Emergency Rescue Planning for Work at Height

If someone falls while working at height and is left suspended in fall arrest equipment, you have minutes — not hours — to rescue them. Without a proper rescue plan, what should have been a prevented injury can become a fatality.

Why rescue planning is required

Emergency rescue planning is a legal requirement under the Work at Height Regulations 2005. If you use fall arrest equipment (harnesses and lanyards), you must have a documented rescue plan before work begins.

The regulation states:

Employers must ensure that persons have sufficient information, instruction and training to enable them to use work equipment safely, and to ensure prompt and effective rescue in an emergency.

Why this matters:

When someone falls and is arrested by a harness, they're left suspended in mid-air. Even though they haven't hit the ground, they're in immediate medical danger from suspension trauma (also called harness hang syndrome).

Suspension trauma timeline:

• 0-5 minutes: Discomfort, difficulty moving
• 5-15 minutes: Blood pooling in legs, reduced circulation to vital organs
• 15-30 minutes: Risk of unconsciousness
• 30+ minutes: Risk of death from cardiac arrest or organ failure
• After rescue: Risk of fatal complications if not handled correctly

When a rescue plan is required:

Mandatory situations:

• Any use of personal fall arrest equipment (harnesses and lanyards)
• Work on roofs with fall arrest systems
• Rope access work
• Working in confined spaces at height
• Any work where someone could fall and become suspended or trapped

Recommended situations:

• Scaffolding work (what if someone is injured on a high platform?)
• MEWP operations (what if the controls fail?)
• Ladder work in remote locations (what if someone falls and is injured?)
• Any work at height in isolated areas

Work at Height Regulations 2005 requirements

The regulations are clear about rescue planning responsibilities:

Duty to plan and organize (Regulation 4)

Employers must ensure work at height is:

• Properly planned — including emergency procedures
• Appropriately supervised — with competent oversight
• Carried out safely — with prompt rescue available

Duty to provide information and training (Regulation 8)

Workers must:

• Be informed of emergency procedures
• Receive training in emergency response
• Understand how to raise the alarm
• Know their role in rescue operations

Duty regarding personal fall protection systems (Schedule 5)

Where fall arrest equipment is used:

• Rescue plan must exist before work begins
• Rescue equipment must be available on-site
• Personnel must be trained in rescue procedures
• Regular practice drills must be conducted

Types of rescue situations

Rescue planning must consider different scenarios and the methods available to respond.

Situations requiring rescue:

Fall arrest activation:

• Worker falls and is suspended in harness
• Unable to self-rescue
• Suspension trauma developing
• Most time-critical — rescue needed within 20 minutes

Injury at height:

• Worker injured on platform, scaffold, or roof
• Conscious but unable to descend safely
• May require medical treatment before moving
• Needs assistance to reach ground level

Medical emergency:

• Heart attack, stroke, or other sudden illness
• Worker unconscious or incapacitated
• May need emergency medical access at height
• Requires rapid evacuation for treatment

Equipment failure:

• MEWP breakdown with worker trapped in basket
• Scaffold collapse with worker stranded
• Ladder failure leaving worker on roof
• Access route blocked or damaged

Environmental hazards:

• Fire or toxic atmosphere developing
• Structural collapse risk
• Flooding or weather emergency
• Immediate evacuation required

Types of rescue

There are three main categories of rescue, and your plan should specify which methods apply to your work.

1. Self-rescue

The worker rescues themselves without external assistance.

Methods:

• Descent devices: Using a self-rescue descender attached to the anchor or lanyard to lower oneself to safety
• Trauma relief straps: Deploying foot loops built into the harness to stand up and relieve leg compression
• Climbing back up: Using assisted climbing devices to ascend to a safe platform
• Moving to safety: Shuffling along a lifeline to reach a secure area

Advantages:

• Fastest response (immediate)
• No waiting for help
• Reduces suspension trauma risk
• Worker maintains control

Limitations:

• Requires specific equipment (descent devices, trauma straps)
• Worker must be conscious and capable
• Needs training and regular practice
• May not be possible if injured or panicked
• Not suitable for all work situations

When self-rescue is appropriate:

• Workers trained and equipped with self-rescue devices
• Regular work at height in the same location
• Solo workers who cannot rely on immediate assistance
• Low-risk environments where injury from fall is unlikely

2. Assisted rescue

Co-workers or supervisors perform the rescue using equipment and training.

