In the Field-Fall 2024

Equipping Ironworkers with Life-Saving Skills

Rescue training for falls, heat, and mental health crises

By Julia Kunlo and Emily Thomas

Julia Kunlo is a Certified Safety Professional (CSP) with a Master’s Degree in Occupational Safety and Health. She is an authorized OSHA Outreach Trainer in Construction and General Industry. As the President of Evolution Safety Resources, she leads a team of more than 40 safety professionals nationwide.

As the old saying goes, an ounce of prevention is worth a pound of cure. But incidents can happen even when preventative measures are taken.

When it comes to rescue training for ironworkers, the first thing that usually comes to mind is rescuing personnel from falls. However, there are many other safety awareness topics that warrant rescue training —including response to heat illness and mental health crises. Time is of the essence, whether you are talking about retrieving a worker from a fall, treating someone suffering from heat illness, or responding to indications that someone is having a mental health emergency. Providing workers with training on how to respond to these situations can contribute to better outcomes to injured and vulnerable workers.

Response to a Fall

Falling is one of – if not the most crucial – hazard associated with steel erection. Working at height is a high risk activity; the chance of falls are constant and almost imminent. While prevention and proper PPE usage is the priority, steel safety professionals understand that a rescue plan is a mandatory component of all safety programs. Rescue training equips workers with the knowledge necessary to respond effectively and gives them the skills necessary to respond promptly and properly after a fall.

For any emergency rescue situation on the jobsite, knowledge of basic first aid can be critical. Before providing first aid or CPR to an injured person, assess the situation to make sure the area is safe and that the person requires assistance. Call 911 and stay

Emily Thomas has a Master’s Degree in Linguistics, specializing in producing Occupational Safety and Health content. As a technical author, she creates safety manuals, standard operating procedures, and training materials. She is an active participant in the National Association of Women in Construction (NAWIC).

with the person until help arrives. Check for any visible injuries, like bleeding, loss of consciousness, burns, or broken bones. Check that the person is breathing and ensure that their airway is open. Begin CPR if necessary and if you are trained to do so. If the person is injured due to a fall from height, ensure that they do not move until a medical professional arrives.

In the event of a fall, the first step should be to calmly assess the situation to determine the appropriate rescue method. If the worker is able, they should initiate self-rescue techniques, like deploying trauma straps to prevent suspension trauma. If possible, they should locate a nearby structure (such as a ladder, scaffold, or platform) that they can reach safely, and use their fall protection lanyard or rope to pull themselves towards it and climb to a secure position.

When self-rescue isn’t an option, the supervisor in charge of the jobsite should determine the best rescue method, assessing hazards present and equipment available to assist in rescue procedures. Equipment used for fall rescues can include ladders,

mobile elevated work platforms (MEWPs), ropes, and rescue kits with retrieval systems.

It is important to maintain communications with the fallen worker to keep them calm and to monitor their condition. Whether raising or lowering the worker to safety, these workers are advised to use slow, steady movements to prevent further injury. Anyone who falls should be given prompt medical attention. Suspension trauma can have delayed effects, so it’s important to have a medical professional examine the person for any possible injuries. Even those who survive the “immediate” risks of a fall are still at risk for longer term health hazards such as cardiac arrest, blood clots, heat stress and mental health concerns.

New Focus on Heat Exposure

The number of people who have died from heat-related illnesses has increased steadily over the years; according to the Department of Health and Human Services, 2,302 people died from heat-related causes in 2023, up from 1,722 deaths in 2022 and 1,602 deaths in 2021. Earlier this year, OSHA released a proposed rule on Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings. If implemented, the standard would apply to all employers and be triggered when employees are exposed to temps of 80 degrees F for more than 15 minutes in a one-hour period.

When preventative measures fail, knowledge of heat illness rescue procedures can save a life. The first step is to recognize and identify the symptoms of heat illness and heat exhaustion before they progress into heat stroke. The symptoms of heat exhaustion

include sweating, cold and clammy skin, fast and weak pulse, nausea or vomiting, dizziness, and headaches. The symptoms of heat stroke include body temperatures above 103° F, red, dry or damp skin, a rapid and strong pulse, confusion, nausea, headaches, and loss of consciousness. These conditions are even more likely to exist when workers are exposed to intense factors of stress, increasing heart rate and perspiration in situations when dehydration may already be present.

Helpful Tip:

At the first sign of heat exhaustion, the victim should be moved to a cool area and given cool water to drink. If heat exhaustion symptoms don’t improve, or the victim shows signs of heat stroke, contact emergency services immediately. While waiting for help to arrive, place the worker in a cool, shaded area and fan or mist them with cool water. Loosen any heavy or tight clothing and provide fluids (preferably cool water) as soon as possible.

Helpful Tip:

If you notice the signs of crisis in a coworker, it is recommended that you talk about your concerns in a one-on-one conversation. Describe the specific behaviors you have noticed, and tell the person that you are concerned about them. Acknowledge the difficulties that the person is facing and ask them how they’re feeling.

Share ideas for how to get help. Resources include Employee Assistance Programs (EAPs), calling 988 (the suicide hotline), local counseling services, and various organizations like The Partnership for Workplace Mental Health and Working Minds.

Mental Health Matters

Another frequently neglected form of rescue training is mental health crisis response. Mental health crises can be varied, and can include self-harm, suicide, and harm to others. According to the CDC, construction workers are four times more likely to commit suicide than workers in other industries.

There are a wide variety of factors that can contribute to mental health crises for construction workers, including high-stress work environments, high rates of on-the-job injuries, physically demanding work, and lack of resources for support. The stress caused by a fall, combined with the stress created during the period awaiting rescue, is likely to trigger mental health concerns in those involved and those who are previously disposed to mental health instability.

This year, Construction Suicide Prevention Week is September 9-13. Using this week to create awareness, provide training on identifying signs of crisis, and how to respond is a good first step. Warning signs can be verbal, emotional, or behavioral. Visit constructionsuicideprevention.com for tool box talk topics.

Act Decisively

Whether the crisis is a fall, heat illness, or mental health crisis, a prompt response can be the difference between life and death. Supervisors should be prepared to respond by calling 911 (or 988 for mental health help) and providing basic first aid until help arrives. Regular training for emergency response can keep workers calm in the face of an emergency, and knowledge of basic first aid can help keep a victim stay alive while waiting for emergency services to arrive.

When workers are properly trained in rescue techniques, they can act swiftly and confidently in emergency situations. Rescue training ensures that everyone on the jobsite understands their role during an emergency, reducing confusion and panic when quick, decisive action is required. •