not!)

Ok, as a paramedic, this "suspension trauma" as its being stated is basically the same as a prolonged crush injury, when upon release of pressure (harness in this case) on the lower extremities, the acidotic blood returns to the heart and causes possible dysrhythmias, kidney damage and even death. MY BEST GUESS of treatment, according to what i was taught was to administer a fluid bolus, along with sodium bicarbonate, and high flow oxygen, to help alkalize the blood and combat the acidosis.

But there was also an article I read in school about the US Army conducting research on injuries where tourniquets were used to stop blood flow from gunshot wounds and other trauma that had been left high up on extremities (such as at tops of arms, and thighs) for LONG periods of time (many hours to almost days) with no adverse affects upon being released, granted this was to my knowledge done on one extremity, not bilaterally like a harness would constrict so IN MY PERSONAL OPINION I think you would have a little more than a few more minutes before shit hit the fan if the pt was laid flat after being in a harness.

This is my OPINION and is in no way a be all end all guide to emergency medicine or the best course of treatment for the injured person in question. If you think you know something I dont, by all means post it up, im always open to new schools of thought.

Seems to me that if you are hung up and waiting for rescue, it should be your responsibility to move your extremities as much as possible so that even a little circulation is allowed to occur. Right?

Yes, assuming you can do so.

A friend had to sit hanging in a harness dangling from a power tower for around 4 hours. Rescue operations were incredibly lame. It should have taken 20 minutes.

its also known as compartmental syndrome.
rock climbers and SAR should be familiar.

I have a friend who hung upside down and soaked in Avgas for a few days in the Alaskan bush after wrecking his Super Cub. His injuries were magnified by the additional trauma. He is one bad-ass sit-skier now.

jon

Close, but compartment syndrome deals with ischemia from rising intrafascial pressure from a deep tissue injury, whereas "suspension trauma" mainly deals with the restriction of blood flow to an extremity, with or without a traumatic injury. They both are bad, but the treatments are vastly different. Compartment syndrome usually requires surgical intervention to stop the deep seated bleeding and to relieve the pressure build up, where as suspension trauma, you have to alkalize the acidotic blood, and give fluids.

well put me in orthopedic shoes because i stand corrected.

i was under the impression that compartmental syndrome was where the blood is restricted from being filtered by the kidneys by a harness of some sort. oftertimes caused by dangling unconcious.

you get rescued only to have your harness removed and the acidic blood does you in.

i have no idea what ischemia or intrafascial mean, but wikipedia says youre right.

thanks for the heads up.

Hey, no problem man, and thanks for being a good sport, unlike some, who blow up and get all pissy when their statements are adjusted, "suspension trauma" is VERY CLOSE to compartment syndrome, but i figured id clarify, since this medical crap is all I know and can offer input on, lol (beacuse I have absolutely no valid input or experience in this BASE stuff, but still love to learn as much as I can about it even if i never do actually get to try it).

Ischemia is when cells are starved of oxygen, but havent fully died yet, they can be revived if their oxygen supply is restored, an INFARCTION (such as myocardial infarction or heart attack, is when irreversible damage is done, the cells are dead and nothing can be done to reverse it)

Intrafascial means inside the fascial space, or grouping of muscle fibers/ cells, muscle fibers are grouped in bunches, and wrapped in faschia, which are tough protective sheets, which separate the muscles into said groups.

Thought I'd add a picture of a compartment syndrome surgical intervention. I've had both my leg and arm patched up after they needed a compartment release. The leg picture is much better but I can't find it right now. Sure is a good thing that this wasn't my pitching arm! I'll share it later. I have seen suspension like trauma before when extracting someone from a bad car wreck. Vehicle removed, acidotic blood release, heart goes stop. This is the same reason why MAST pants were pulled from most ambulances. Docs would cut off the pants and acidosis would kill the patient. Hypothermia, acidosis, and coagulopathy are why you die in trauma.

 
I don't understand. What are we looking at there? I see the end of a scar but it looks like it's healed? I see where the skin has been opened and spread but the other hand that is holding it is bare? No glove? The arm doesn't look like I'd imagion preped for surgery? I don't see it rubbed with iodine or with an adheasive mask or any thing that they cut through like I've seen on tv? What exactly does this involve? Do they leave it open like that or do they just drain the fluid out of the commpartment and reclose it?

Lee

I've seen similar photos of patients after the London tube bombings and it was a similar thing. It looked like they just left the wounds open.

I remember the Dr who gave the presentation even talking about how it was beneficial avoid closing the wound for as long as possible in case they had to go back in, but that could've been to do with some other form of blast injury. A lot of it went over my head.

Has there ever been any cases of jumpers being affected by suspension trauma? From what little I've read, it sounds a bit like fainting is likely to precede any of the more complicated problems and I'm wondering if slipping out the back of your rig could be a greater worry if you're unconscious. Never really paid any attention to how much you actually use your core to sit in your lag straps before. Something to try check out next time....

BTW I know one bloke who keeps a couple lengths of prussic in his saddle bags, mainly to try ascend the lines if he can get to something more solid, but they could be a handy tool to at least let you stand up and shift around a bit (maybe buy you a little more time).

BJ

good tip about the prussik lengths in saddle bags!
+1

His self rescue kit is pretty impressive.