Methods:

• Lowering systems: Using rope and descent devices to lower the casualty from above
• Raising systems: Using mechanical advantage systems to lift the casualty to a platform
• Lateral retrieval: Pulling the casualty horizontally to a safe area
• Rescue from adjacent structure: Accessing the casualty from scaffolding, MEWP, or ladder

Requirements:

• Rescue equipment on-site: Ropes, descenders, pulleys, stretchers, backup harnesses
• Trained rescue personnel: At least 2 people trained in rescue procedures
• Immediate availability: Rescuers must be on-site and able to respond within minutes
• Communication: Reliable way to raise alarm and coordinate rescue

Advantages:

• Faster than waiting for emergency services
• Tailored to your specific work environment
• Rescuers familiar with site and equipment
• Reduces suspension trauma risk

Limitations:

• Requires dedicated training and equipment
• Personnel must be available on-site
• Regular practice needed to maintain competence
• May not be suitable for complex or high-risk rescues

When assisted rescue is appropriate:

• Multiple workers on-site during all work at height
• Work location allows access for rescuers
• Company can provide training and equipment
• Work duration justifies the preparation

3. Technical rescue (emergency services)

Fire and rescue service or specialist rescue teams respond.

When to rely on emergency services:

• Short-duration work where on-site rescue team not practicable
• Public areas where emergency services have rapid access
• Complex rescues requiring specialist equipment
• Backup plan when on-site rescue fails or is unsafe

Important considerations:

Response times:

• Urban areas: 10-20 minutes typical
• Rural areas: 30+ minutes possible
• Problem: Suspension trauma can be fatal within 20-30 minutes
• Solution: Fire service response may be too slow to prevent suspension trauma injury or death

Fire service capabilities:

• Trained in technical rope rescue
• Equipped with ladders, platforms, rescue equipment
• Medical first aid capability
• BUT: May not be familiar with your specific site or equipment

Coordination requirements:

• Call 999 immediately when fall occurs
• Provide clear location and access information
• Have site contact waiting to guide emergency services
• Secure area and keep access routes clear
• Provide information about casualty and equipment

Choosing the right rescue method:

Your rescue plan may include multiple methods:

Hierarchy of rescue (best to worst):

1. Self-rescue with trauma relief — worker deploys foot loops to stand and relieve pressure while awaiting rescue
2. Self-rescue descent — worker uses descender to lower themselves to safety
3. Assisted rescue by trained on-site team — co-workers execute rescue within 5-10 minutes
4. Emergency services rescue — fire and rescue service responds (may take 20+ minutes)

Best practice: Your primary plan should achieve rescue within 10 minutes maximum, with emergency services as backup only.

What a rescue plan must include

A rescue plan is a documented procedure that explains how someone will be rescued if they fall or become stranded at height.

Essential components:

1. Scope and scenarios

Define:

• What work activities are covered
• What rescue scenarios are anticipated (fall arrest, injury, equipment failure)
• Which rescue methods will be used
• When emergency services will be called

Example scope statement:

This rescue plan covers all work using personal fall arrest equipment on the warehouse roof. Primary rescue method is assisted rescue by on-site trained team. Self-rescue equipment provided as immediate relief. Emergency services called immediately as backup in case on-site rescue is not successful.

2. Roles and responsibilities

Clearly assign:

• Primary rescuers — names and contact details
• Backup rescuers — if primary unavailable
• Emergency coordinator — person who calls 999 and manages overall response
• First aider — medical support after rescue
• Site controller — manages access for emergency services

Important: Named individuals must be on-site during all work at height. If they're absent, work must not proceed or alternative arrangements made.

