Holy vasovagal syncope, Batman

Hey, everyone!  I’m writing this, at home, in the middle of the morning, because I had to step away from a surgery case.  Again.

(I like saying “step away“.  It makes it sound much more professional than “feel incredibly hot, nauseous, realize the room is threatening to spin, pray the surgeon is almost done suturing, but… nope.  Game over, verbal notice of giving up, head between my knees in a corner.”)

After a few minutes, it was obvious I wasn’t going to re-scrub in, so the surgeon suggested I leave.

Sometimes I think about writing a post called Lies Med School Tells You.  #1 would be “If you feel sick during a surgery, just politely tell the team and step back.  It happens all the time; they won’t bat an eye.”

HAH.  In my experience, they act like you just announced “I’m going to collapse on the patient immediately, maybe pull out a few tubes while I’m at it; hope that’s okay.”

I mean, who can blame them?  You should still calmly tell the team you’re going to step away – but don’t expect them to act like this is anything short of a national emergency.

(To any pre-meds worrying about this: don’t.  I learned months ago that this does not happen if I just drink 2 bottles of gatorade the day before & have a non-sugary breakfast with absolutely no coffee.

Naturally, this meant that yesterday I drank absolutely no water, and this morning had a reasonable breakfast of 4 cups of coffee and a cinnamon roll.  Because I make good choices.)

I don’t know if I should go back in for the next surgery.  The surgical team doesn’t expect me to (and would probably be happier if I didn’t.  Nobody likes having to hover over the notoriously vasovagal med student), I absolutely don’t want to, and even if it makes the surgeon think less of me, he’s not grading me.  And I physically feel like there’s a very good chance I’ll do this again on the next case.

But the fact remains: I’m scheduled to be in the OR today.  So naturally, there’s a really annoying voice in the back of my head that’s saying, “You idiot.  You know what you have to do.  Get back in there.”

… I hate that voice.

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7 thoughts on “Holy vasovagal syncope, Batman

  1. Here’s what helped me:

    1. Salty big breakfast right before first surgery of the day. Like a sausage egg and cheese muffin. Followed by a bottle of water (24oz). SIPS ONLY! Otherwise you’ll have to pee mid case (which probably looks worse than passing out). Bottle to be consumed between 7 and approximately 12. Then get a new bottle if possible.
    2. March in place and do toe raises during the surgery even if you currently feel well. Helps with the good ol’ venous return. People will look at you like you’re nuts, but who cares.

    Good luck!

  2. I feel your pain. I almost passed out during a good 5-6 surgeries. I’m pretty sure the residents made fun of me for it. Gatorade is key, lots of food is key.

  3. I was the medical student who actually fainted when the baby was born. And my OB rotation was after 12 weeks of surgical rotations during which I saw trauma that actually gave me nightmares. I still don’t know why I hit the deck, but I did – big time. The new daddy saw me the next morning across the parking lot and shouted ‘HEY! ARE YOU DOING OK?”. humiliating.

  4. I wish someone had told me any of this before my first. And you are so right about them acting like you are planning on toppling over a few surgeons on your way to the floor. I merely mentioned that I was feeling a tad clammy, and I was instantly escorted out by nurses like a shoplifter and forced into a corner while they hovered over me like hungry vultures waiting for me to die.

  5. The only time I’ve felt faint in a surgery was after fully completing my Ob and Surgery rotations without incident and scrubbing in on a c-section during Family Med. I was 8 weeks pregnant and hadn’t told anyone yet and when I stepped back and said I was going to scrub out and sit down the scrub tech literally LAUGHED out loud and told me something along the lines of “ohh the noobs always pass out at this part.”

    I seriously felt an urge to a throw a bladder blade at her because I’ve spent more hours standing in really boring surgeries WISHING I would pass out than I could count. Maybe that was just the first trimester hormones, though.

    However, lesson learned – if you’re going to feel lightheaded or nauseated in surgery – do so in the presence of a non-surgeon family medicine doc doing a c-section…they’re the only ones nice enough to just ignore you and move on. Scrub techs however…not so much.

    Also, stay away from the burn and skin-graft ORs…holy Hell. Literally.

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