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Blood and guts???

Discussion in 'Medical Students - MD' started by ppdka, Feb 26, 2001.

  1. I'm posting on the allopathic forum to try to get some input from current med students.

    I want nothing more than to become a doctor. However, I've experienced some negative psychosomatic reactions to carnage in the past (Lost conciousness while having my own blood drawn). That being said, I've watched video of an elbow reconstruction and an abdominal laporoscopic procedure without any ill effects. That being said, are there any ideas about desensitizing techniques that you may have and is this addressed in med school?

    Thanks in advance for any information that you may have...
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  3. turtleboard

    turtleboard SDN Advisor 10+ Year Member

    Jun 3, 1999
    New York, New York
    On an old episode of "Doogie Hoswer, MD" the young doctor told some student to think of blood as just "plasma, platelets, and cells." This apparently worked for the student, but I'm not sure if it has any real world applicability.

    In any event, I'd suggest watching more videos and attending live surgeries if given the chance. Everyone has a different threshold. I almost lost my lunch when we were shaving the cadavers' heads during Gross last year -- but didn't feel queasy at any other point during the course. Watching an elbow reconstruction and a lap procedure on tape isn't exactly the same thing as standing there and watching it live.

  4. I remember that episode!! Thanks for your advice, I really appreciate it. I know that watching something on tape isn't really like watching it live, but I don't know how to get that experience... How would one go about watching a live surgery??? Also, I have no idea of where my threshold is, so I don't want to smack the floor after someone is nice enough to let me watch them work....
  5. Cobragirl

    Cobragirl Hoohaa helper ;) 10+ Year Member

    Aug 18, 2000
    In residency HELL
    If you're anything like me, I wouldn't worry about your fainting spells too much. I've fainted during (actually AFTER) blood draws myself...I have NO problem watching them stick me, I have no problems watching the blood fill the bag, but for some reason, EVERY time it's over and done with, I get dizzy and faint (I tried to blame it on dehydration/lack of food the first couple of times, but since it's happened everytime now, it has to be something else). I think it's just something to do with it being YOUR blood! I've been a vet-tech for several years, been up to my elbows in blood & guts and NEVER, EVER had a problem with being queasy!!!! I don't get it either.... [​IMG]
  6. tussy

    tussy Senior Member 10+ Year Member

    Feb 12, 1999
    What you've experienced is extremely common (even among med students) and is called the "vasovagal reflex" . When you see blood, you experience increasee parasympathetic activity (via the vagus nerve), you vasodilate, dropping your blood pressure and you feel cold, sweaty, dizzy, lose your vision, and may even pass out.

    Good news - you do desensitize to it with increased exposures. My first day of clerkship I was in the OR and fainted. Luckily for the patient I had the good sense to fall backwards rather than into his open abdomen. Bad news for me because my head bounced off the very hard OR floor (ouch). Also, I almost fainted the first time I put in a chest tube! Where am I now? Applying for a surgery residency that's where. I never feel faint in the OR any more. Many of my classmates have had similar experiences, and they too found that they got less woozy with experience.

  7. Starflyr

    Starflyr Manic Faerie 10+ Year Member

    Apr 11, 2000
    Dickinson, Tx
    Well, from my (not having started med school yet) observations of friends who also have the same issue with blood etc, people can faint/be queasy/etc at the site of their own blood, but be perfectly fine with other people's. Other people are the other way 'round, and yet others just cant stand blood at ALL.
    I guess Im one of the lucky ones who just is naturally immune to such things - except during an autopsy if they have to get eyeball fluid for analysis and when they remove the vocal cords (ick...::shudder: [​IMG].

    Anyways, Id suggest what others have suggested too - go see actual surguries, etc to see where you're at. And Ive heard its true also that you get desensitized pretty quickly...

    just my 2 cents..
  8. roo

    roo Voice From The Wilderness 10+ Year Member

    Nov 16, 2000
    I agree that for some, there is something different of blood being drawn from one's body vs. everything else. About 1 out of every 3 times that my blood is drawn, the world will "white out" (just go lighter and lighter until it is almost a full white image). I am wise enough to wait until it goes away by resting supine.

    Nothing else even registers a blip on the radar: assisting invasive sugery, cadaver dissections with the portable saw, zip.