3. Equipment and location

List all rescue equipment:

• Self-rescue descenders (if used)
• Trauma relief straps (if fitted to harnesses)
• Rescue ropes and lengths
• Descent devices and pulleys
• Backup harnesses for rescuers
• First aid kit and blankets
• Communication equipment (radios, phones)
• Stretcher or evacuation equipment

Storage location:

• Where is rescue equipment stored?
• How quickly can it be accessed?
• Who has keys or access?
• Is it clearly marked and identifiable?

Inspection status:

• All rescue equipment must be inspected regularly
• Record inspection dates
• Remove defective equipment immediately
• Maintain spare equipment

4. Step-by-step rescue procedure

Document the exact sequence:

Example assisted rescue procedure:

Step 1: Immediate response (0-2 minutes)

• Worker raises alarm (shouts, radio, phone)
• Primary rescuer responds immediately
• Emergency coordinator calls 999
• Work area secured, bystanders cleared

Step 2: Casualty assessment (2-3 minutes)

• Communicate with casualty (conscious? injured? can you deploy trauma straps?)
• Instruct casualty to deploy trauma relief straps if able
• Assess suspension point and access options
• Decide rescue method (lower from above, raise to platform, lateral retrieval)

Step 3: Rescue setup (3-5 minutes)

• Collect rescue equipment
• Rescuers don harnesses and attach to independent anchor points
• Set up lowering system or raising system
• Attach backup line to casualty

Step 4: Rescue execution (5-10 minutes)

• Attach descent device or haul system to casualty
• Communicate throughout the process
• Lower or raise casualty to safe ground level
• Control descent speed, avoid swinging or impacts
• First aider ready to receive casualty

Step 5: Post-rescue care (10+ minutes)

• Lay casualty down carefully (DO NOT stand them up immediately — risk of reflow syndrome)
• Monitor vital signs
• Keep warm, reassure, and monitor
• Hand over to paramedics when they arrive
• Record incident details

Step 6: Post-incident

• Do not resume work until investigation complete
• Preserve equipment for inspection
• Report to HSE if serious injury or dangerous occurrence
• Review rescue plan effectiveness and update if needed

5. Communication procedures

Raising the alarm:

• How will a fallen worker alert others? (shout, radio, alarm)
• What if they're unconscious?
• Who monitors lone workers?

Emergency services:

• What's the exact address and access information?
• What3words location for remote sites
• Who will meet and guide emergency services?
• What information will you provide? (height, equipment type, injuries)

Internal communication:

• How do rescuers communicate during the rescue?
• How are other site personnel notified?
• How do you prevent others entering the danger area?

6. Training and competence

Document:

• Who has been trained in rescue procedures?
• What training have they received and when?
• When is refresher training due?
• What drills have been conducted?

Training requirements:

• Understanding of suspension trauma
• Use of rescue equipment
• Anchor point selection for rescue
• Rope work and descent systems
• First aid for suspended casualties
• Communication during emergencies

7. Emergency services integration

Pre-planning with fire and rescue:

• Some fire services offer site familiarization visits
• Provide maps and access information in advance
• Agree on liaison and communication procedures
• Understand their capabilities and response times

On the day:

• Call 999 immediately (don't wait to see if on-site rescue works)
• Provide clear information: "Worker suspended in fall arrest harness, 10 metres high, conscious, warehouse roof at [address]"
• Have someone waiting to guide them in
• Don't cancel them until casualty is safely on ground

Suspension trauma and first aid

Understanding suspension trauma is critical for rescue planning and post-rescue care.

What is suspension trauma?

When a person is suspended upright in a harness after a fall, gravity causes blood to pool in the legs. The leg veins act like a reservoir, holding blood that cannot return to the heart efficiently.

