i've heard that most med students will faint sometime during surgery. having fainted once before during 1st year (completely unexpected), this sort of freaks me out... does anyone know why it happens or what you can do to prevent it?
El Nos said:what are TED's?
El Nos said:i've heard that most med students will faint sometime during surgery. having fainted once before during 1st year (completely unexpected), this sort of freaks me out... does anyone know why it happens or what you can do to prevent it?
(nicedream) said:But what if you eat before and then have to poo?
(nicedream) said:But what if you eat before and then have to poo?
Where would they sell compression stockings at?
Where would they sell compression stockings at?
One other thing nobody has mentioned... If you find yourself getting lightheaded (or get the vasovagal "cold sweat") frequently - say twice or more in a couple months - go have your iron levels checked. 'Specially us menstrual-age gals have a tendency to get a simple iron deficiency anemia that never gets quite bad enough to notice during "normal" daily life. But add in all of the above - heat, dehydration, hypoglycemia, postural issues - and you're on the floor. I had two near-syncopal episodes a month or two apart, during surgeries I'd done a zillion times, nothing unexpectedly gross or whatever, and then another a few weeks later, a couple hours after giving blood (NOTE: I passed their little blood-drop test, so you've really got to get the lab test where they check ferritin). After diagnosis (and doc's orders to take iron supplements until my numbers improved, and then a daily women's multivitamin thereafter), I thought back and realized that I used to get the same symptoms fairly often during menstruation in high school and college, during which time I ate hardly any meat. Probably been slightly anemic most of my life and never knew it...Yeah, I heard the fainting doesn't usually occur because of queasiness or squeamishness. More due to postural hypotension and other factors you totally can control for.
Try to avoid entering cases on an empty stomach. Big trouble in the making.
Heat + blood + hunger + tension = trouble
So I get that it's OK for a med student to excuse him/herself if feeling faint. But does this happen to residents too? And what about attendings? I've never seen a resident ask to step out. Is this because they are actually DOING the case and don't have time to feel faint, or do you just become desensitized by that point?
Speaking from personal experience, the two times I felt queasy were due to the combination of being sleep-deprived, undernourished, and what was going on.
The first time was during a circumcision of a nine-year old boy. A surgeon watching the procedure started expressing concern that the one cutting was taking too much off - that concern (which was baseless in the end) and seeing the bleeding unit made me get a bit vagal out of empathy for the boy's situation.
The other time was during the first autopsy I witnessed during a forensic path rotation. Seeing a freshly-dead person get butchered is a lot different than a cadaver. Everything is so much more lifelike, and profusely bloody. After that I was desensitized, and I didn't have any reactions to subsequent autopsies.
In both situations, I felt sick to my stomach, started sweating, and felt light-headed, but I hung in there, did my best not to hyperventilate, and got past it.
i know an MS3 who was holding the pt's leg during childbirth, the gush of blood and amniotic fluid, smells, and heat caused him to drop the leg and pass out. he ended up being admitted to the same hosp..how embarrassing. good advice given here - eat, stay hydrated, dont forget to breathe.
I nearly passed out last week after the placental delivery and sewing up the perineal region. It wasn't the blood or smell, i think it was the god awfully hot lights blazing into the field, not enough hydration, and leaning over the field at an odd angle. I said I needed to step back for a moment- would much rather sit down for a minute and get some water than to drop face first into a bloody perineum and make a fool of myself!
well said, well said. experienced it a couple of times. dehydration, low blood glucose - these two am sure of in my case. wasn't tensed up at all on all those circumstances i almost fainted. But tension indeed plays a role too.Try to avoid entering cases on an empty stomach. Big trouble in the making.
Heat + blood + hunger + tension = trouble
Most pharmacies carry them or can order them. They arent the most comfortable devices to put on, but after a half hour you forget youre wearing them.
People have mentioned some great tricks...here are mine (I apologize if there are repeats)
1. Never skip breakfast. Few surgeons will scoff at the thought that "the med student went to go grab a muffin" unless he/she is told this while actually scrubbing in. Just make sure you are in the OR in time to help prep the patient. Remember, attendings come in later than you (usually) and have an opportunity to eat before hand.
2. Keep yourself well hydrated. It is far less annoying to ask to be excused to use the restroom than it is to face-plant into an open abdomen. Many of the long cases have moments when you can take a quick break...rads need to bring in the c-arm, path needs to call back with a report, nurses need to flash something in the autoclave.
3. Never skip lunch. See #1.
4. Stretch before going into the OR. OK, I know it sounds stupid, but trust me on this one. Proper posture and stretching will help limber you up and allow you to stand more comfortably and avoid NavyDOcs scenario of locking the knees.
5. Don't get into awkward positions in the OR. If you need a stool (or 2), ask for it. If you cant see the field without craning your neck into ungodly positions, then dont look at the field...hopefully youre not first assist in this case!
One attending once told me the medical students who passed out in the OR would make great surgeons...because they wouldnt make the same mistake twice.