Vasovagal Syncope

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Springtime is a new adventure for many first-year medical and nursing students. After a semester in the classroom, they are let loose to observe the real world. Invariably, the same scenario plays out.

All is well as they enter the operating room. The anesthesiologist is finishing putting the patient to sleep, and the student is set to observe an actual surgical procedure for the first time. The room is excessively hot to keep the patient warm on the table. The surgeon puts sterile drapes across the body, the bright lights are turned on, and the only noise is that of the ventilator breathing for the patient. The surgeon turns to the anesthesiologist, asks permission to begin and makes a long, slow incision into the body with the scalpel edge.

Meanwhile, the student's cool veneer begins to show cracks. The heat of the room has made sweat start to stream on the forehead. The lights start to blur, and voices in the room become distorted. The sickening nausea, the lightheadedness, vision fades to black, and all this is quickly followed by the sound of the firs- year student hitting the floor in a faint.

It's not the first time this has happened; one of the surgical nurses wanders over and checks on the student, who gradually wakens and sits up. In a few minutes the newbie is escorted into the break room where the nurse helps soothe the damaged ego and reassures the poor soul that this is standard operating procedure. Many people pass out with their first operation.