What happens:

1. Blood pools in legs — venous return to heart reduced
2. Reduced cardiac output — heart doesn't have enough blood to pump
3. Drop in blood pressure — brain and organs don't get enough oxygen
4. Loss of consciousness — brain oxygen deprivation
5. Cardiac arrest — heart can't maintain circulation
6. Death — within 20-60 minutes in severe cases

Risk factors that accelerate suspension trauma:

• Being completely immobile (unconscious or injured)
• Hot weather (dehydration)
• Tight harness fit restricting circulation
• Pre-existing heart or circulatory conditions
• Lack of trauma relief measures

Trauma relief straps

Built-in foot loops that deploy from the harness.

How they work:

• Worker pulls loops down from harness
• Steps into loops to create standing position
• Weight transfers from leg loops to foot loops
• Relieves pressure on leg veins
• Restores some circulation

Effectiveness:

• Can extend survival time from 20 minutes to 60+ minutes
• Gives rescuers more time to execute rescue safely
• Reduces risk of unconsciousness
• Simple to use, no additional equipment needed

Limitations:

• Worker must be conscious and capable
• Must be trained in deployment
• Still requires rescue — not a permanent solution
• Some harnesses don't have them (older models)

Post-rescue first aid

Critical: How you manage a casualty after rescue can determine survival.

DO:

• Lay the casualty down carefully as soon as they're on the ground
• Keep them horizontal for at least 30 minutes
• Monitor vital signs (breathing, pulse, consciousness)
• Keep them warm (blankets, shelter)
• Reassure and calm them
• Call 999 if not already done
• Stay with them until paramedics arrive

DO NOT:

• Stand them upright immediately after rescue
• Let them walk away (even if they feel fine)
• Remove harness immediately (unless medically necessary)
• Give food or drink (water only if conscious)
• Leave them alone

Reflow syndrome (rescue shock)

When blood that's been pooled in the legs suddenly returns to circulation, it can cause:

• Drop in blood pressure
• Cardiac arrhythmia
• Shock
• Loss of consciousness
• Cardiac arrest

This is why you must lay the casualty down immediately and keep them horizontal.

Medical handover: When paramedics arrive, provide:

• How long they were suspended
• Whether trauma straps were deployed
• Consciousness level during suspension
• Any injuries from the fall
• Vital signs you've observed
• Medical history if known

Testing and drills

A rescue plan that hasn't been tested is just paperwork. Regular drills are essential to ensure:

• Equipment is present and functional
• Personnel know their roles
• The plan actually works in practice
• Timings are realistic
• Gaps and problems are identified

How often to conduct rescue drills:

Frequency recommendations:

• Before first use of a new rescue plan
• Monthly for high-risk or frequent work at height
• Quarterly for regular work at height
• Annually minimum for occasional work at height
• After any changes to personnel, equipment, or work location
• After any incident or near-miss involving work at height

Types of drills:

Desktop exercises

What: Talk-through of the rescue plan with team

How:

• Gather rescue team
• Present a scenario (e.g., "Worker has fallen and is suspended 8 metres up, conscious but injured")
• Team talks through each step
• Identify who does what, in what order
• Discuss equipment, timings, and decision points

Benefits:

• Quick and low-cost
• Good for new team members
• Identifies gaps in knowledge
• Can be done frequently
• No equipment setup required

Limitations:

• Doesn't test physical capability
• Doesn't identify equipment problems
• Doesn't give realistic timings
• Not a substitute for practical drills

Practical rescue drills

What: Full-scale practice of the rescue procedure

How:

• Set up realistic scenario (use dummy or volunteer in harness at height)
• Raise the alarm as per plan
• Execute rescue procedure from start to finish
• Time each phase
• Observe and record what happens
• Debrief afterward to identify improvements

Benefits:

• Tests the plan in realistic conditions
• Identifies equipment problems (missing items, wrong sizes, defects)
• Builds muscle memory and confidence
• Reveals realistic timings
• Highlights communication issues
• Provides training value

Requirements:

