Almost fainted while assisting in surgery

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kool-beans

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Hi everyone,

So I've been on a surgery rotation for a while now (but it's my first clinical year) and I've really enjoyed it so far - it has led me to think that I'd like to do something surgical in the future as a career path (didn't like general med very much). I've been spending a bit of time in theatre just watching, and never really felt squeamish.

Then today I was hanging around outside hoping to go in and watch, but the surgeon asked if I wanted to scrub in and assist. So I agreed even though I didn't really feel prepared and I was quite terrified. It's all going fine but next minute, there I am holding the incision open, and all of a sudden I have this moment of like "oh f*** what the f*** am I doing" and I started to feel light headed. Didn't really want to pass out into the sterile field so I acted early and told them that I needed to step out.

I put it down to how anxious I felt. Don't know if this is normal. I wasn't that grossed out I don't think. I don't have an issue with the smell of the diathermy, and I had eaten not too long before. Maybe I hadn't had enough water.

Anyway I was pretty embarrassed and I'm a bit disheartened that I should forget about wanting to do anything surgical. I've had this issue before - nearly fainted while watching suturing under local anaesthetic twice (don't cope well with seeing people in pain). But then I did an excision biopsy and stitched it up with no problem and never felt faint with cadavers. So not really sure what the issue is?

Is this the kind of thing you get used to?

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Judging from the number of people who immediately told me what to do if I thought I was going to faint when they heard I was on my first week of surgery, this is super common. Don't stress it.
 
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Hi everyone,

So I've been on a surgery rotation for a while now (but it's my first clinical year) and I've really enjoyed it so far - it has led me to think that I'd like to do something surgical in the future as a career path (didn't like general med very much). I've been spending a bit of time in theatre just watching, and never really felt squeamish.

Then today I was hanging around outside hoping to go in and watch, but the surgeon asked if I wanted to scrub in and assist. So I agreed even though I didn't really feel prepared and I was quite terrified. It's all going fine but next minute, there I am holding the incision open, and all of a sudden I have this moment of like "oh f*** what the f*** am I doing" and I started to feel light headed. Didn't really want to pass out into the sterile field so I acted early and told them that I needed to step out.

I put it down to how anxious I felt. Don't know if this is normal. I wasn't that grossed out I don't think. I don't have an issue with the smell of the diathermy, and I had eaten not too long before. Maybe I hadn't had enough water.

Anyway I was pretty embarrassed and I'm a bit disheartened that I should forget about wanting to do anything surgical. I've had this issue before - nearly fainted while watching suturing under local anaesthetic twice (don't cope well with seeing people in pain). But then I did an excision biopsy and stitched it up with no problem and never felt faint with cadavers. So not really sure what the issue is?

Is this the kind of thing you get used to?

Totally common. It happened to me for the same reason.

First surgery: assist on an orchiopexy and the patient jerked a little. My knees locked. Tunnel-vision. Mouth dry. "Ah crap." Luckily, the circulating nurse figured out what was going on, popped a chair behind me, insisted I sit, and wheeled me to safety. The surgeon just lawld.

Yesterday: assist on an extensive debridement for bilateral lower limb necrotising fasciitis. The medial thighs and genitalia ended up looking like a page from Netter's. Met the family prior to surgery too. It was sad, awful, and smelled worse than you could imagine. But we just soldiered on... and then the poor MS3 bolted from the room. Everybody lawld (including me). It's just how it goes. Everybody knows what's up.

It will get better.

Practical tips: drink water, eat when you can, bend your knees, pump your calves and loosen the bottom part of your mask. Air should flow along the underside of your chin. It helps a surprising amount.
 
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Best advice: wear a lot of padding, it'll make you a more comfortable standing stool for whomever comes in to help assist. Cheers.
 
Practical tips: drink water, eat when you can, bend your knees, pump your calves and loosen the bottom part of your mask. Air should flow along the underside of your chin. It helps a surprising amount.
There's the info you need right there. Over time you start to recognize when it has the potential to happen. For instance if you forgot to eat, didn't sleep well, or if the room is hot. Before every case go to the break room and pregame with some fluids and carbs. As the previous poster said, keep your knees moving and stay relaxed. However if you do feel it coming on then get out in front fast. Smooth breathing, relax, move your knees, and positive self talk to reestablish control.

My first time almost passing out I was just along for the ride. I felt it coming, DDDABDA, then asked to scrub at the last minute. If I had waited any longer I don't think my speech would have been comprehensible. Now if it ever does start, despite my preparation, I can manage it using the techniques listed above.
 
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I don't think it's that uncommon. You'll probably get used to it. as other's have said no straight knees, be well hydrated. I'm not a surgeon but when I worked at an inner city trauma center (ER) I've seen multiple med students and a few off service residents faint during messy procedures, not really a big deal. but it is distracting so better if you can either step out or sit down.
 
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