I passed out during a delivery

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ashar008

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Hey all, just a little story today to vent about my experience and would like some input. So I am hopefully applying for general surgery residency with an interest to enter trauma afterwards. During my surgery rotation I loved my trauma weeks and had absolutely no problems. However, until today I observed my first vaginal delivery in obgyn and it was quite messy and I passed out halfway through delivering the placenta for the first time in my life. I never shy away from blood and guts, today was just different. Everyone in the room knew my intentions to go into trauma surgery. I was absolutely embarrassed for myself. Am I a punk for passing out in front of everybody like this?
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No. No one spills blood like OB. And, it's OBGYN. I mean, damn. Don't think anything of it. It can happen to anyone, even the get-to-the-choppa adrenaline junkies. It's OBGYN bro.
 
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Yes and you should wear a scrub skirt from now on and curtsy for your attending
 
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I feel like passing out every time I'm in an ob room
 
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Hmmm this is not good considering your career ambitions. I think to get past this you will need to eat some of the placenta. Gotta own it in this situation.
 
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I’m surprised more people don’t pass out with all the blood, amniotic fluid and poop everywhere. Absolutely disgusting
 
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I’m the same way. Not much gets to me. I never shy away from blood and guts and actually love surgery (although I want to do anesthesia).

First delivery I saw on Ob (first in my life, actually) I’m sure my facial expression was somewhere between “oh god” and “please get me the hell out of here”.
 
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Almost, had the same thing happen to me during my obgyn rotation as well. Only difference was that it was a D&C and I felt it coming and asked for permission to step aside and then I was helped to the ground by the nurses. Like you, I don't have problem with blood and guts so for me, I'm guessing that it could of been from the lights, dehydration or I locked one of my limbs out when I was retracting and didn't notice it. My preceptor tried to make me feel better about it by nonchalantly saying "Yah, probably a simple virus going around ;)"
 
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Always lock your knees. It helps stand for much long time. Cheers.
 
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ashar008 said:
Hey all, just a little story today to vent about my experience and would like some input. So I am hopefully applying for general surgery residency with an interest to enter trauma afterwards. During my surgery rotation I loved my trauma weeks and had absolutely no problems. However, until today I observed my first vaginal delivery in obgyn and it was quite messy and I passed out halfway through delivering the placenta for the first time in my life. I never shy away from blood and guts, today was just different. Everyone in the room knew my intentions to go into trauma surgery. I was absolutely embarrassed for myself. Am I a punk for passing out in front of everybody like this?
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On my peds anesthesia rotation as a CA-2, saw a general surgery upper level pass out during surgery. She was literally like a board falling and slapping the floor. Had to get stitches in her head from where she hit the floor. Point is... it happens. Nothing in life is worth pursuing if you don't go through a little bit of humility to get there.

First central line I ever put in was on a lady with INR of 4 who was septic. Needed a line for pressors. IJ didn't look good to my upper level ED resident at the time (I was an intern). So, went for a femoral, which was a massive target. I was so excited when I go blood back and the wire thread I mentally checked out at that point (or maybe it was because it was midnight?). When I went to pull dilator out, I pulled the whole thing out (wire included). She bled like a stuck pig. My upper level looked at me and said, "Hold pressure on that. And you will never do that again!"

I was mortified... I am an attending anesthesiologist now and don't have any problem throwing in central lines with the best of 'em. At the time, I thought I was going to be a terrible anesthesiologist since I couldn't do one of the big procedures we commonly perform. It all worked out.

P.S. That general surgery resident? She scrubbed back in like a boss. We eventually HAD to make her go sit back down. After all, like I tell my kids, "What do you do when you get knocked down?" We get back up again.
 
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ashar008 said:
Hey all, just a little story today to vent about my experience and would like some input. So I am hopefully applying for general surgery residency with an interest to enter trauma afterwards. During my surgery rotation I loved my trauma weeks and had absolutely no problems. However, until today I observed my first vaginal delivery in obgyn and it was quite messy and I passed out halfway through delivering the placenta for the first time in my life. I never shy away from blood and guts, today was just different. Everyone in the room knew my intentions to go into trauma surgery. I was absolutely embarrassed for myself. Am I a punk for passing out in front of everybody like this?
Click to expand...