• Safe setup (rescuers wearing harnesses, secure anchor points)
• Competent observer to supervise
• Rescue dummy or volunteer (max 80kg)
• All rescue equipment
• Timing equipment
• Debrief and record findings

Frequency: At least annually, more often for high-risk work

Unannounced drills

What: Surprise activation of rescue procedures

How:

• Without warning, simulate an alarm (radio call, shout for help)
• Observe how quickly team responds
• Test if they know where equipment is
• See if they follow the procedure correctly
• Identify complacency or forgotten steps

Benefits:

• Most realistic test
• Identifies real-world readiness
• Tests response time honestly
• Reveals gaps in competence

Considerations:

• Must be done safely (don't create actual hazards)
• Brief participants afterward
• Use to identify training needs, not to punish

Recording and learning from drills:

After every drill, record:

• Date and participants
• Scenario tested
• What went well
• What went wrong or was unclear
• Timing for each phase
• Equipment issues identified
• Actions to improve the plan
• Date for next drill

Use drill results to:

• Update the rescue plan
• Identify training needs
• Improve equipment or positioning
• Adjust timings or procedures
• Recognize good performance

Common rescue planning mistakes

1. Assuming emergency services are the rescue plan

The problem:

• Fire service may take 20+ minutes to arrive
• Suspension trauma can be fatal within 20 minutes
• Remote locations may have even longer response times

The solution:

• On-site rescue capability for all fall arrest work
• Emergency services are backup only, not primary plan
• If you can't rescue within 20 minutes, don't use fall arrest equipment

2. No rescue equipment on-site

The problem:

• Rescue equipment locked in van or off-site
• Wrong equipment or incompatible components
• Defective equipment not replaced

The solution:

• Rescue equipment stored at the work location
• Pre-checked and ready to deploy within minutes
• Regularly inspected and replaced when needed

3. Untrained or absent rescuers

The problem:

• Named rescuers not actually on-site
• Workers assume someone else knows how to rescue
• No one practiced the procedure

The solution:

• Confirmed presence of trained rescuers before work starts
• If rescuers absent, work doesn't proceed
• Regular training and refresher drills

4. No plan for unconscious casualties

The problem:

• Plan assumes casualty can help (deploy straps, communicate)
• What if they're unconscious from head injury?
• More complex rescue procedure needed

The solution:

• Plan for worst case — unconscious, injured casualty
• Practice rescuing deadweight (use rescue dummy)
• Additional equipment or personnel may be needed

5. Rescue plan not specific to the site

The problem:

• Generic plan copied from template
• Doesn't account for actual heights, access, anchor points
• Rescue method specified isn't actually possible at the location

The solution:

• Site-specific rescue plan for each location
• Test the plan at the actual site
• Update plan when site conditions change

6. Ignoring suspension trauma timeline

The problem:

• Plan assumes rescue can take 30-60 minutes
• No urgency built into procedures
• Trauma relief not included

The solution:

• Target: rescue within 10 minutes
• Trauma relief straps on all harnesses
• Time your drills to ensure realistic expectations

Frequently asked questions

Next steps

If you use fall arrest equipment, developing and testing a rescue plan should be your immediate priority.

Start by:

1. Assessing your rescue needs — what scenarios could occur, what timescale is realistic, what methods are appropriate?
2. Assigning rescue roles — who will be trained and available for rescue duties?
3. Acquiring rescue equipment — what's needed for your chosen rescue method?
4. Training your team — formal rescue training for designated rescuers
5. Documenting the plan — written procedure with roles, equipment, and steps
6. Testing with drills — practice at least quarterly to ensure the plan works

Tools and templates:

Rescue Plan Template →

Working at Height Risk Assessment →

If you're not sure where to start or need help developing a site-specific rescue plan:

Related articles:

• Do I Need Fall Protection?
• What is Working at Height?
• Ladder Safety Guidance

Useful tools:

• Risk Assessment Tool
• Emergency Planning Tool