A.G.R.O. Suspension Team Procedural Protocols

The following hook placement, removal and clean-up protocols have been developed by A.G.R.O. team leaders to ensure personal safety, an optimal suspension experience, and maximum efficiency. Anyone working with A.G.R.O. during meets or special events will be expected to follow these protocols at all times.
Your cooperation is appreciated!

Standard Procedure for Placement of Suspension Hooks

_ 1. Wash your hands!

2. Don nitrile gloves, wipe down procedure tray (Mayo tray) with hard surface disinfectant, and let sit for manufacturers stated duration to achieve effectiveness.

3. Change gloves and drape any areas that will be used for piercing with disposable covers (procedural tray with tray cover, chair with drape cloth, etc).

4. Set-up your tray with all necessary items for procedure as best to suit your needs. This set up should include, but is not limited to: sterile prep-pack, sterile hooks, sterile needles.

5. Open sterile prep-pack completely. Apply a small amount of Gentian Violet to the plastic see through side of the envelope. Remember, a little of this goes a long way! Also, apply a small amount of lube to the clear plastic side. Change gloves.

6. Apply germicidal skin prep to the area to be pierced. Apply the skin prep in a circular motion working from the center outward. Using a sterile paper towel, remove any excess skin prep. Change gloves.

7. Using a sterile tooth pick and Gentian Violet mark the placement for the hooks. Once all marks have been made, change gloves.

8. Have the suspendee sit or lie on designated chair/table that has already been draped with a disposable barrier drape cloth.

9. Pinching the tissue marked in between your thumb, index, and middle finger, roll the tissue back and forth, lightly pulling up. This is to help in the separation of the tissue from underlying structures such blood vessels, muscles, and nerves. THIS STEP SHOULD ALWAYS HAPPEN!!

10. Once you feel the tissue is ready to be pierced place the hook and needle in your hand in the most ergonomic way for you. Using the opposite hand pinch and roll tissue to place it in the best position to hit both marks on the skin.

11.Once you are in a good position to do your piercing say, “SET!” that way everyone knows you are ready to do your piercing. Once everyone has said “SET!”, the person in charge of the piercing crew will have the suspendee take in a deep breath. On the suspendee's exhale, the piercing will be done as quickly and accurately as possible. This should be done with a smooth yet forced push.

12. When every hook has been sank into place, the needles will be taken to the sharps container one at a time. There is no need to crowd, as to prevent needle sticks!

13. After all needles have been disposed of, designated persons will place shackles on the eyes of the hooks. One designated person will dispose of used paper products, etc and will wipe down the procedure tray & chair/table used with hard surface disinfectant in preparation for the next procedure. All others will remove their gloves, and WASH their hands.

14. Once all shackles are put into place, one designated gloved person will escort the suspendee to the suspension rig, and will stay with the suspendee until their suspension is complete. Your duties during the suspension are to make sure that all gross amounts of blood are controlled from the piercing wounds (this is commonly referred to as “working bio on the floor”). Once the suspension is complete you will be responsible for the suspendee getting back the the cleanup area.

Standard Procedure for Hook Removal
and Bio Clean-up/Containment

_ 1. Immediately following a suspension- SINK HOOKS and bring the suspendee to clean-up area, DIRECT the suspendee to where you want them to go (sit in a draped chair or stand here, etc...)

2. If there is running blood, CONTROL BLEEDING asap w/dry sterile towel and light pressure to avoid getting it on floor, all over them, etc. You can remove the hooks if it helps, or leave them in. Always use sterile towels on all openings in the skin. Regular towels can be used on places where the blood has run down, but only where there is no open skin (back, hips, legs, etc).

3. If you have not done so yet, REMOVE HOOK (drop directly into hook box). If the blood is dried onto the hook, use a direct application of surgical scrub or saline to loosen the dried blood and facilitate quick removal.

4. Next you will need to cover the opening, and BURP out any air and excess blood that has pooled under the skin. You can do these one hook/area at a time. Burping will ensure that the suspendee doesn't come back 20 minutes later with blood running out from under the bandage. This will also help ease the amount of soreness they feel the next day. DO NOT skip this step! It is included to maximize efficiency.

5. CLEAN UP ENTIRE AREA with surgical scrub, as well as any nearby areas that have dried blood. The idea is to get ALL of the blood off of them- even if it has run down the entire back! Never send your suspendee out into an event venue with blood flaking off onto everything they come into contact with.

6. RINSE AREA WELL! Use a saline saturated towel to wipe off all surgical scrub and blood residue. If you do this right- you may not need an alcohol swab, unless they are very hairy- the hair tends to hold the moisture and soapy surgical scrub to the skin, making bandage adhesion brief if not impossible. If you think alcohol is necessary to save a bandage, then go for it. Alcohol swabs are cheaper than repeat bandaging.

7. Thoroughly pat the area DRY using a sterile dry towel.

8. Change gloves and BANDAGE appropriately. If they bled a lot, then expect they may do it more and use a bandage with a larger gauze section, or add a sterile non-stick gauze under a tegaderm style bandage. If they bled very little, then use a smaller bandage.


There are a few IMPORTANT POINTS to remember when wroking in the clean-up area:

- NEVER bring contaminated towels, etc back to the work table!!!
  N E V E R!!!

It's just like in the piercing station...after we use a needle, we DO NOT put it back on the tray. It goes straight to the bio-hazard container. Anything you use on a bloody person should go one of two places: bio-hazard or trash. It's optimal to go from less contaminated to more contaminated, but never the other way.

-NEVER use a non-sterile item on an opening in the skin.

-Always wear your full PPE (personal protective equipment).

-Always cover openings in the skin when applying pressure.