Do you feel faint at the sight of blood?  If so, you’re not alone.  The most recent reader who was concerned about it wrote to me:

Hey, Paul! 

I’m currently a senior biology undergraduate and your website and it has really helped me with trying to narrow down my choices for schools and has reaffirmed my choice to go the PA route — until recently, that is.  You see, I have an internship at a hospital in my hometown and have had the opportunity to sit in on 3 surgeries.  Unfortunately, I have had to leave 2 out of the 3 surgeries due to queasiness and light-headedness. This really concerns me and my future in the medical field. Should I change my plans or will it get better with time?   

    -Patrick

Why We Get Faint at the Sight of Blood

This is actually fairly common, and I wanted this reader to know.  Here’s my reply:

Dear Patrick,

In a word, no, you shouldn’t change your plans – at least not at this point. 

Because I’m not treating you*, I can’t say for sure, but it sounds like your feeling faint at the sight of blood is what is known as a vaso vagal reaction.  Lots of things can cause vasovagal reactions, such as

  • Seeing something distressing, like blood or surgery
  • Painful or unpleasant stimuli such as having medical procedures, or a trauma
  • Workout out too hard
  • Dehydration
  • Sleep deprivation

And many others. 

Basically, when you experience something stressful, sometimes our brain goes into “shock” mode, your higher brain (the cortex) signals the brainstem about the event.  For reasons that aren’t well understood, the brainstem sends a powerful parasympathetic message through the Vagus nerve (hence the name vasovagal) to the heart that causes it to slow.  Blood vessels also simultaneously lose their tone, which causes them to dilate.  As a result of these, your cardiac output and blood pressure drop suddenly.  This  makes it hard to get enough blood to the brain, and you become uncomfortable, hot, faint, dizzy, or pass out altogether.  Because parasympathetic stimulation causes peristalsis, your stomach churns and you may become nauseated.  Sometimes ringing in the ears (tinnitus) occurs as well.

In most cases, fainting at the sight of blood doesn’t mean you can’t go into medicine – it just means you need to adjust how you do it. With gradual exposure to the triggering stimulus, some people are able in time to get used to blood and guts and it isn’t a problem.  If you don’t get used to what triggers you, there are plenty of PA specialties that don’t require that kind of work – psychiatry, medical cardiology, endocrinology, dermatology, and many others.  Surgery is the biggest offender for this problem because you’re wrapped in a gown and other constricting clothing, looking at blood, and standing the whole time.  

Don’t feel bad; it sounds like you didn’t have a gentle introduction to surgery, which makes things worse.  There was a student in my class who passed out while watching her first pelvic exam on a patient. The exam room was packed with the patient, instructor, and student, and it was hot and stuffy, which didn’t help.

If you’ve had other conditions ruled out by your medical provider, you’ll probably be fine – just study up on it, and remember that some specialties may not be for you.

– Paul

How to Prevent Feeling Faint at the Sight of Blood

If you have a problem with feeling faint at the sight of blood, there are also some precautions you can take:

  • Get plenty of rest
  • Stay well hydrated with fluids that have a little salt in them, like sports drinks.
  • Don’t go into situations that trigger you when you have an empty stomach – a light meal 30-60 minutes before is best.
  • Alternate between sitting and standing so that you aren’t standing for hours without a break.
  • If you are standing for prolonged periods, try wearing compression stockings – they reduce the pooling of blood in the legs.

If You Feel Faint at the Sight of Blood

  1. Get familiar with the symptoms.  It generally begins with just feeling bad overall, hot, and possibly nauseated.
  2. If you feel these early symptoms, remove yourself from the situation before you progress to passing out (vasovagal syncope).  The danger of vasovagal syncope comes from the risk of hitting your head when you faint.
  3. Walking around helps to force blood from the legs up into the torso, and can sometimes be helpful.
  4. Loosen tight or constricting clothing, such as neck ties.
  5. If these don’t help, the best way to get relief is to lie down with your legs elevated to a position higher than your head.  This helps with perfusion to the brain, and after 5-15 minutes should relieve the other symptoms like nausea as well.
  6. Talk with your doctor, PA, or NP about it to make sure your episodes aren’t caused by another condition.

Options in PA Medicine

The other reason that I bring this question up is that it’s a good example of how diverse the PA profession is, and the kinds of problems you can overcome while in it, if you think creatively.  If you can’t get past feeling faint at the sight of blood, psychiatry is a nice specialty to consider.  It pays well, and you rarely see anything gory.  Don’t like working one job for very long?  Consider locum tenens (traveling) work.  There are always options in such a big field.

*Just a reminder: this information is provided for educational and illustrative purposes.  If you get faint at the sight of blood, you should check with your doctor or PA to rule out more serious causes.[subscribe2]