    I have wondered why the self-blood draw is the only one that induces an effect. There could be some Freudian stuff going on (I had alot of hospital stays when I was a very young child) or if its just a pure physiology from the blood loss.
  9. Kirk

    Kirk Senior Member 10+ Year Member

    Feb 20, 2001
    Kansas City
    I worried about giving an IV until i finally got the chance to do it. I didn't have enough pressure on the vein, and when I pulled out the needle, blood started pooring out the catheter- I grabbed the line and pushed it in and everything was cool. Talk about a major adreline rush... I was really shakey afterward, but luckily I didn't pass out.
  10. Is this "vasovagal reflex" some sort of defense mechanism when injured? I.e., Stimulus -> Increased Parasympathetic Activity -> Vasodialtion -> Lowered BP -> Decreased Rate of Blood Loss
  11. Djanaba

    Djanaba Senior Member 10+ Year Member

    May 4, 2000
    Minneapolis, MN
    I doubt it. Part of the body's job is to maintain vascular supply to the brain; too low BP isn't conducive to it in the least. It's odd what our higher centers (conscious brain) can do to the unconscious body!

    I, too, get lightheaded at the end of giving blood, but have less problems giving plasma. Since the volume lost in plasma donation is quite a bit more, I know it's not a purely physical cause. I also have had issues in surgery and watching certain procedures, but it has gotten better over time. (Last week's shoulder injection was ok.) When I am actively involved, either in the procedure or active, interested learning, or even distraction that's active, I'm fine. I love and hate the desensitization process all at once.
  12. I've addressed the topic of vasovagal reactions before, but some suggestions to help you survive it (if and when it happens):

    keep cool - don't bundle up in the OR, especially during Ortho cases where you might be wearing lead. Take off that t-shirt under your scrubs - nerves, warm ORs (especially for Trauma, Burns and Peds cases) and scrub attire can make you hot, so don't add to it with more clothes than necessary

    keep fed - don't go into the OR or anatomy lab hypoglycemic or having filled up on candy. Eat nutritiously and well (although don't eat too much - see above on heat capture) until you can handle it on an empty stomach (if you have to)

    keep moving - don't lock your knees while holding retractors. Besides preventing cramps and DVTs, moving about will make you more comfortable and less likely to keel over. Move your feet about, bend your knees, etc. - just don't drop that retractor!

    keep focused - mental preparation. Some never get used to "blood and guts" and some of us never get enough! Don't start focusing on what you're "doing to a person" but on the procedure, the anatomy, whatever makes you feel better. Looking at the suction bottle doesn't help!

    keep your feet and legs comfortable - TE stockings DO help as do comfortable shoes/clogs.

    Most importantly, KEEP EVERYONE INFORMED...if you feel like passing out, excuse yourself (early if you are holding a retractor or doing something vital in the ER/Gross Lab) and BACK AWAY. There is no shame in this. It happens all the time. If you heat up, ask the rotating nurse to mop your forehead (its hard to ask, as it seems so arrogant, but if it prevents you from passing out or going blind with sweat in your little eyeballs its worth it) or get you a wet towel down the back of your scrub gown.

    Prepare yourself and you'll find its survivable and perhaps even enjoyable. best of luck!
  13. Nurse2Doc

    Nurse2Doc Senior Member 10+ Year Member

    Oct 26, 2000
    I stick people multiple times in a 12 hour shift in a trauma unit, have seen traumatic amputations, a partial decapitation, a 12inch hunting blade buried into a man's skull 9 inches worth (& he lived to tell about it), and I won't even go into the horrifically mangled bodies of some of the motorcycle accident victims~~I STILL get woozy actually watching the needle go into ME~it is not the pain part (don't think I actually feel anything at that point for the lack of oxygen to the pain receptors in my brain)~I delivered a baby au naturale,no problem, I can't exlain it. There is just something surreal about that needle going into me. They had to use ammonia to bring me back around the first and last time I had stitches, and yet I held my 10 year old son while they reset a badly broken wrist and stayed in the room while they relocated his shoulder~Go figure. You will be fine as long as you are not your own worst patient.

    Some people look better with their clothes on!
  14. True that was a good episode. Plasma, platelets, and cells.

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