Interested in ER, almost passed out while suturing today, helppp

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alisepeep

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Hi guys, i am a 3rd year highly considering going into the ER yet today something happened that made me afraid i cant handle it. While suturing a screaming/ crying 3 year old's forehead, with the mom hovering over my every move, I nearly passed out. I developed palpitations and started sweating profusely. I had to excuse myself and let the PA supervising me take over. This was my 2nd time ever stitching up anyone, and the first time was a grown man's knee..that went totally fine.
So am I cut out for ER or does this episode indicate that ER may not be for me? Anyone have similar stories that you've been thru?/
 
Highly likely you'll get used to it. I know enough surgeons / orthos / ER people who tell funny stories about passing out as 3rd years or in the gross lab...

Don't give up too easily 😉
 
any situation where you have limited experience can be stressful. with more experience, this should get better.
I used to get stressed putting in central lines.
Now I can duck the occasional punch from a patient, restrain them with an elbow, and use both hands to get the job done.

If you like the medicine and environment, don't let some discomfort keep you away.
 
1st of all - were you standing? If so, sit down next time you stitch. Stitching while standing is bad for the back.

When I 1st drew blood it was at the VA (of course). I was standing. When the vet saw me going pale as my shaky hand brought a needle towards his vein, he said "don't worry 'bout it sonny, I'm the one who's getting stuck."

Man, do I adore veterans.

Now I can manage central line complications in a crashing patient while fully gowned in a hot, stuffy room without a twitch. Our quotidian is the average person's nightmare - this stuff takes getting used to.
 
Hard to say - when I first went into the OR (as a premed), I almost passed out and had to step out. As an MS-1, I remember interviewing an AIDS patient with a gangrenous leg - felt like I was going to spew on them. Spending 3 months with a corpse in anatomy lab helped to desensitize me. How did you do on surgery rotation? If you like the field, give it a few chances before you give up. How do you suturing a calm adult who really doesn't care about having a scar?
 
Damn near passed out during an orchiopexy on my urology rotation 3rd year. Had been in the OR for years (even as a student volunteer before med school). Just one of those things. May have been blood sugar related. Who knows? My point is, it happens to all of us.

I was putting in a finicky central line last night - had to switch sides on the patient's neck (I think I was coming up against a thrombus on the first side I tried, who knows) - hands covered in blood, lots of blood soaked 4x4s... etc, etc... was thinking to myself, man I've come a long way! You'll be fine!
 
alisepeep said:
Hi guys, i am a 3rd year highly considering going into the ER yet today something happened that made me afraid i cant handle it. While suturing a screaming/ crying 3 year old's forehead, with the mom hovering over my every move, I nearly passed out. I developed palpitations and started sweating profusely. I had to excuse myself and let the PA supervising me take over. This was my 2nd time ever stitching up anyone, and the first time was a grown man's knee..that went totally fine.
So am I cut out for ER or does this episode indicate that ER may not be for me? Anyone have similar stories that you've been thru?/
Click to expand...

These situations can be stressful, not so much the procedure, but the combination of the kid screaming and much more so the piercing parental eyes, panicking that this med student is going to turn their future elite model into bride of Frankenstein, while you're trying to learn the procedure. That's what got you; the parental eyes. It's no small stuff. But you didn't pass out. You got nervous. That's normal. This incident alone by itself means nothing. I'm sure after you've sutured 500 screaming kids with helicopter-parents hovering, you'll fly through it like anyone else. You just have to decide if you want to double down on the specialty, because when the fit hits the shan, and everyone else runs away, you have to run towards, no matter what your SA node is doing, no matter what your sweat glands are doing, and whether your rectal sphincter is up to the job or not.

You might have to resuscitate dying kids with parents watching.

You will definitely have to notify parents their child has died unexpectedly.

You'll have patients drop dead in front of you unexpectedly, and it's your job to fix it.

You will certainly have to stitch, suture, cut holes, start hearts, stop hearts, and work with blood flying and screams hurling even while your heart races, sweat pours or sphincter gets dizzy, IF the situation is stressful enough, until you get seasoned enough.

That being said, the more you face these situation the more the terrifying becomes routine, but just when you think you've seen it all, and there's nothing that could get your adrenaline pumping again......





...those doors crash open again just one more time.
 
Birdstrike said:
These situations can be stressful, not so much the procedure, but the combination of the kid screaming and much more so the piercing parental eyes, panicking that this med student is going to turn their future elite model into bride of Frankenstein, while you're trying to learn the procedure. That's what got you; the parental eyes. It's no small stuff. But you didn't pass out. You got nervous. That's normal. This incident alone by itself means nothing. I'm sure after you've sutured 500 screaming kids with helicopter-parents hovering, you'll fly through it like anyone else. You just have to decide if you want to double down on the specialty, because when the fit hits the shan, and everyone else runs away, you have to run towards, no matter what your SA node is doing, no matter what your sweat glands are doing, and whether your rectal sphincter is up to the job or not.

You might have to resuscitate dying kids with parents watching.

You will definitely have to notify parents their child has died unexpectedly.

You'll have patients drop dead in front of you unexpectedly, and it's your job to fix it.

