Almost Fainted in the OR Twice!!

[gymnut]

This is long but, I need some advice so hang in there with me!

So as a few of you may recall I am enrolled in a surgical technologist program through my hospital. I absolutely LOVE it and am doing great academically. We have started doing our clinicals, well, we are scrubbed to observe for right now but in January is when we officially start setting up, handing off the instruments etc.

The second time we went to clinicals we were just going to observe and not get scrubbed in but, my scrub tech was very enthusiastic about teaching so my instructor let me scrub in. About 20 minutes into the case I felt the heat begin to creep up my body and my vision start to go. The circulator nurse helped me out of my gown and gloves and sat me on the floor until my instructor came and took me to the lounge were I had orange juice. After that I just went back to observe and was fine. I know I can pinpoint why I almost fainted and that was because it was very hot (The heating cooling system was going haywire that day and it was almost 80 in the room) and I was so excited to watch the surgery that I pretty much forgot to breath and along with locked knees and a crap breakfast (a Poptart while running out the door) is a recipe for hitting the floor.

So today I promised I would not make those same mistakes. I got a good nights sleep, had a ginormous muffin and coffee for breakfast, put on my compression stockings (I don't have any vascular problems they just make my legs feel good after being on them for so long) and remembered to breath in through my nose and out through my mouth and shuffle my feet every so often. Everything was going great and I was really enjoying myself and learning a lot when about an hour into the second case I felt that old familiar heat start again. I tried walking around to the back table figuring it would get my blood moving and started taking deep breathes to get more oxygen but I couldn't make it. I let the tech know and again the circulator got me out of my scrubs and before I knew it I was in the hallway and these guys had one arm under each of mine and kept telling me to keep talking as they walked me to the lounge were again I drank orange juice and had a nurse hold my legs up while I laid down. They said I turned a greyish green color and my eyes were rolling the back of my head.

The funny thing is, is that both times I fainted all the nurses and techs began telling me stories of them fainting, doctors fainting in the middle of surgeries, nurses, PAs, and pretty much all who enter the OR. One guy jokingly said that that's the OR welcome mat! So while I'm still embarrassed I don't feel abnormal.

The thing is I have to figure what's wrong. I think I can pinpoint it to my eating a garbage sugar filled breakfast (Poptarts? Giant muffin? What was I thinking?!?!) all washed down with coffee filled with even more sugar and creamer. I know when I felt it today I was thirsty and starting to get hungry. I'm guessing my blood sugar dropped really low and down I went. I was also wearing those sketcher shape up shoes so I don't know if that was messing with my posture as well. They may be great for walking but maybe not for standing. I also made an appointment this Thursday with my doctor to get some blood work done.

The strange thing is when I worked in a factory I worked in hotter conditions will long sleeved heavy scrubs, gloves, gown and mask and many time I would have to stand in one spot and pack or fold and I never fainted. However we did have 3 breaks for snack and lunch. I know when I'm a PCA on the floor I often miss lunch but I still am able to jam a graham cracker or piece of bread into me to keep some fuel in my body. I know I'm not fainting over blood, organs or smells because they don't bother me at all. In fact the more I see the better!!

The thing I'm terrified of is I won't be able to stop the fainting spells. My one friend had to quit the program because if she stood still for too long her BP would drop really low and she's pass out. I want to be a surg tech with all my heart so I don't know what I would do if I couldn't

So any advice would be great right now because I feel like a schmuck :heartbeat

[Zippy7]

Some of my classmates fainted during their OR rotations as well and I can totally understand why. When you're in the OR, there's a mixture of feeling hot from what you're wearing, the long hours of standing, and the smell. One of the things I did before stepping into an OR last year was put a dab of peppermint oil on my nostrils. My instructor was the one who suggested this technique and I'm so glad she did. I'm sure in the long run, you'll also get accustomed to the OR environment, but in the mean time, try researching other little techniques you can do. Good luck!

[canesdukegirl, BSN, RN]

Oh honey, I know how you feel!

Try some high protein foods for breakfast. My fave is boiled eggs that I peel and put into a ziplock bag the night before, so I can just eat them on the way to work in the morning. I also LOVE the "Naked" drinks-they are full of protein, and the Blueberry one has a ton of B vitamins in it. Another great breakfast (if you like fish) is to mix a packet of salmon with some walnuts. It sounds gross, but it is 'super brain food', as my Indian friend calls it. It is packed with protein. He introduced this to me one day when I was complaining of being hungry as a hostage at 0930, and still had at least 3 hours to go until lunch relief rolled around.

