Fall Rescue Plans — What to Include and How to Respond in an Emergency  

You need a plan of action for your crews to follow in the event of a fall.

• By David Ivey
• Aug 02, 2021

A fall incident can be a confusing and frightening event on a job site, so it is wise to have a rescue response plan carefully constructed in a clearheaded moment beforehand.

Fatalities caused by falls continue to be a leading cause of death for construction employees. Preventing falls is always best, of course, and having fall protection in place is an excellent preventative measure, but it is not enough—just as installing a smoke detector isn’t enough to prepare your team in case of fire.

You need a plan of action for your crews to follow in the event of a fall. Creating a thorough fall rescue plan arms your workers with the knowledge and processes they need to follow in an emergency to prevent serious injury or death.

The Importance of a Swift Rescue Response

In the event of a fall, even after the fall is arrested, the worker is not yet out of danger. A rapid rescue is essential for preventing secondary injuries, and even death, that can occur in a fall incident, even after the danger of a direct falling injury has passed.

Fall protection harnesses are designed to arrest a fall but not for prolonged suspension. The straps and buckles that absorb the force of a fall can begin to cut off blood circulation if the worker remains suspended for more than a few minutes. While the worker remains suspended in a fall protection harness, his or her circulation is restricted, which can lead to a condition known as suspension trauma.

Suspension trauma, also called orthostatic intolerance or harness hang syndrome, is caused by the disruption of blood flow. The loss of circulation can lead to nausea, a drop in blood pressure, loss of consciousness and the onset of circulatory shock. Uncirculated blood that pools in the legs lacks oxygen from the lungs, which raises the acidity of the blood. This acidic blood can shock the liver, kidneys and heart once circulation is restored.

OSHA  requires fall protection plans to include plans for a prompt rescue due to the risk of suspension trauma. In a technical bulletin, OSHA states suspension trauma can be fatal within 30 minutes and that dangerous effects of suspension trauma can occur within as little as three to five minutes of the fall. When it comes to fall rescue, speed is of the essence. Calling the local fire department and waiting for rescue to arrive is not a good option. Having a carefully thought-out rescue plan can save precious minutes, which can translate to saving lives.

Components of a Rescue Plan

Your rescue plan should include all the information your team would need to access immediately in the event of a fall.

The first element to include in your fall rescue plan is a list of the names and contact information of authorized rescuers and first-aid trained employees. These will be the people called upon to respond to a fall incident to execute a swift rescue and, if necessary, tend to the fall victim. Only trained personnel should attempt a rescue retrieval in dangerous circumstances or provide first aid, so having a readily accessible list of employees qualified to help is key to providing timely rescue.

Next, provide employees with a complete on-site fall response checklist. Clearly and methodically think through the steps employees should follow in an emergency beforehand to provide your team with a simple checklist. This checklist will prompt any employee, regardless of their experience level or training, to run through the basic responses to a fall without forgetting an important step in the heat of the moment. Items to include on the checklist might include questions or prompts such as:

• “Can the victim be pulled to safety to avoid hanging suspended?”
• “Is the worker’s harness equipped with trauma straps or attached to a self-retracting lifeline (SRL)?” *“Do rescuers have access to a rescue ladder or lift?”
• “Have emergency services been called?”

Next, your rescue plan should include the location of all pertinent emergency supplies. This should include the location of rescue equipment (detailed below), first aid kits, defibrillators and telephones to call for help. Although the location of these items can seem obvious in the abstract, an accident can create confusion or even panic in the moment. Again, seconds matter when responding to a fall, so spelling out the location of these important items can save precious time.

You should also include a list of emergency phone numbers that should be used in the event of an incident, including the supervisors or safety managers who should be notified, the nearest medical facilities, emergency services (9-1-1 and local police and fire departments) and OSHA.

Your plan should also provide guidance on how to assess the situation once the fallen worker and all rescuers are returned to safe ground. If the victim may have sustained an internal injury, lost consciousness at any time during the incident, or remained suspended for more than a few minutes, they should be taken to the nearest hospital or medical facility for evaluation.

Rescue Equipment

Depending on the situation, you might employ one or more types of rescue equipment to help a fallen worker in suspension.

Trauma straps. Trauma straps are emergency PPE coiled into pouches attached to a harness at the hips. When hanging suspended and awaiting rescue, a fallen worker can deploy the trauma straps by uncoiling them, hooking them together, and standing on them like a bridge until help arrives. This engages the worker’s leg muscles to encourage more normal blood flow and takes the weight off the harness that could otherwise cut off circulation.

Self-rescue ladders. A self-rescue ladder is portable rope or nylon ladder housed in a pouch that attaches to an anchor point and to the worker’s harness. If equipped in advance, a self-rescue ladder deploys automatically during a fall, allowing the victim to simply climb the ladder to safety. Even if not equipped in advance, a rescue ladder can be deployed from the original anchor point or a temporary anchor point within reach.

Rescue harnesses. Rescue harnesses include handles on the shoulders that allow nearby workers to hoist a fallen worker back onto safe footing. This should only be attempted for short fall distances where workers can safely reach the victim without putting themselves at risk of falling as well.

Recovery SRLs. Self-retracting lifelines (SRLs) are best known as personal fall protection devices that serve a similar function to shock-absorbing lanyards. Recovery SRLs allow a rescuer to hoist a fall victim to safety with the help of an inbuilt winch mechanism.

Aerial work platforms.  A personnel lift such as a bucket truck, boom lift or scissor lift can be used to retrieve a fallen worker if one is available on site and can safely reach the fallen worker’s height. Only use personnel lifts or rescue baskets intended to hold workers aloft; do not attempt to rescue workers using other construction equipment or vehicles.

Reporting an Incident to OSHA

Any fall should be treated as a serious safety incident, even if no injuries occurred. Any fall incident that results in a worker losing consciousness, requiring medical treatment beyond first aid, or missing work (including restrictions on their ability to work) is considered a recordable incident, according to OSHA. You must report these incidents to OSHA by law. You can use the follow forms to report a fall incident to OSHA:

• OSHA Form 300 (Log of Work-Related Injuries and Illnesses)
• OSHA Form 300A (Summary of Work-Related Injuries and Illnesses)
• OSHA Form 301 (Injuries and Illnesses Incident Report)

All three forms can be downloaded from OSHA’s website. Record as many details of the incident as possible.

Following a reported incident, OSHA may conduct an inspection. If inspectors arrive, you must comply with their requests for documentation and information. A company representative has a right to be present and accompany all walkaround inspections. Following the walkaround, the OSHA inspector will discuss any observed violations. You can ask them questions about standards being cited and about the severity or penalties, but do not argue or try to negotiate. Ask them to send your company a record of any citations. Keep good notes and take photos and measurements during or immediately after the inspection. Correct any unsafe conditions the inspection revealed as quickly as possible.

We all hope to avoid workplace accidents and do what we can to prevent falls. With any luck, you won’t ever need to employ your rescue plan. But it is far better to have a plan and not need it than to need a plan and not have it.

This article originally appeared in the July/August 2021 issue of Occupational Health & Safety.