Don’t over think it. It happens. Means absolutely nothing in terms of which specialty to pick
 
I will never forget the humidity and smell of fresh **** of the first delivery room I ever entered. When I stepped in to do the delivery and saw actual **** on the table, I started to wonder if I was even going to be able to get through the rest of medical school.
 
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Delivery of the placenta might be the single grossest thing in all of medicine - the thing looks like it's part of an alien, not a person.

I think you'll be fine. Maybe don't ask that attending for an LOR though.
 
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I used to love taking the placenta and showing to interested parties in the room, showing the amniotic sac, the "tree of life" formation of the blood vessels, the cord.

It was something encourage by my school for students to do to. I thought it was neat as did a lot of people I showed.

Placenta is cool, yo. Not gonna eat it though.
 
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ashar008 said:
Everyone in the room knew my intentions to go into trauma surgery. I was absolutely embarrassed for myself. Am I a punk for passing out in front of everybody like this?
Click to expand...

upload_2018-2-4_0-22-29.png
 
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Crayola227 said:
I used to love taking the placenta and showing to interested parties in the room, showing the amniotic sac, the "tree of life" formation of the blood vessels, the cord.

It was something encourage by my school for students to do to. I thought it was neat as did a lot of people I showed.

Placenta is cool, yo. Not gonna eat it though.
Click to expand...

Teh fu
Now I can almost smell placenta, nearly barfed
 
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Crayola227 said:
I used to love taking the placenta and showing to interested parties in the room, showing the amniotic sac, the "tree of life" formation of the blood vessels, the cord.

It was something encourage by my school for students to do to. I thought it was neat as did a lot of people I showed.

Placenta is cool, yo. Not gonna eat it though.
Click to expand...

o_O

I got a good OB story.

When I was in residency I was doing a delivery with a midwife and unforunately as many of you are aware, women sometimes poop during delivery. Well this unfortunate baby was welcomed into the world right as their mom decided to poop all over them. Like literally covered in ****. So I’m holding this poop baby out of moms vision and I’m like uhhhhhhhhhh???? The midwives where I trained were super into skin to skin. Baby comes out, skin to skin on Mom. She’s telling me: ok give it to Mom. I’m in sterile gown, mask and hat. All you can see is my eyes. And I look at her, look at the baby, look at her, look at baby. Eventually under my breath I say: this baby is covered in ****! Doesn’t matter. “Ok give it to Mom.” Well at that point I say ok screw it. I hand this baby to the nurse who puts it on Mom who has the most terrified look on her face. She actually told the nurse to take it away. Poor baby. One minute into the world and they have already been **** on AND rejected by their parents.

Anyways hope that makes you feel better OP. I nearly passed out during my first c section in med school. Like had to sit down and felt like a complete tool too. Now I’m a (mostly) functional ED doc. Don’t feel bad. It happens and it doesn’t mean anything. Just be sure to eat and drink prior to doing bloody stuff.
 
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Not a punk. A few stories...

1. My CT surgery preceptor said he was in an open heart surgery in med school and after he scrubbed out he fell flat on his face in the hallway.
2. There was a rumor that a general surgeon passed out in the OR after piercing a hydrocele that resulted in squirting clear fluid.
3. Personally I nearly passed out IN THE CLINIC when a pt was getting a port removed. Really caught me off guard.
4. Nearly passed out again during a particularly bloody C section.

What I do to not pass out now days: try to remain hydrated all day and not starved, squeeze my calves and butt during bloody surgeries or just standing long periods in the OR, deep breaths now and then in an attempt to increase preload. It does get better with time. Btw, I love trauma and surgery and I'm going into anesthesia. Some people are just more prone to it than others. It has nothing to do with aptitude.
 
Tenk said:
o_O

I got a good OB story.

When I was in residency I was doing a delivery with a midwife and unforunately as many of you are aware, women sometimes poop during delivery. Well this unfortunate baby was welcomed into the world right as their mom decided to poop all over them. Like literally covered in ****. So I’m holding this poop baby out of moms vision and I’m like uhhhhhhhhhh???? The midwives where I trained were super into skin to skin. Baby comes out, skin to skin on Mom. She’s telling me: ok give it to Mom. I’m in sterile gown, mask and hat. All you can see is my eyes. And I look at her, look at the baby, look at her, look at baby. Eventually under my breath I say: this baby is covered in ****! Doesn’t matter. “Ok give it to Mom.” Well at that point I say ok screw it. I hand this baby to the nurse who puts it on Mom who has the most terrified look on her face. She actually told the nurse to take it away. Poor baby. One minute into the world and they have already been **** on AND rejected by their parents.

