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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Dynamic Media Sales Verlag
2020
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oai:doaj.org-article:e88072b2b11b4202a488780b57fcdd6a2021-11-16T19:01:40ZMountain & Alpine Medicine0344-59252510-526410.5960/dzsm.2020.434https://doaj.org/article/e88072b2b11b4202a488780b57fcdd6a2020-11-01T00:00:00Zhttps://www.germanjournalsportsmedicine.com/archiv/archive-2020/issue-11-12/suspension-syndrome/https://doaj.org/toc/0344-5925https://doaj.org/toc/2510-5264Suspension 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 CareLechner RRauch S3Dynamic Media Sales VerlagarticleSports medicineRC1200-1245DEENDeutsche Zeitschrift für Sportmedizin, Vol 71, Iss 11 (2020) |
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DOAJ |
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DE EN |
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Sports medicine RC1200-1245 |
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Sports medicine RC1200-1245 Lechner R Rauch S 3 Mountain & Alpine Medicine |
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 |
format |
article |
author |
Lechner R Rauch S 3 |
author_facet |
Lechner R Rauch S 3 |
author_sort |
Lechner R |
title |
Mountain & Alpine Medicine |
title_short |
Mountain & Alpine Medicine |
title_full |
Mountain & Alpine Medicine |
title_fullStr |
Mountain & Alpine Medicine |
title_full_unstemmed |
Mountain & Alpine Medicine |
title_sort |
mountain & alpine medicine |
publisher |
Dynamic Media Sales Verlag |
publishDate |
2020 |
url |
https://doaj.org/article/e88072b2b11b4202a488780b57fcdd6a |
work_keys_str_mv |
AT lechnerr mountainampalpinemedicine AT rauchs mountainampalpinemedicine AT 3 mountainampalpinemedicine |
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1718426211654303744 |