Feeling faint during invasive procedures--can this be overcome?

[PsychStudent]

I'm not sure if this is the right place to post this, but I definitely need some advice. I'm a premed and I volunteer on a pediatric floor. Yesterday a nurse asked me if I could assist in holding a 5-month-old baby still while she inserted an IV. I was really excited to some something semi-hands on, but after 10 mins of holding the baby while staring at the injection site (where the nurse was just digging into this poor, dehydrated baby's vein), I began to feel more and more faint and almost passed out. I didn't feel at all nervous or upset (just bad for the sweet, crying baby), so it really surprised me. Perhaps wearing a mask didn't help either because I couldn't breathe as deeply as normal.


The nurse was very nice to me and I put my head between my knees and drank some juice, but I was very embarrassed. Worse, I really want to be a doctor and do procedures (i.e. not do psych, path, etc). I watch a lot of medical shows with invasive procedures and have never had this reaction, although I often do feel dizzy when I myself am the patient in an invasive procedure (I've only gotten an IV twice, but became extremely dizzy both times).

Is there absolutely anything I can do about this? When I mentioned to the nurse afterwards that I was premed and was worried about what the dizziness meant as far as my ability to pursue that career, she told me it was no big deal and I would get over it. But how?

Thanks so much, and sorry this got so long!

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[psipsina]

use the search function, enter fainting, there is a wealth of great posts about this.

What happened to you is very normal and happens to alot of us, especially when we are just standing there, its hot, we feel for the patient, etc. Its a natural response, there are ways to get over it that you'll find in the huge threads already done about this. Don't worry, this isn't the end of your medical career or anything.

 

[mjl1717]

But I will confess Im basicallly healthy but when I did an anaesthsia (spelling?)
rotation.
While observing the anaesthiologist Im not sure if one of the gases or anaesthetics was escaping from a cannister but I for the first time EVER I had to walk out of the O.R. literally feeling like "Im about to faint" it was a very weird "passing out feeling" that I had. And I got to the outside of the O.R. just in the nick of time. .

 

[deleted89854]

1) Make sure you eat and drink water (coffee bad) before you go to work in the morning.
2) If you're standing around for a while (like in surgery). Make sure not to lock your legs and pump your calves every once in a while.
3) You'll get used to it.

 

[Catalystik]

1) Make sure you eat and drink water (coffee bad) before you go to work in the morning.
2) If you're standing around for a while (like in surgery). Make sure not to lock your legs and pump your calves every once in a while.
3) You'll get used to it.

And ingest more salt to assist retention of the fluids you drink, and thereby keep your blood pressure up.

 

[CCLCMer]

I'm not sure if this is the right place to post this, but I definitely need some advice. I'm a premed and I volunteer on a pediatric floor. Yesterday a nurse asked me if I could assist in holding a 5-month-old baby still while she inserted an IV. I was really excited to some something semi-hands on, but after 10 mins of holding the baby while staring at the injection site (where the nurse was just digging into this poor, dehydrated baby's vein), I began to feel more and more faint and almost passed out. I didn't feel at all nervous or upset (just bad for the sweet, crying baby), so it really surprised me. Perhaps wearing a mask didn't help either because I couldn't breathe as deeply as normal.


The nurse was very nice to me and I put my head between my knees and drank some juice, but I was very embarrassed. Worse, I really want to be a doctor and do procedures (i.e. not do psych, path, etc). I watch a lot of medical shows with invasive procedures and have never had this reaction, although I often do feel dizzy when I myself am the patient in an invasive procedure (I've only gotten an IV twice, but became extremely dizzy both times).

Is there absolutely anything I can do about this? When I mentioned to the nurse afterwards that I was premed and was worried about what the dizziness meant as far as my ability to pursue that career, she told me it was no big deal and I would get over it. But how?

Thanks so much, and sorry this got so long!

Yeah, like the other people said, you do get used to it. We use unpreserved cadavers at my school, and the sights and smells of some of them were rough on us at the beginning. Plus they bleed like crazy. But after you see them every week over and over, it stops affecting you as much. So I guess what I'm telling you is that the best way to desensitize yourself is to keep watching people start IVs on patients until it stops bothering you. And if you need to put your head down, do it sooner instead of later. It's infinitely better to feel a little faint than to crash to the floor.

