Suspension Trauma: Reflow syndrome

Reflow sydrome in suspension trauma

Anyone who has developed suspension trauma is also at risk from reflow syndrome - caused when the pooled blood in their legs is allowed to flow back into their body. It is potentially fatal.

The exact details of what happens and why are dealt with in our medical treatment section, but the idea is simple enough to summarise. The blood that is pooled in the legs starts off perfectly normal, with oxygen and nutrients dissolved in it. Over time, the cells in the legs use up the oxygen and nutrients - even though they may not be moving much, they still need to stay alive. When all the oxygen is used up, the cells start to burn fats. This process, called anaerobic metabolism, is usually only seen in extreme exercise, and relies on a fast blood flow to keep the process safe. As the blood in the legs is not moving, toxic byproducts of fat burning start to build up in the blood. After quite a short time they can reach dangerous levels.

If the blood is allowed to rush back into the rest of the body then these toxins, and the lack of any oxygen, can cause very serious problems. The heart can stop, the liver, kidneys and brain can be damaged, and in many cases they will die. This will happen if the patient is allowed to lie flat on the floor. It's therefore very important that they stay in a safe position until they reach hospital, or until the blood has had time to gradually clear the toxins. A 'safe position' is the same as for the rest of suspension trauma - sitting upright with their legs bent at the waist. During a rescue, transport to hospital or even when they arrive, they have to be kept in this position and NEVER allowed to lie down. Our guideline is that they should stay sitting for 30 minutes after being released from suspension. It does not matter if they have fainted or not.

Suspension Trauma

Reflow sydrome in suspension trauma

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