From vague memory, there's one bit of cord that stays larks headed to his hip ring with 2 biners (one to go to the other ring and one on a fixed knot in the middle), there's the other 2 prussics I spoke about, one of those 3 tipped skyhooks and possibly some other small bits gadgetry as well. Maybe another biner in there somewhere...? If you really wanted to streamline, you could even do away with a couple biners and use rapide links.

It's all connected to the cord fixed to his hip so he can't drop anything. When he fished it all out to show us it was like a bloody clown hanky. It just kept going!

Makes me wish I'd got saddle bags on my rig.

Not a doctor, so perhaps somebody will correct me. As I understand it, though, compression syndrome is when a body part swells up enough that blood flow is restricted or stopped to everything past the swelling. The treatment, plus or minus, is to slice the limb (for example) down its length so that the swelling tissue isn't restricted anymore, and it can go ahead and swell without stopping blood flow to stuff downstream.

I assume the photo is post-slice.

Yeah thats pretty much my take on it as well, they slice it open to release pressure and restore blood flow. Compartment syndrome USUALLY happens where there are 2 long bones (such as the forearm and lower leg) where blood and tissue between can become entrapped hence the need to release the pressure,

Yeah the prusik idea is a great one, we used them to ascend lines in a high angle rescue course in rope ops. its a pain in the ass to do, but if it saves your life then id say its worth it...

Only downside would be if while you're ascending, you manage to bounce your canopy off what ever's snagged it. That would be a bad day out.

Yeah, depending on the circumstances, it may be worth the risk. Other times it may not be, such as if people know exactly where you are and when you should be back.

Totally. It's very situation dependant.

Might be worth thinking about using prussics twice as long so you can use auto blocks rather than prussic knots. At least that way if you can release one of the loops, it might clear itself off your lines.

The foot loop's easy, but anything going to a biner could benefit from a bit of though about a releasable knot on one end. Climbing gear can be surprisingly hard to cut when you're in a hurry.

Something involving a mariner's knot comes to mind, but it's far too late for me to be thinking about that right now.

Anyone out there good with these sorts of things?

probably a dumb question but what is an autoblock?

the way I was taught to ascend lines using tandem prusik cords, COULD be done with one hand, albeit it wouldnt be the easiest thing in the world but it is possible. The way i would do it, would be to bunch up all the lines of the chute, then you tripple (or doubble) wrap your prusik cord around the bundle connecting one to a carabiner and put one through your foot, and slide the top one connected to your beaner up as high as it goes, then lock it, then move your foot one up then step upthen you can pop the one attached to the beaner off with one hand. trust me its possible, we had to do it in our high angle ropes class. its a p

You're using a standard prussic knot for this yeah? (or is it prusik?)

http://www.chockstone.org/TechTips/prusik.htm

I think the method you were describing is basically what I had in mind, but using autoblock instead

http://www.chockstone.org/...prusik.htm#Autoblock

(note the picture there is for a klemheist, but see the comment below it for an autoblock)

That way, if you do find yourself back under canopy, the knot can be released just by dropping one or both of the loops and your lines might hopefully open out normally.

That's interesting! Hadn't seen it done that way yet, that would be much easier to take apart quicky, if for some reason you did find yourself back under a canopy (youd have to be REALLY high up though, haha). I think they both do the same thing, but with just 2 different knots. if i can dig up my climbing gear, I want to see how well it ascends.

You're right about the prusik sometimes being hard to open, but I personally have not had much of a problem, wet or dry. if you do use the top method, the "traditional" one and its wet outside, i would tripple wrap it, since it does become slippery and less grippy when wet, we found that out the hard way ascending lines in a severe thunder storm, let me tell you, theres nothing like being suspended 40 odd feet in the air only to have the tinly little rope thats holding you start slipping down the rope, because you didnt wrap it enough times because youre a smaller guy and figured you could get away with it, haha!

So due to the number of wraps and ease of release i would go with the autoblock, in theory. If tomorow i were to get hung up somewhere id still use the old school style just because its what I know, but the theory of that knot looks solid.

(yeah its prusik, i believe, but either way everyone knows whats being talked about, lol)

Hehe, yeah. That's why I said the knot MIGHT release

I like the autoblock. I use it when I ever I want to back up an abseil. Really easy to tie and take off. From a climbing point of view, you can always leave one end clipped so you can't drop it either. Haven't tried any ascending on it, but don't see why there'd be any dramas. If in doubt, just give it another wrap or two.

Having thought about this a bit more, another idea might be to just use a friction knot to help you raise your legs, lie back on your harness and wait for rescue, rather than to actually ascend out of trouble. Kind of a cross between a bosuns chair and birthing stirrups?

I get the impression that being hung vertically is as much of an issue for venous pooling as the legs straps actually cutting off circulation themselves. Correct me if I'm worng.

Less bouncing on what ever (little) is holding you up that way too.

Yeah venous pooling is an issue too, so if youre awake try to keep at least your toes moving, i wouldnt wanna swing too much since as you said youre probably not hanging on by much and dont want t knock yourself off.

I really wish i could find the military tourniquet study where they left them of for long periods of time with no ill effects.

We use these at work, thier small and easy to use. I dont jump with them but there are NO trees around here....seriously... none. You could clip it to your d-rings or even the hip rings and release pressure from your leg straps.

http://www.msanorthamerica.com/catalog/product501208.html