Suspension Trauma: It Can Kill You in Just 6 Minutes

Suspension trauma is a dangerous, life-threatening condition that can occur when a climber is suspended in their harness for too long, especially after a fall or unconsciousness. It’s a critical issue for rope solo climbers (TRS and LRS), as being left hanging without the ability to move can cause blood to pool in the legs and lower extremities, depriving the brain and vital organs of oxygen. Without prompt action, suspension trauma can quickly escalate to unconsciousness, organ failure, and death, sometimes in as little as 6 minutes.

Note that Jean-Marc Boivin (famous French alpinist) survived 14 hours suspended in a harness in 1982. He survived for such an extended period thanks to his athletic physique, ability to stay warm, and maintain consciousness and stability while awaiting rescue. The typical survival time due to suspension trauma is much shorter—usually within 30 minutes to 2 hours. Quick rescue is essential to prevent life-threatening conditions.

What is Suspension Trauma?

Suspension trauma happens when a person is suspended upright for too long, with limited movement. Under normal conditions, muscle activity helps circulate blood throughout the body. However, when the body remains still in a harness, particularly in an upright position, the blood struggles to circulate properly. This results in blood pooling in the legs and a lack of oxygenated blood reaching vital organs, including the brain.

For rope solo climbers, this becomes a serious risk if a fall leaves them hanging unconscious or immobile for an extended period. The condition can develop very quickly, with symptoms typically appearing within minutes. If left untreated, it can lead to unconsciousness, organ damage, and, in extreme cases, death.

Recognizing Suspension Trauma Symptoms

Early Symptoms
Suspension trauma can strike quickly, and the initial symptoms can be subtle but important to recognize. These include:

• Dizziness or light-headedness
• Nausea
• Tingling or numbness in the arms and legs
• Anxiety or panic
• Visual disturbances

As the condition worsens, the victim may lose consciousness, and the body’s systems can begin to shut down. It’s essential to act quickly once these symptoms are noticed.

Key Factors That Affect Survival Time

• Blood Flow Restriction: Being immobilized in a harness can restrict blood flow, especially in the legs. This can cause blood to pool, reducing blood return to the heart and potentially leading to unconsciousness or death if not alleviated.
• Harness Design and Fit: Some harnesses distribute weight more evenly, which may delay symptoms, but any harness that holds a person motionless for an extended period will eventually contribute to suspension trauma.
• Physical Condition: Physically fit and hydrated climbers might withstand suspension longer, but the lack of circulation still becomes an issue.
• Consciousness and Movement: A person who can shift their weight and adjust position, like pressing their legs or feet against the rock face, can slow the onset of symptoms.
• Environmental Conditions: Cold weather can increase the risk of hypothermia, while hot conditions may increase dehydration risk.

What to Do in an Emergency

For Conscious Victims
If the victim is still conscious and suspended in their harness, the primary goal is to relieve pressure on the body and restore circulation. The person should be encouraged to move their limbs or take weight off the harness if possible:

• Stand on foot loops to relieve pressure.
• Seek a ledge or other support to help redistribute the weight.

This will help prevent the blood from pooling in the legs and keep oxygen flowing to the brain and vital organs. If moving isn’t possible, the victim should be lowered to a safe place as quickly as possible.

For Unconscious Victims
If the victim is unconscious or semi-conscious, immediate action is required:

1. Lower the victim immediately to a safe location, ideally to the ground or a flat surface. A quick descent is crucial in preventing the progression of suspension trauma.
2. Raise the legs: If you cannot lower the person right away, raising their legs above the level of their heart can help increase circulation back to the brain.
3. Position the victim correctly: Lay them in the recovery position (on their side) to ensure the airway is clear and to prevent choking in case they vomit.

Get Medical Help
Even after you manage to get the victim down and restore some normal circulation, seek medical attention immediately. Suspension trauma can cause long-term internal damage, so medical professionals should assess the individual as soon as possible.