Anyways hope that makes you feel better OP. I nearly passed out during my first c section in med school. Like had to sit down and felt like a complete tool too. Now I’m a (mostly) functional ED doc. Don’t feel bad. It happens and it doesn’t mean anything. Just be sure to eat and drink prior to doing bloody stuff.
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That's a great story. I literally laughed out loud. Hilarious.

My only good OB story involved being two or three months into my intern year on OB where I performed the typical triage-intern responsibility (i.e. seeing all of the new patients and taking down their information, writing the note, etc). One night, I am sitting at the computer and I hear this blood curdling scream around the corner. I get up, turn the corner, and see a nurse with a VERY pregnant woman in a wheel chair. She looks in my direction and says "I need a doctor." Naturally, I turn around to see who is available to fill her request. Yup, no one was there. She was looking at me.

I go up to the patient (who is not in a bay yet) and reach inside the bay to dawn some gloves. As I am about to do this, this G6P5 woman proceeds to lift her self up on the wheel chair and deliver the baby. I now must make a split-second decision: take the time to put the gloves on or let this infant who is about to be imminently born hit the tile floor head first.....

So, naturally, I did what any good doctor would do...
 
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Totally normal reaction and not at all something to worry about. I think everyone at least almost passes out at some point in med school or residency. Usually med students/doctors are dehydrated and go way too long without eating and are expected to stand for hours at a time, usually under hot delivery room or OR lights while in 15 layers of clothes. The important thing is figuring out the early signs and having the humility to ask to step out for a minute. If in the OR, most surgeons or scrub nurses will ask that people who are lightheaded just sit down on the floor immediately to avoid passing out into a sterile field (I know re-scrubbing seems like the end of the world in M3, but it's really not... especially if the alternative is falling into a patient cavity and having everyone really upset at you).

In undergrad, I was dealing with a bunch of pain while I was rounding with a doctor I worked with. I realized I was either going to pass out or throw up from pain, and I tried to very quietly ask a nurse nearby where a bathroom was so I could excuse myself without embarrassment. Unfortunately, she took one look at how pale and clammy I was and threw me into a chair while pushing my head between my knees. She then proceeded to stop rounds to yell at the doctors to get me orange juice. They spent the rest of the day asking if the case was too much for me. I was mortified, but it makes for an amusing story now.
 
girlofgrace7 said:
Totally normal reaction and not at all something to worry about. I think everyone at least almost passes out at some point in med school or residency. Usually med students/doctors are dehydrated and go way too long without eating and are expected to stand for hours at a time, usually under hot delivery room or OR lights while in 15 layers of clothes. The important thing is figuring out the early signs and having the humility to ask to step out for a minute. If in the OR, most surgeons or scrub nurses will ask that people who are lightheaded just sit down on the floor immediately to avoid passing out into a sterile field (I know re-scrubbing seems like the end of the world in M3, but it's really not... especially if the alternative is falling into a patient cavity and having everyone really upset at you).

In undergrad, I was dealing with a bunch of pain while I was rounding with a doctor I worked with. I realized I was either going to pass out or throw up from pain, and I tried to very quietly ask a nurse nearby where a bathroom was so I could excuse myself without embarrassment. Unfortunately, she took one look at how pale and clammy I was and threw me into a chair while pushing my head between my knees. She then proceeded to stop rounds to yell at the doctors to get me orange juice. They spent the rest of the day asking if the case was too much for me. I was mortified, but it makes for an amusing story now.
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Out of idle curiosity (and I know that nobody would ever let you get away with it in reality) but: technically if you sit down on the floor and then stand up, all without using your hands at all in either direction, wouldn't you still be sterile? Your butt never counted as sterile anyway, right? The only issue I foresee is if you bend too far at the waist while standing up and some of the 'technically too low' portions of the gown contact the lowest areas of the 'technically sterile' portions.
 
I almost passed out watching a chest tube being put in :(
 
Almost passed out watching my first C-section.

I remember hearing the attending say something like "raise his legs if he passes out."
 
