MY PA TRINING

Do You Faint at the Sight of Blood?

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]

 

  • Bekah August 24, 2012, 6:05 pm

    Hello Paul!

    I am currently a high school senior and was torn between the MD or PA route. I am so thankful for your website, it gets me excited to pursue the PA field.

    I have noticed that most applicants are not fresh out of their undergraduate degree and are a little bit older. I plan to not have a gap between my undergrad and PA schooling. I am already a dental and medical assistant, is this plus hospital volunteering during my biology undergraduate studies enough for PA HCE requirements?

    Thank you in advance!

    Reply
    • Paul August 25, 2012, 7:45 am

      It could be – it really depends on how much time you spend working, and what you end up doing. I suggest you try to accumulate as many hours as you can in diverse medical experiences.

      Reply
  • Gene March 16, 2013, 1:35 pm

    Hello Paul,
    Just want to ask you for advice. I am currently working in the dental field. I am Registered Dental Assistant and I would like to change my carrier to PA field. I would like to know if my dental experience will be consider for PA school, or required only medical field.
    Thanks for you advice.

    Reply
    • Paul March 18, 2013, 11:43 am

      Gene – you will get some credit, but it won’t be as much as you feel you deserve. Don’t lean on it – go out there and get some (other) great HCE to add to what you already have. Critical care experience would be good, so EMT would be the natural (but not only) choice.

      Reply
  • jill April 11, 2013, 7:19 am

    Hi everyone, I wanted to offer a story of hope about this topic. To give some background I am graduating university in May and was on my second interview at a dermatology/surgery center to be an MA there. The second interview went very well and I thought I had the job when I walked out of the door. The office manager was kind enough to ask me if I wanted to come back in to watch a surgery. Of course I said yes! The doctor explained that this surgery is pretty intense and that it is only done 1-2 times a month. I looked on in interest as a 1 inch by 4 inch piece of skin was being moved from a patients forehead to their nose. I was fine for the first 5 minutes. Once they were finishing up the sutures I started feeling hot, and lightheaded and I walked for the door and I remember walking up on the hallway floor. This was definately not how I wanted my interview to go. I felt extrememely embarassed and frustrated and I thought that I didnt get the job that I so dearly wanted. That night the office manager was nice enough to call and check up on me, and offer me the job. I explained that I had a midterm that morning, was dehydrated from only drinking coffee all day and she agreed that I wil slowly work my way up to the most intense surgeries. I am truely excited to start work there tomorrow! I’ll let you know how my experience getting sensitized to surgeries goes! But now I feel like I have to work even harder to prove that I am a valuable MA to them after that fun little experience:)

    Reply
    • Paul April 11, 2013, 2:23 pm

      Great story! You can learn to put up with more intense stuff. Part of what makes people pass out (AKA having a vasovagal response) is the surprise factor. The more surprising something is, the more likely it is to faint. So being exposed to things regularly makes them less surprising until (hopefully) there isn’t much chance of it happening.

      Reply
  • Sarah November 14, 2013, 3:04 pm

    Hello Paul,
    I think I may need help I have one of those frightful thoughts during college about if I should really do this major. I wanted to become a Pediatric Nurse because I really like being around kids. Then I changed my mind to a Nurse Practitioner because of the difference in money. I honestly don’t think that $50,000 a year might cut it after taxes are taken out. I was reading everything I can find about being a PA. My dad even talked to me about changing my major to that. I also don’t really blood, surgery, and seeing people die, its too nerve wrecking. Can you please help me on what i should do Im just not sure anymore.

    Thanks.

    Reply
    • Paul November 14, 2013, 10:20 pm

      You will probably make more money as a nurse than as a pediatric nurse practitioner, and possibly more than as a PA (sad, but true). But I say: don’t follow the money – follow your bliss. Do what sounds like the most fulfilling work to you.

      Reply
  • Molly March 3, 2014, 10:14 am

    I’m a high school junior and I am going for early application to a state university. I know I want to go into medicine, but I don’t want to be a doctor because of the hours (my family is composed of doctors, I see it first hand) and I don’t want to be a nurse because of the, well, nastier job details.
    I’m torn between PA and PT. I like PT because currently I am a swimmer and do martial arts and I love being physical active. But I want to feel useful instead of waiting months and months to feel like I’ve made a difference. And PTs don’t get much respect in the medical world.
    I like a PA because it is the knowledge like a doctor without the responsibility, but I don’t like the idea of being an assistant. And I would NOT want to do be a GP’s assistant, I’d die of boredom from sniffles and strep.
    What do you think? I want knowledge, stimulating days, activity, and respect for my field. Would there maybe be a PA specialty that would be like PT? I can be okay with surgery. I think.
    I plan on majoring in either Clinical Laboratory Science or Biological Sciences either way.
    Thank you for your help!

    Reply
    • Paul March 7, 2014, 12:35 am

      Hi, Molly!

      PA’s aren’t really “assistants.” They work pretty much independently. You will actually find that in surgery they come the closest to being “assistants,” in that they are never technically the lead in the OR. Their work outside of the OR involves plenty of decision making and challenging medicine, but they often are implementing a surgeons (general) orders. But if PT and surgery interest you, you should look into ortho as well as physical medicine and rehabilityation (PM&R). PM&R is like ortho and pain management together, with procedures, but no true surgeries.

      I will say that I felt EXACTLY the same way about primary care when I started working. I now work at an urgent care clinic where we do a large variety that includes urgent care (suturing, etc), primary care, and industrial medicine (workman’s comp). although you will see plenty of colds, I still have fun. There are days that you can be a lot of help to a patient who has a cold, and it can be very satisfying to have something “easy” to help your day move by. In the end, for me, medicine is about the relationships you have with patients, and colds give you a chance to have that.

      Reply

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