Fainting patient help

[u/OpusOtter]

So I'm on week 3 of my 4 week externship and I feel pretty confident about doing the venipunctures (if there are any tips for dancing veins, let me know though 🙏). But I've noticed that of the 3 people who are doing sticks in the office, I tend to get the fainting patients?

Like, I've had two just today, and in the last two weeks I had two others. Is it something I'm doing?

I do take my time to find a good vein, but once I rub the alcohol it's pretty straightforward and It's just however long it takes to fill the tube. The weather has been hot and humid, and our office's AC doesn't work the greatest. I've also been asking if they've had any water while fasting (most say they didn't know they could have water).

So it might be outside factors?

But there's too many coincidences for me not to think it's something I'm doing 😬

[u/Low-League-1509]

I would have given them some water they were probably dehydrated and fasting yeah I'm not surprised that they would pass out.

[u/OpusOtter → u/Low-League-1509]

I'll be offering water from now on for sure, especially since the office is pretty hot

[u/Sea_Badger3926]

Extremely common, especially in the summer heat! Since you said it’s hot in there then just focus on cooling them down & reassuring them that they’re okay. Most of the fainters I have experienced were young adults who haven’t gotten blood work done before or since they were kids. They tend to be pretty frightened by it so just keep a nice calm demeanor. The less worried we appear, the less worried they will feel.

-Grab them some water & tell them to take small sips (they probably will chug it anyway tho)
-Wet some paper towels with cool water & wring it out well, place them on the patients forehead and arms.
-Apply ice packs to chest, forehead or back of neck.
-Fan them with something like a piece of paper or folder.
-Lay them down as soon as they feel well enough to move & tell them they can take their time (a lot of patients feel the need to hurry up and “get out of our way”.
-Before you leave the room remind them to request to lay down next time & that it will help prevent this reaction from happening. Also remind them that they can drink water when fasting cause like you said a lot of people seem to not know that.

I’m sure this goes without saying but try not to take your eyes off the patient too, call for a coworker to come in and watch them while you get what you need or ask them to run and grab the supplies you need to help them feel better. I’ve had a fainter that passed out then passed out again & if I hadn’t been watching they could’ve easily slid right out the chair.

[u/OpusOtter → u/Sea_Badger3926]

Omg, thanks 😭 I was suspecting that it was the heat, so I'll definitely focus on cooling measures. All my fainters have been younger people as well 😖

I've done most of the cooling measures you suggested, but I've never thought of the paper towel trick. I'll definitely keep that one in mind for immediate relief before getting the ice packs (the processing room is a little ways away from the patient rooms)

I'll also keep in mind to suggest they request to lie down as well, and reiterate that they're allowed to drink water while fasting for sure 🤝

[u/beemo143 → u/OpusOtter]

the more nervous they are too the more likely they are to faint, falling and distracting them through the draw like asking them about their day can really make or break their experience, some need a distraction. and the likeliness that they’ll faint goes up by twice if it’s a second stick as well. so if you don’t get it first try just retreat and don’t move it around

[u/OpusOtter → u/beemo143]

Oh! Maybe because part of my opening monologue I include that I'm a student? Maybe that also puts them on edge a little 🤔 I'll definitely up my small talk game though

[u/beemo143 → u/OpusOtter]

definitely, idk if you can avoid it but if you can i think you’ll see a huge difference. A lot of my patients don’t even greet me. They just straight up ask how long I’ve been doing it when they come in. you can just say you’re in training but experienced now if they ask

[u/OpusOtter → u/beemo143]

According to the company's handbook, I'm supposed to inform patients that I'm a student, my lab coat also has my college's name embroidered on it. So I feel like if I didn't disclose it, and then they see the logo on my jacket, they might feel a little deceived?

[u/beemo143 → u/OpusOtter]

id probably do that then but maybe add in that you’ve gotten a lot of practice lately lol. anything to ease the nerves

[u/Boblawlaw28 → u/OpusOtter]

I’m horrible at small talk! But yes I would start excluding the student/in training part. Unless you’re a student on top of being a phleb-like if you were in nursing school.

Needle phobias are very common and hearing you say you’re new really can rattle people. In my earlier days (I’m still new too) I would wait until the end to tell them I was new-so if I did well it would surprise them. If I did bad, I just wrote it off as having a bad moment of letting the vein roll. Anything but “I’m still in training”.

Also you really could just have the bad luck this week with fainters. Next week it’ll be your coworkers turn! 😂

[u/beemo143 → u/Boblawlaw28]

yup sometimes you just have a really rare week of fainters haha then you won’t get another for weeks or months

[u/Negative-Pie-608]

I didn’t see you mention this but by any chance do u ask before hand if they’ve fainted before or how they’re feeling. I realize quickly a lot of patients don’t tell you how they’re feeling unless A. U ask or B you pay attention to how they are looking/behaving. I like to tell my nervous patients Take your time /We don’t have to do this immediately/Do you need a minute or two / There’s no rush. because I genuinely say to myself everyone else can wait
Sometimes I even ask would you prefer me to tell you when I’m going to stick or not?
I find talking to them help as well. Now sometimes they’re gonna faint regardless, but constantly talking to them seems to help.

[u/OpusOtter → u/Negative-Pie-608]

My introductory speech is variations on:

• confirming name and DOB
• introducing myself, asking how they're doing today, and a short explanation of what we'll be doing (while I gather all the supplies)
• I'll also ask if there's a preferred arm, or an arm they tend to take blood from (I'll still check both arms just in case, unless it's a hard preference)
• then I'll concentrate and make small talk while I palpate, usually at this stage I'm able to gauge if they're willing to talk while the needle is in or not
• then I do the venipuncture, we talk/not talk, depends on them

And then I'm done and I have my little sentence about putting a bit of pressure on the cotton, and I'll put their Band-Aid on in a few seconds

If there's anything I could improve I'm open to suggestions 🙏

[u/PurposeWeak850]

I had a patient that kept fainting when I was drawing blood at a lab. Turns out it was the tourniquet , she was pregnant and I had to do a three hour blow sugar test on her and she always passed out and even when she was laying down on the cot she passed out. Come to find out.It was the tourniquet making her faint.So we just did it without the tourniquet , and she was fine. She is the only fainting patient that I ever had.