Prevention and Preparedness for Rope Solo Climbers

For rope solo climbers (both TRS and LRS), suspension trauma is a real risk that requires proactive planning. While rope soloing, the absence of a partner means that you’re solely responsible for your own safety, including self-rescue if something goes wrong.

Here are a few tips for minimizing the risk of suspension trauma and being prepared for emergencies:

• Know your limits: Be mindful of how long you’re hanging in your harness, and avoid prolonged suspension if possible.
• Practice self-rescue techniques: Familiarize yourself with ways to ascend back to your rope or adjust your position in case of a fall. Learn how to quickly set up a foot loop or make use of your gear to shift your weight.
• Carry appropriate rescue gear: Always have a rope, ascenders, and foot loops with you for self-rescue. Consider a load-releasable tether for emergency situations.
• Have a plan: Develop an emergency procedure for situations where you might be suspended for a prolonged period. Know how to rescue yourself or what actions to take in the event of an unconscious fall.

Final Thoughts

Suspension trauma is a deadly condition that can strike with alarming speed, particularly in rope solo climbing scenarios. In the event of a fall, it’s critical to recognize the symptoms early and act quickly to relieve the victim’s suspension and restore circulation. Whether you’re rope soloing or climbing with a partner, ensuring you have the right knowledge and gear can mean the difference between life and death.

If you or a fellow climber experiences suspension trauma, remember: every second counts. React swiftly and don’t hesitate to call for medical assistance. And always remember, it can kill you in just 6 minutes.

Essential Self-Rescue and Safety Measures for Rope Solo Climbers

Given the life-threatening risks associated with suspension trauma, rope solo climbers should be vigilant and prepared. Here are essential measures to ensure your safety during solo climbs:

1. Ensure Physical, Mental, and Gear Preparedness: Wear a helmet. Choose your harness carefully to be compfortable. Before climbing solo, confirm that you are physically healthy, mentally prepared, and equipped with the right gear. Solo climbing can be demanding, requiring endurance, focus, and reliable equipment that is checked and ready for use.

2. Reliable Communication Device: Keep a secure, accessible communication device, such as a cell phone, an inReach satellite communicator and /or a Personal Locator Beacon (), on your harness at all times. If you’re climbing in remote areas, the ability to call for help is invaluable.

3. Share Your Climbing Plan: Inform a trusted contact of your climbing location, route, and estimated return time, along with instructions on when and how to initiate a rescue if needed.

4. Prevent Suspension Trauma During Suspension: Practice methods to alleviate harness pressure and improve circulation. Techniques include:

   • Using foot slings or stirrups to stand in and relieve pressure.
   • Shifting your weight between legs to improve blood flow.
   • Adding or adjusting suspension points to reduce prolonged pressure on any single area.

5. Pre-Rig Anchors with Releasable Knots: Set up your anchors with releasable knots, such as the Munter Mule Overhand (MMO), to allow for controlled adjustments or release in emergency situations.

6. Self-Rescue Skills: Be proficient in self-rescue techniques for both ascent and descent. Practice these skills until you can perform them confidently and efficiently in various scenarios.

7. Single-Handed Practice: Accidents can limit the use of one arm. Train yourself to execute self-rescue procedures using only your non-dominant hand to simulate potential emergency scenarios.

8. Low-Visibility Training: For additional preparation, practice self-rescue with limited vision, such as while blindfolded. Use a safe environment, like a top-rope backup with a partner or a low position above a crash pad, for this type of practice.

9. Consider a Crash Detection Device: Adding a crash detection sensor, like those found in some mountain bike helmets, could provide an added layer of emergency notification if a fall occurs and you are immobilized.

10. Continuously Evaluate and Improve: Solo climbing is highly individualized. As you gain experience, reflect on your techniques and safety measures, and seek out new ways to enhance your safety based on the unique demands of each climb. If you think about something new, contact me and let me know!

By implementing these measures and practicing regularly, solo climbers can increase their preparedness for potential emergencies, significantly reducing the risks of suspension trauma and enhancing overall safety on every climb.