Mountain & Alpine Medicine

Suspension syndrome is a potentially fatal event of unknown incidence that can be caused by motionless hanging in the rope during rope-secured activities. During prolonged hanging, generalized hypoperfusion with reduced cerebral blood flow and consecutive loss of consciousness occurs.Two mechanisms...

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Main Authors: Lechner R, Rauch S, 3
Format: Article
Language:deu
Published: Dynamic Media Sales Verlag 2020-11-01
Series:Deutsche Zeitschrift für Sportmedizin
Online Access:https://www.germanjournalsportsmedicine.com/archive/archive-2020/issue-11-12/suspension-syndrome/
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author Lechner R
Rauch S
3
author_facet Lechner R
Rauch S
3
author_sort Lechner R
collection DOAJ
description Suspension syndrome is a potentially fatal event of unknown incidence that can be caused by motionless hanging in the rope during rope-secured activities. During prolonged hanging, generalized hypoperfusion with reduced cerebral blood flow and consecutive loss of consciousness occurs.Two mechanisms are discussed as the cause leading to loss of consciousness: venous pooling in the legs and a sudden reduction of heart rate and blood pressure, similar to a neurocardiogenic syncope. The most important preventive measure is the activation of the muscle pump during hanging.In principle, the treatment follows standard <C>ABCDE care. The patient should be rescued from the hanging position as fast as possible and airway obstruction caused by hyperflexion of the head during unconscious hanging has to be reversed. There is an increased risk of hyperkalemia. Therefore, ECG monitoring should be established as soon as possible to recognize cardiac arrhythmias. Pulmonary embolism should be considered as a potentially reversible cause of cardiac arrest. Hypothermia prophylaxis and treatment have high priority. For suspension longer than two hours, a medical treatment facility able to provide continuous renal replacement therapy should be chosen.There is no evidence that laying a patient flat immediately after rescue is harmful.  Key Words: Neurocardiac Syncope, Venous Pooling, Rescue Death, Generalized Hypoperfusion, Standard <C>ABCDE Care
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spelling doaj.art-e88072b2b11b4202a488780b57fcdd6a2023-07-04T17:04:29ZdeuDynamic Media Sales VerlagDeutsche Zeitschrift für Sportmedizin0344-59252510-52642020-11-01711110.5960/dzsm.2020.434308723Mountain & Alpine MedicineLechner RRauch S3Suspension syndrome is a potentially fatal event of unknown incidence that can be caused by motionless hanging in the rope during rope-secured activities. During prolonged hanging, generalized hypoperfusion with reduced cerebral blood flow and consecutive loss of consciousness occurs.Two mechanisms are discussed as the cause leading to loss of consciousness: venous pooling in the legs and a sudden reduction of heart rate and blood pressure, similar to a neurocardiogenic syncope. The most important preventive measure is the activation of the muscle pump during hanging.In principle, the treatment follows standard <C>ABCDE care. The patient should be rescued from the hanging position as fast as possible and airway obstruction caused by hyperflexion of the head during unconscious hanging has to be reversed. There is an increased risk of hyperkalemia. Therefore, ECG monitoring should be established as soon as possible to recognize cardiac arrhythmias. Pulmonary embolism should be considered as a potentially reversible cause of cardiac arrest. Hypothermia prophylaxis and treatment have high priority. For suspension longer than two hours, a medical treatment facility able to provide continuous renal replacement therapy should be chosen.There is no evidence that laying a patient flat immediately after rescue is harmful.  Key Words: Neurocardiac Syncope, Venous Pooling, Rescue Death, Generalized Hypoperfusion, Standard <C>ABCDE Carehttps://www.germanjournalsportsmedicine.com/archive/archive-2020/issue-11-12/suspension-syndrome/
spellingShingle Lechner R
Rauch S
3
Mountain & Alpine Medicine
Deutsche Zeitschrift für Sportmedizin
title Mountain & Alpine Medicine
title_full Mountain & Alpine Medicine
title_fullStr Mountain & Alpine Medicine
title_full_unstemmed Mountain & Alpine Medicine
title_short Mountain & Alpine Medicine
title_sort mountain amp alpine medicine
url https://www.germanjournalsportsmedicine.com/archive/archive-2020/issue-11-12/suspension-syndrome/
work_keys_str_mv AT lechnerr mountainampalpinemedicine
AT rauchs mountainampalpinemedicine
AT 3 mountainampalpinemedicine