You will certainly have to stitch, suture, cut holes, start hearts, stop hearts, and work with blood flying and screams hurling even while your heart races, sweat pours or sphincter gets dizzy, IF the situation is stressful enough, until you get seasoned enough.

That being said, the more you face these situation the more the terrifying becomes routine, but just when you think you've seen it all, and there's nothing that could get your adrenaline pumping again......





...those doors crash open again just one more time.
Click to expand...

This sounds so amazing. EM is very high on my list.
 
I went near syncopal watching my first I&D as an MS2, my first OR case as a 3 and my second OR case as a 3. I'm pretty sure it hasn't happened since, but boy was I worried about EM, especially because pretty much all of my eggs were in that basket going into med school. You get used to it.
 
Birdstrike, hope you didn't stop their heart for too long. Must be adenosine.
 
I used to be terrified of needles growing up. I almost passed out every time I saw blood drawn when I worked in an ER as an undergrad. Almost passed out when I had to give a flu shot to a classmate as a 1st year med student.

Now I'm an intern.....You just don't have time for that anymore. As third year of med school went on, it got easier. Being squeamish just wasn't an option.

I wish I could give advice for how to get over this, but I can't. It's just something that goes away with repetition. I seriously was awful around blood or vomit - now I'm completely fine. Got an abscess? No problem -hand me a scalpel. Deep lac? Let me get some lido and suture. Tough stick? I'll grab the US and throw in a PIV. Obtunded pt who vomitted? I'll happily grab a blade and ET tube and get up close and personal (with a mask, lol).

Trust me, you get over it. It's your job and you just don't have time to think. Good luck.
 
Birdstrike said:
Really? How so? I was afraid a post like that would be horrifying to the uninitiated...


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Click to expand...

I thrive in high-stress, chaotic situations. The mundane, predictable, and even-keel has never really done it for me. Working in an environment, where literally anything could be bursting in the door is exciting to me. Though, I could see how it isn't for a large majority.
 
yanks26dmb said:
I thrive in high-stress, chaotic situations. The mundane, predictable, and even-keel has never really done it for me. Working in an environment, where literally anything could be bursting in the door is exciting to me. Though, I could see how it isn't for a large majority.
Click to expand...

What happens when the high-stress and chaotic, becomes mundane and predictable?


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Birdstrike said:
What happens when the high-stress and chaotic, becomes mundane and predictable?


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Click to expand...

I think that's all in one's perspective. If I'm doing what I enjoy, in an atmosphereI enjoy being in, I don't see how things could ever get mundane.
 
Birdstrike said:
Really? How so? I was afraid a post like that would be horrifying to the uninitiated...


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Click to expand...

Maybe this individual likes the idea of pooping his/her pants in a room full of people and crying off terrible situations in ED bathrooms?
 
To me there is nothing worse than doing a procedure and having people stand over my shoulder. Usually the room is hot enough as it is, but then you're sweating, mask is fogging up, and overall anxiety increases, whether it is a parent, family member, attending etc...

With parents and suturing young kids, try to give the parents something to do. Ask them to hold the child's hand/talk to them. It can help calm the kiddo so it makes your job easier, and it gets them off your back, alleviating two major sources of anxiety for yourself. And as for suturing kids specifically, when they are screaming their heads off, its usually anxiety rather than not enough anesthetization that is making them do it. I sware you stick a needle into them and instantly you get blood curling screams that make the rest of the staff think you are murdering this kid, but if you get helicopter mom to get the kid to face the other way, it is like you aren't even doing anything.

Sometimes family backfires on you. I had to take three freakin sutures out of the most histrionic 21 yo girl who asked me no less than 55 times if it was going to hurt. I continually said no and that it will take me three seconds to be done. I barely touch the end of the suture with my foreceps when she starts bawling, and grandma over in the corner is there yelling "OH ITS DEFINITELY GONNA HURT, THEY SAY IT WONT BUT IT ALWAYS DOES. YOU SEE? THEY LIE TO YOU!!! THEY SAY IT WON'T HURT BUT NO MATTER WHAT IT WILL ALWAYS HURT YOU".
 
engineeredout said:
Sometimes family backfires on you. I had to take three freakin sutures out of the most histrionic 21 yo girl who asked me no less than 55 times if it was going to hurt. I continually said no and that it will take me three seconds to be done. I barely touch the end of the suture with my foreceps when she starts bawling, and grandma over in the corner is there yelling "OH ITS DEFINITELY GONNA HURT, THEY SAY IT WONT BUT IT ALWAYS DOES. YOU SEE? THEY LIE TO YOU!!! THEY SAY IT WON'T HURT BUT NO MATTER WHAT IT WILL ALWAYS HURT YOU".
Click to expand...

Classic.

At that point you could touch the patient with a cotton ball and induce status pseudoseizure histrionicis. Been there more times than I care to remember.
 
Last edited:
engineeredout said:
I had to take three freakin sutures out of the most histrionic 21 yo girl who asked me no less than 55 times if it was going to hurt. I continually said no and that it will take me three seconds to be done.
Click to expand...

"Doc, you gotta put me out for this. I don't like pain."
 
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