Compression hose-good call! Most people forget to do this.

Get some Danskos if you like the way they feel. They are great for standing all day long. My feet never hurt at the end of the day, even when I have been standing for 12-15 straight hours. I promise that it will be the best $120 bucks you will ever spend.

If you KNOW that you are going to be in a really hot room, grab a bag of sterile water/saline out of the freezer, put a stockinette around it (or you can wrap a baby blanket around it) and then using some 3-4" cloth tape, tape that sucker around your waist, with the bag resting on the small of your back. You are gonna look like you have a badonkadonk booty, but you will be COMFY! I do this when I know that I am scrubbing in the burn room, where the temps are 90+. If you feel awkward about asking for a bag of water or saline, buy some of those gel thingies that you freeze to put in a cooler-they do just as well.

Some masks are different than others, and I find that I can breathe through the green ones better than the blue ones. Which mask are you using?

What procedure were you in when you fainted?

[Rose_Queen, BSN, MSN, RN]

A good breakfast helps. Not sugary crap, but something that will last a while. I used to not eat breakfast at all- I'd drink it in liquid caffeine form. I felt the same way you did. Now I have a decent sized breakfast- either scrambled eggs and toast or a sandwich with meat and egg.

If it's the heat, try putting a cold wet towel around your neck and under your scrubs. I work with someone who does this for every case they scrub. We also have a few surgeons who wear cooling vests that have pockets designed for ice packs. Maybe you could look into that.

I don't get the people who like shape ups. I just don't think they'd be comfortable to stand around in, and how are they for running down the hall with arms full of supplies for an emergency?

[canesdukegirl, BSN, RN]

Zippy brought up a great point that I forgot to consider. Sometimes the smell does get overwhelming. You can use peppermint oil, or a dab of Mastisol on your mask. If the surgeons are using a bovie for fatty tissue (i.e., breast reduction, mastectomy or panniculectomy), the suction will become your BFF. Suction that smoke, girl! The surgeons will appreciate it too.

[canesdukegirl, BSN, RN]

We also have a few surgeons who wear cooling vests that have pockets designed for ice packs. Maybe you could look into that.

I work for our state disaster team, where we have a large supply of cooling vests. One of the burn surgeons, who also works for our disaster team, asked me to get him one to try in the OR. I showed him how to use it, filled the pockets with the ice packs and strapped it on. He stood there, looking confused. I asked him what was wrong, and he replied, "Uh...shouldn't these pockets be filled with ice cold beers instead?"!

[LouisVRN, RN]

All of the other posters brought up the main things I would suggest. The only other one would be are you sure you're not pregnant? The only times I have felt like passing out at work without a cause has been very early on in both my pregnancies.

[gymnut]

Thank you guys for your advice! I will try out the cool patched cloths and eat a nice big protein filled breakfast before I go in. I just have to adapt to the environment. I knew what it was going to be like beforehand but, knowing and experiencing are two different things.

Oh and canesdukegirl I was in a procedure were they were resectioning an ileostomy. It was so much fun to watch. Actually now that I think of it even more I wasn't really moving at all. I was on the side of the resident and the tech and surgeon were on the other side. So I just stood there watching. Maybe it will be better when I'm moving around and getting all the stuff prepped because my mind will be so focused on other things rather than soley watching the procedure.

[Twinmom06, ASN, APN]

I was going to suggest a high protein/complex carb (like whole wheat bagel/bread with eggs) and drink water!! I find its better than caffeine for waking up my brain!

[gymnut]

All of the other posters brought up the main things I would suggest. The only other one would be are you sure you're not pregnant? The only times I have felt like passing out at work without a cause has been very early on in both my pregnancies.

No, definitely not pregnant!

[netglow, ASN, RN]

Nature Valley Granola bar (Oats and Honey - green box). Eat both of the bars in one packet, put 2 TBSP of peanut butter on one of them but eat both. In the car or on your way in, eat one banana, wash it down with 8 oz. orange juice -or- one can V8, Vfusion strawberry-bannana juice.

Do the above and you'll last.

[Brea LPN]

I passed out in the OR too. Idk why. I ate a good breakfast and remembered to shuffle my feet. Another student in my class passed out also. I don't think I got nauseous either because I was just watching a colonoscopy not a limp amputation or anything.