Dealing with shakes

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chadderdo21

chadderdo21

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Hey everyone
I have noticed a problem with myself that has shown up in the last couple of months that is really getting annoying. Sometimes in the past when I have been giving an injection or doing sutures or anything else with my hands, they tend to start to shake. It bothered me in OB/GYN and last month in ER quite abit. I do not know what may be causing it. I am not a coffee drinker and the caffeine I do consume is fairly light. Stress can get at me, but I am not sure if this has anything to do with it. Anyone else have this problem too?
 
chadderdo21 said:
Hey everyone
I have noticed a problem with myself that has shown up in the last couple of months that is really getting annoying. Sometimes in the past when I have been giving an injection or doing sutures or anything else with my hands, they tend to start to shake. It bothered me in OB/GYN and last month in ER quite abit. I do not know what may be causing it. I am not a coffee drinker and the caffeine I do consume is fairly light. Stress can get at me, but I am not sure if this has anything to do with it. Anyone else have this problem too?
Click to expand...

I shake a bit too, maybe not the amount you describe but enough to make it annoying trying to get subq sutures into a four-year-old for instance. I've found different ways of coping, like using my little finger as a base to steady the hand or adjusting my body and/or the patient to a more comfortable overall position. Also not a coffee drinker, but it does make a difference being well-hydrated and fed. Plus I think a lot of it is just fighting to establish some muscle memory, hoping we'll all get better with practice. Anyway, would love to hear other people's thoughts and strategies on this as well.

A completely different animal would be if you're say an experienced phlebotomist, no probs until recently started noticing the shaking. In that case it might be worth a discussion with your regular doc, a visit to student health, or someone that knows more than a paragraph about you.
 
Everyone's hands shake initially. It should get better with practice, unless you've got a resting/intention tremor.

For now, make sure your wrists are anchored on something when you're placing an IV, suturing, cutting, etc.
 
alphaholic06 said:
Not to hijack the thread, but does anyone have a problem with sweating?
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Not to continue hijacking the thread, but I have a huge problem with this in the OR. I am kind of a sweaty guy to begin with, but get me in there under those hot lights with all that crap on my head and a surgical gown and gloves, and I start sweating through my scrubs like immediately. Then it starts running down my face and making me feel like my glasses are going to slip off despite the croakies... even though they are already all fogged up from all the heat coming up through the neck of my gown... Argh... :meanie:
 
drfunktacular said:
Not to continue hijacking the thread, but I have a huge problem with this in the OR. I am kind of a sweaty guy to begin with, but get me in there under those hot lights with all that crap on my head and a surgical gown and gloves, and I start sweating through my scrubs like immediately. Then it starts running down my face and making me feel like my glasses are going to slip off despite the croakies... even though they are already all fogged up from all the heat coming up through the neck of my gown... Argh... :meanie:
Click to expand...

There are a couple of threads that address this specific issue.

If glass fogging is your only problem, then using tape to hold down your mask should do the trick. I just made sure to tie my mask tighter, and that worked for me (along with breathing through my mouth and exhaling "downward").

As for excess sweat... someone recommended dousing under armour with water (and I assume wringing it as well, unless you want to be totally drenched), then wearing it under your scrubs. There are scrub caps/headbands out there that can help absorb some of the sweat too.
 
Terpskins99 said:
There are a couple of threads that address this specific issue.

If glass fogging is your only problem, then using tape to hold down your mask should do the trick. I just made sure to tie my mask tighter, and that worked for me (along with breathing through my mouth and exhaling "downward").

As for excess sweat... someone recommended dousing under armour with water (and I assume wringing it as well, unless you want to be totally drenched), then wearing it under your scrubs. There are scrub caps/headbands out there that can help absorb some of the sweat too.
Click to expand...

Hmm, I will give some of these a try. Can you recall any of those threads in particular?
 
I have a small resting tremor in my hands which varies in intensity from day to day. I have found it useful, to do as others have suggested, to position yourself and the patient to your best advantage and resting your arm or hand on something. I find it is often enough just to rest my elbow on the bed rail or cot when suturing, intubating, dropping an NG, etc. This can be a bit more challenging when sterile technique is required. Good luck.
 
If it's really a problem for you, and your BP and HR can handle it, maybe you should go on a beta blocker. I have a friend who is a surgery intern who it worked wonders for
 
I had this problem as a student when I was nervous. One month one of the attendings decided to "help" me with this problem by standing beind me in the OR and going, "Stop shaking! Stop shaking!" That was nice.

I don't have much advice since I only shake when I'm nervous, and the nervousness goes away the more experience you get, so mine is pretty self-limited.

One thing I will say though: If you're drinking a lot of coffee or soda, stop. I've noticed a huge difference since I quit drinking caffeine on operative days.
 
Tired said:
I had this problem as a student when I was nervous. One month one of the attendings decided to "help" me with this problem by standing beind me in the OR and going, "Stop shaking! Stop shaking!" That was nice.

I don't have much advice since I only shake when I'm nervous, and the nervousness goes away the more experience you get, so mine is pretty self-limited.

One thing I will say though: If you're drinking a lot of coffee or soda, stop. I've noticed a huge difference since I quit drinking caffeine on operative days.
Click to expand...

I second the coffee/soda thing..caffeine gives me the WORST shakes.
 
Hmmm...not having caffiene gives me the shakes. I think I have a problem.
 
I've learned to stop drinking coffee during conference/Grand Rounds on the days before going to the OR.
 
I had a similar situation with shaking in med school. I was actually diagnosed with hyperthyroidism and once that was fixed I am now steady.
 
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