I have been given the task of generating a rescue plan for working at height on flat roofs etc, I was just wondering if anyone could share their knowledge in this area, or provide tips/pointers, as this is something I have never done before?

Toby Rescue from heights can be very different in every case, and as Tony says you need to be really clear about equipment and conditions, in particular access. You give the example of flat roof's but these can be very different. I now of flat roofs where access is via a normal staircase and door. Work on areas of them is hazardous because of lack of edge protection, but rescuing an injured worker would be little different to from the top floor of the building. Place then an a stretcher and carry them down - very simplified explanation. If you are accessing from scaffolding or potentially have suspension trauma to deal with then the situation is very different. This is one area for me that generic risk assessments are rarely sufficient. When the Work at Height Regulations came in the HSE did have some reasonable presentations on their web site I don't know if they are still there. Because of the specialist knowledge needed for work at height rescue I would strongly recommenced you find some one that is experienced in this area who can look at your specific issues with you to begin with. You may be able to make contact with someone at your local IOSH branch. It will be difficult for people to give you exact answers on this forum as they will not know all the site conditions. Sorry I know some people don't like that type of answer but sometimes we all need onsite help from someone more experienced.

You haven't mentioned harness use or suspension trauma issues, and leaving that aside there remains the safe evac of a casualty from the roof. A consideration of the means of access and egress and general safe systems will otherwise give you an idea of potential issues for paramedic access and casevac. As a slight aside, the fact that those on a roof perhaps can't hear the fire alarm is often overlooked. In a wider sense, the emergency arrangements should also consider that.

Its how you learn and gain knowledge and I take your comments and everyone elses on board thanks for taking the time to comment.

Hi ya, Best of luck with this procedure its so hard to write one, I had to do one on my last project, and it took forever. We had to do gutter works on a flat roof, scaffold was not going to be used because of issues with a rail line, MEWP's couldnt get in there, and no other form of platform could be used, so we therefore had to work on the actual roof. In the end, we used a removable/ movable anchor (suitable for flat roofs with a covering that could not be penetrated) for a harness to be fixed, this was positioned 2-3 meters from the edge to do gutter works, the harness had a restricted rope therefore there was no risk of fall (if the person hooked on correctly). We underwent training on the use of the whole system, and in the procedure there was to be two guys working under a permit, with a watch man with them, with a radio.

Toby, Email me at damian2701@aol.com, I have a generic rescue plan risk assessment and method statement you can use as a guideline to point you in the right direction. Look forward to hearing from you Damian

There are also some useful pieces of information here to help. http://www.healthandsafe...Pages/Work_at_Height.htm Please don't miss Ron's point ...The working at height directive/regs make it clear that all who are involved in working at height should be aware of the risks from suspension trauma and first responders should know how to deal with it... Just finished reviewing a fatal investigation where there was no other injury except they guy was suspended...the first aider wasn't trained didn't have the right kit with him ..laid the guy flat and he was dead in 3 mins...they had all been on a 2 day WAH course which didn't cover reflow syndrome...but they knew the BS standard for webbing!.. So this isn't something to go into lightly, not saying you would...

@ SteveDM......Not wishing to hijack the thread but I am interested in your comment about laying the casualty flat. Did this particular action really have a significant bearing on the outcome of incident? I only say that because the HSE did research into this and following that research their advice in such situations is to lay people flat as per normal First Aid practice. So with the potential contradiction in advice what is the correct approach with regard to First Aid after suspension? http://www.hse.gov.uk/falls/harness.htm

This sounds similar to the dilemma in a crush injury, where first aiders are told not to release the person if they have been trapped for more than 15 minutes, because of the possibility of sudden death from either release of toxins or sudden changes in blood pressure. I believe that it is recommended to keep the casualty in the sitting position after rescue from suspension. However, the advice changes from time to time (like the CPR advice) so this may be out of date - perhaps someone could confirm current thinking?

Had a reply drafted then phone called and logged out...grrrrrrr. Come from remote rescue mountaineering...yes HSE have not supported Seddon, however the research still stands the current view is to treat the individual..there are lots of likely causes in an individual....bear in mind that the suspensions I am talking about here are in hours rather than minutes, and I would like to think that in an industrial environment it would be unlikely to be suspended for anything like that... It is a rare event but there is enough to be worried about it...sould be part of the risk assessment. Everyone's view is different...attended the International Rescue Meeting (no FAB, or thunderbird comments please!) in November last year and not all of us could agree then!!!

As far as FAW and treatment for ST goes, I think you would struggle in front of the man with the curly wig if you did anything but the HSE's regulations. In advance casualty care we have a slightly more open book. But for FAW follow the guidelines unfortunately. Phil

Agree with HeO2 as a first aider follow the FAW.. Other first responders will have other guidance/governance locally.

I have an interest in this topic, would anyone suggest a type of training organisation for dealing with suspension trauma? I think it should be a practical course. I haven't done a first aid course for a while, does that cover it?

For any training requirements - I have been on a few of their courses and they are excellent. http://www.narc.co.uk/

Two problems : 1. First aid at work guidance does not recognise / mention orthostatic shock / suspension trauma etc 2. it does exist and has had very serious consequences - check with IRATA / Mountain & Cave Rescue etc We now have an issue about what are your rescue arrangements - answer could be something beyond basic FAW? Surely first aid / rescue provision should be based on an assessment of needs (risk assessment). Dave Merchant does know his stuff - medically and rope access wise - this is a case of an organisations needs going beyond 1st aid in the same way as cyandide, hydrofluoric acid, deep diving etc Just my point of view

i dont think fall arrest should be used but fall restraint, which is what I had said in the first instance, there is no risk with suspension trauma as there is no fall, the operatives is physically inable to fall (once the equipment is set up correctly). I think we need to know more about the task at hand.

Understandable, but if the person is unconscious then the aim is to get that person to safety ASAP regardless of the ST

There isn't a clinical base to put a blanket 30min sitting after suspension...however we have it as one of the treatment options...in a similar vein (excuse the pun) we don't really know how chest compressions work but we do it...as we know that part of the overall response we can save a life... Treat the patient not the symptoms...we are all different..all we need for this is the legs are lower than the heart and you are not moving them.. I think you have enough...for your rescue plan..Toby otherwise we may decend into conversations on rhabdomyolysis, compartment syndrome and crush....

Redken. Yes. But it is likely to be much simpler. As I said early on in this thread you have to think about the access to the area and how easy it would be to remove a casualty. Edge protection may mean no fall protection equipment is needed for work on a flat roof but say for example someone broke a leg how would you get them off?