 

[gary5]

You'll get used to it. In anatomy lab, if you pass out, they pick you up and you try again. Eventually, you'll stop passing out.

 

[Hurricane95]

I've never really had this problem before, for some reason it does not bother me, but from what I've heard, you do adapt to it after a while. What I still have yet to get used to is vomit. Man... watching a patient just heave and eliminate chunks (and the accompanying smell) makes ME want to hurl. Downright disgusting (not that it's the vomiting patient's fault of course).

 

[DocJMengele]

Sure it can be overcome. I heard that PT's are in need right now.

 

[Bertelman]

But I will confess Im basicallly healthy but when I did an anaesthsia (spelling?)
rotation.
While observing the anaesthiologist Im not sure if one of the gases or anaesthetics was escaping from a cannister but I for the first time EVER I had to walk out of the O.R. literally feeling like "Im about to faint" it was a very weird "passing out feeling" that I had. And I got to the outside of the O.R. just in the nick of time. .

Anesthesia. Anaesthesia if you're British.

Unlikely to have been the gases. The onset/offset isn't that fast, thus simply walking out of the room would not have solved the problem so quickly. And if the cannister were leaking, I would imagine everyone in the room would have gotten a similar sensation.

 

[Rugby MD]

I've never really had this problem before, for some reason it does not bother me, but from what I've heard, you do adapt to it after a while. What I still have yet to get used to is vomit. Man... watching a patient just heave and eliminate chunks (and the accompanying smell) makes ME want to hurl. Downright disgusting (not that it's the vomiting patient's fault of course).

Anybody else have this problem? I'm an MSII and watching people puke (not in a medical setting..yet) has made me puke in the past. Do you get used to puke like you do blood? interestingly, blood is no problem. a big fan of poo either.

 

[sprinkibrio]

I used to have that problem with vomit as a kid, but I think seeing so much puke in college and even helping my friends by cleaning it up kind of got me over it. I was so nice...

Now, I'm volunteering in the OR and slowly I'm getting over fainting. I always have a chair for me to sit when I start feeling dizzy. During the beginning of a surgery I use it about every 10 minutes but during the end of a surgery I can stand for around an hour and a half and feel fine. I must say, before you try to push yourself to stand through surgeries, learn to realize when you've hit the point of no return. There are varying degrees of dizzyness, so once you recognize when only laying or sitting down will keep you from fainting, you're a lot less likely to faint at all and embarass yourself.

Oh, and laughing helps A LOT. Listen to the jokes the doctors and nurses tell instead of continuously eyeballing the patient. And don't start putting yourself in the position of the patient or thinking about how painful the surgery would be if the patient was awake. Control your thoughts and distract yourself. This is just another day.

Also, if you're not scrubbed in, every once in a while open the bottom of your mask a little to get some real oxygen. I like to alternate between standing on one leg at a time and standing with my heels together and knees bent. It seems to keep me from locking my knees.

If someone like me can slowly get over this (I fainted in 5th grade just READING about diabetes needles) then you can.

 

[psipsina]

I used to have that problem with vomit as a kid, but I think seeing so much puke in college and even helping my friends by cleaning it up kind of got me over it. I was so nice...

Now, I'm volunteering in the OR and slowly I'm getting over fainting. I always have a chair for me to sit when I start feeling dizzy. During the beginning of a surgery I use it about every 10 minutes but during the end of a surgery I can stand for around an hour and a half and feel fine. I must say, before you try to push yourself to stand through surgeries, learn to realize when you've hit the point of no return. There are varying degrees of dizzyness, so once you recognize when only laying or sitting down will keep you from fainting, you're a lot less likely to faint at all and embarass yourself.

Oh, and laughing helps A LOT. Listen to the jokes the doctors and nurses tell instead of continuously eyeballing the patient. And don't start putting yourself in the position of the patient or thinking about how painful the surgery would be if the patient was awake. Control your thoughts and distract yourself. This is just another day.

