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

[gymnut]

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.

The first time we went in myself and two others went down and this time it was one of the students from the first time and myself. I didn't get nauseous or anything either. Just really hot (like a hot flash) and then my vision and hearing faded.

[Horseshoe, BSN, 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.

Not everyone could tolerate that many carbs. A breakfast like that would have me on the floor a couple hours later for sure.

I eat a high protein breakfast with only complex carbs, never juice, and a serving of a healthy fat, and that does it for me. The OP may need to experiment with limiting simple carbohydrates and focusing on protein and a small dose of a healthy fat, especially if lunches are hard to come by until late, as is the case where I work.

[NurseSnarky]

Breakfast...it really is the most important meal of the day when heading into the OR. I can oh so feel it if I've not eaten well. Don't be stingy on that btw...eat a healthy BIG breakfast with the protein and whole wheat natural bread (no high fructose corn syrup)....and oatmeal with nuts was always a fav of mine with scrambled eggs on the side. Work up to that if you're not used to eating it. I'm glad you're going to check things out with your doc...good idea to r/o other problems. And think WATER is so underrated!! I drink TONS of water during the week when I'm working. Bring a tumbler/cup with the straw and keep it filled all day!

I ALWAYS wear my compression socks (don't do hose) and I'm never without my Danskos. They are worth every penny and then some.

I always breath out of my mouth if it's a smelly case...I've made the mistake of taking a "sniff" here and there, but I usually just "shut off my nose" if that makes sense.

Heat plays a HUGE factor and people always ask why it's so cold in the OR. Bottom line is, scrubbed-in personnel's comfort. I work with a ST that will wear the vest mentioned earlier if she's in certain rooms that are either long cases or the room is hot.

:redpinkhe I think the bottom line is to not be a hero and take care of yourself. Hopefully between the advice you've received here and talking to your doc, you'll be able to get through this. If you will need to be in the OR before your doc appt. ask to be in SHORT cases and not in hot rooms. If you are able to observe and sit periodically, do it. :)

[NurseSnarky]

Not everyone could tolerate that many carbs. A breakfast like that would have me on the floor a couple hours later for sure.

I eat a high protein breakfast with only complex carbs, never juice, and a serving of a healthy fat, and that does it for me. The OP may need to experiment with limiting simple carbohydrates and focusing on protein and a small dose of a healthy fat, especially if lunches are hard to come by until late, as is the case where I work.

I agree...and don't do pop if you don't have to have it. Water, water, water. Mid-morning I'll have a quick sip of 100% OJ with no added sugar. Oh and I forgot, I also second the Naked juices. Some Starbucks will sell them, so I ask them to blend it with ice to make a smoothie.

[renaissanceart]

Sounds like blood sugar to me and sometimes it's not that it gets very low but rather how fast it falls that will make you feel faint....high protein/complex carb breakfast and then 15 or so almonds about 3 hours later is my routine and it really works. Otherwise, I'm on the floor too!

[sugarmagnoliaRN]

This may seem labor-intensive, but when I had time to make breakfast I'd have 4 egg whites & 1 whole egg, scrambled with cheese and/or salsa, toast w/peanut butter, and some fruit. It's healthy and will definitely keep you full for a long time! My more time-conscious suggestion would be instant oatmeal with peanut butter added. Sounds weird, but it's delicious (I put cinnamon in mine) and it'll keep you full a long time! Only takes about a minute and a half to make. And like others mentioned, water water water! :)

[ORoxyO]

If you do feel another episode coming, sit down! Even if you have to sit on the floor. I had a student who fell this week who went down spectacularly- took out an entire rack of supplies and almost nailed his head on the floor. I leaped across the room and got my hand under his head just before it hit. This young man had been in several cases just fine, but maybe it was the lead this time that got him.

I do agree that most fainters forgo a good breakfast. I lost several students/residents during Ramadan.

Good luck! Hopefully it is an easy fix for you. And like you were told, it does happen, so don't feel like the only person to ever faint in an OR.

[trauma_lama, BSN]

my easy breakfast that works AMAZINGLY well...slow release of glucose into blood, no crash, and lots of fiber to keep you full for a long time: 2 eggo low fat whole grain waffles (the box with the peach slices on the waffle on the cover) toasted. smear 1 tsbp natural jiff on on waf and then slice up 1/2 banana and put on peanut butter. add other waf on top and voila! it's easy to carry (i eat mine in the car on the way every morning) and it seriously keeps me feeling genuinely full up to 5 hours at a time. try a breakfast with more fiber, protein and complex carbs and see if that helps your fainting spells. good luck!!

[renaissanceart]

I have a quick and easy one too....half a cup of egg beaters ( in the carton) microwaved in a bowl for 3 minutes on a toasted high fiber english muffin spread with alittle olive oil buttery spread...wrap in a napkin and eat on the run:)

Some times I add a cheese stick to the bowl in the micro and some chopped onions and green peppers...if time allows:)

[canesdukegirl, BSN, RN]

I have a quick and easy one too....half a cup of egg beaters ( in the carton) microwaved in a bowl for 3 minutes on a toasted high fiber english muffin spread with alittle olive oil buttery spread...wrap in a napkin and eat on the run:)

Some times I add a cheese stick to the bowl in the micro and some chopped onions and green peppers...if time allows:)

OK, now I am hungry!

[gymnut]

You people just rock my socks completely off!!! I have another clinical on the 8th of November so I'll be bumping this thread to let you know how everything goes.

I also have the complete gowning ensemble so I'm going to wear that over my regular scrubs around the house (for a few hours while I study) so my body can adjust again to all that garb. I have a mask with a shield but I think I'll go with just a mask and goggles. Maybe that will help me get more oxygen. One of the nurses mentioned that my mask could be causing me to rebreathe too much CO2. I'm just tackling everything at all angles!!

[Sparrow23]

I had the same thing happen to me. Had never fainted in my life and never had a problem with any bodily fluids/surgeries/etc. Then one day boom: fainted and threw up, and then passed out again. Came to and was given juice, threw up again as soon as I got up, and promptly fainted again. Ugh. Sooo embarrassing.

One thing I noticed- I felt way more susceptible to fainting after that happened, and I think a lot of it was due to anxiety over whether or not it was going to happen again. Fainted once more (watching a PICC insertion of all things... granted it was a million degrees in the pt's tiny room) but hasn't happened since, fingers crossed. Was so nervous about it happening again and felt it coming on during another procedure but was able to walk it off thank goodness.

You've got some excellent tips from the other posters. The only thing I have to add is, don't psych yourself out like I did. Do whatever you can to help yourself relax and not fixate on worrying about whether or not you will faint again. Good luck!