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Will never forget my first c section. First OR exerience ever. Thought it was going to be some delicate meticulous procedure.

ohDKCIO.jpg


Jack the ripper style, slash slash blood everywhere oh **** thats the uterus slash slash YAAAANNK oh **** it's the baby its a miracle oh my god its gray and not breathing and covered in cheese the baby's dead Jesus this is a nightmare oh wait no its fine apparently this is all normal

Dads who opt in to watch that and do fine with it should be evaluated for psychopathy
 
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ashar008 said:
Hey all, just a little story today to vent about my experience and would like some input. So I am hopefully applying for general surgery residency with an interest to enter trauma afterwards. During my surgery rotation I loved my trauma weeks and had absolutely no problems. However, until today I observed my first vaginal delivery in obgyn and it was quite messy and I passed out halfway through delivering the placenta for the first time in my life. I never shy away from blood and guts, today was just different. Everyone in the room knew my intentions to go into trauma surgery. I was absolutely embarrassed for myself. Am I a punk for passing out in front of everybody like this?
Click to expand...

Vagal reflex. Look away if it bothers you. NBD.
 
mehc012 said:
Out of idle curiosity (and I know that nobody would ever let you get away with it in reality) but: technically if you sit down on the floor and then stand up, all without using your hands at all in either direction, wouldn't you still be sterile? Your butt never counted as sterile anyway, right? The only issue I foresee is if you bend too far at the waist while standing up and some of the 'technically too low' portions of the gown contact the lowest areas of the 'technically sterile' portions.
Click to expand...

No, technically anything below around bed height is considered out of range of the sterile field. If bovie or suction fall off the field but don't quite hit the floor, they still should be replaced.

While sitting on the floor is better than falling into the field, simply saying you need to sit and stepping back will usually get you a stool (assuming you aren't literally about to hit the floor) to sit on....and possibly able to stay sterile. Although, experienced circulators are going to undo your gown to help cool you down and eventually have you step out of the room to get some air before re-scrubbing; most won't trust a student to not contaminate themselves when leaving the sterile field.

Even experienced staff and surgeons have moments of feeling lightheaded. Especially if a bit ill or scrubbed much longer than anticipated on an empty stomach. It's not a big deal. Step out for a few minutes and let the feeling pass. The only thing we want to make sure of is that you're ok. Having to send you to the ER for a head CT and sutures would look bad. :p;) It doesn't affect your grade or our opinion of you.
 
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Smurfette said:
No, technically anything below around bed height is considered out of range of the sterile field. If bovie or suction fall off the field but don't quite hit the floor, they still should be replaced.

While sitting on the floor is better than falling into the field, simply saying you need to sit and stepping back will usually get you a stool (assuming you aren't literally about to hit the floor) to sit on....and possibly able to stay sterile. Although, experienced circulators are going to undo your gown to help cool you down and eventually have you step out of the room to get some air before re-scrubbing; most won't trust a student to not contaminate themselves when leaving the sterile field.

Even experienced staff and surgeons have moments of feeling lightheaded. Especially if a bit ill or scrubbed much longer than anticipated on an empty stomach. It's not a big deal. Step out for a few minutes and let the feeling pass. The only thing we want to make sure of is that you're ok. Having to send you to the ER for a head CT and sutures would look bad. :p;) It doesn't affect your grade or our opinion of you.
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Nah, I mean I get what you should actually do and that nobody would ever actually do what I was describing, just wondering if you could still technically be considered sterile.
I'm surprised at the height rule, though...seems like any doc that sat down would automatically be unsterile, then. Heck, for some procedures (thinking lithotomy position, gyn or rectal procedures) you intentionally spend most of your time seated below table height. I always assumed some level of touching was required to break sterility - hence, the instruments falling but not all the way (because when they touch the drape below bed level, they're touching portions that the surgeon's 'nonsterile' legs may have contacted). If someone just took a probe and carefully lowered it to knee height (without touching anything) and back up, is that nonsterile? If no part of my body except my butt and feet touches anything, how does sitting on the floor differ from a stool?

Again, not questions that matter, just idle pondering on the frequent ridiculosities of the OR. :)
They have their purpose, but it is sometimes fun to pick them apart just for the heck of it.
 
^That's because no one's ever really sterile, that's what prophylactic antibiotics are for. I'm tall enough that I technically contaminate the field every time I step into it, and I'm not that tall.

semi-srs
 
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