Also, if you're not scrubbed in, every once in a while open the bottom of your mask a little to get some real oxygen. I like to alternate between standing on one leg at a time and standing with my heels together and knees bent. It seems to keep me from locking my knees.

If someone like me can slowly get over this (I fainted in 5th grade just READING about diabetes needles) then you can.

Hey, how did you go about asking for the chair in the OR? I had one pre-syncope episode in the ER, I'm not sure if it was the bizzarre combo of events (small stuff room, pt covered in feces and decaying open wounds, repeated stabbing trying to find blood in a femoral vein while the patient begs to be left alone, along with the fact that it was the first day of feeling sick in what turned out to be pilonephritis so I probably had a jacked up fever etc, . . . ) but I'm curious what the reaction of the docs you're working with was when you asked since I'm anticipating that I may have to do this too.

 

[ben_medicine]

It happens to the best of us. My first time was in the ER big needle and a lot of screaming pts. Now i am a phleb. I can work codes and watch ppl puke blood (on me) and the effect is nil. I actually hope i haven't been too desensitized.

Anyway stick it out and all will be good.

Eat, Drink and be merry!!

 

[Winged Scapula]

As others have noted, it can happen to anyone, even those of us who are "used to it".

I've had days when I've not felt well going into the OR, days when its horribly hot in the OR, and days when I don't know whats up, but I just got vasovagal for some reason. Fortunately, it happens very infrequently and as I near attending-hood I am much less embarassed by asking to a chair or to scrub out for a min or two. In my field of work, there are very little portions of the operation where I can't scrub out for a short while (if you have some major bleeding from the axilla, that might not be the time to leave).

We know it happens to students too and this says nothing about your future career potential. If you need to step away from the field, try and do so early, rather than wait until everything goes black - that way we can have the scrub hold the retractor or get someone else. If you need a chair, just ask for one - we'll help you. Don't be embarassed..it happens all the time.

Finally, read other threads, especially in the Surgery forum, about how to avoid this happening. Vomit is worse for me than feces, but in the right setting, either can make me gag.

 

[turkleton]

And if all else fails make sure you have a catchers mitt dipped in super glue on the next time you're holding a baby. Dropping patients is a fast way to low passing your peds clerkship. I was thinking of also making a metal prosthesis for med students like yourself- one end has a suction grip on your belly and if you are falling over in a IV induced black out, that bad boy will act like your kickstand. Baby saved.

 

[deuist]

One piece of advice I didn't see mentioned is that you should avoid locking your knees when standing. I've had several classmates faint after standing for an hour in the same position. You could try bending your knees slightly---the behavior won't be noticeable if you're wearing loose-fitting pants.

 

[sprinkibrio]

Hey, how did you go about asking for the chair in the OR? I had one pre-syncope episode in the ER, I'm not sure if it was the bizzarre combo of events (small stuff room, pt covered in feces and decaying open wounds, repeated stabbing trying to find blood in a femoral vein while the patient begs to be left alone, along with the fact that it was the first day of feeling sick in what turned out to be pilonephritis so I probably had a jacked up fever etc, . . . ) but I'm curious what the reaction of the docs you're working with was when you asked since I'm anticipating that I may have to do this too.

I'm actually not rotating, I'm volunteering so the docs may not feel like they have a reason to be mad... I don't even know them, I just ask one of the nurses to call an OR for me to observe in once per volunteer day. One of the times the doctor straight up asked me if I would faint and I said I've had some problems with it in the past but am fine if I have a chair in case. There's usually at least one free chair in our ORs. Another time I asked the head nurse for a chair, but the scrub nurse said she was going to use it so she actually found another from a different room and brought it for me. All the doctors knew I was there to work on getting over fainting before med school (in addition to the fact that watching a surgery is amazing!) None seemed to care that I would occasionally sit and I was never made fun of. Everyone seemed more concerned that I not faint so they wouldn't have to deal with me. It's pretty darn essential that I sit if I want to watch a full surgery, so I got over the embarassment pretty fast. Actually, the first time I went in the OR I barely made it out of the room before I slid down against the wall (but didn't faint). When everyone found out (and they ALLL did) the anestesiologist came up to me in the lounge and told me I should have just sat. There was a chair directly behind me (and I knew it was there)!