vasovagal reflex reaction

NCgunlover · 10-10-2006, 20:23

My question is one that seems kind of funny but can be quite serious. I am looking for ways to combat adverse psychological reactions to needles. I've had more than my fair share over the years and have gotten much better, but I still pass out almost every time I have my blood drawn. So much so that the medics usually gather around when I'm up for the AIDS test. I spoke with a psychologist a while back but he wasn't much help. His advice was basically ignore it as it is untreatable. On the other hand, I saw a Discovery Channel documentary with a woman who wanted to become a nurse but had the same problem. She turned out fine with some progressive therapy. I tried this on my own, visiting the TMC every time they were giving out free needles. Do Not ever try to give yourself therapy! It didn't go so well. Now, I'm fine with most other medical stuff. I was there for the birth of both of my children and have seen my share of trauma, but this needle thing still gets me.

Any advice? Has anybody worked with troops that have a similar problem?

**The Reaper** · 10-10-2006, 20:27

We used to just practice giving one another IV sticks with big needles in the team room.

The medics were real popular partners. The 18Bs and Cs, not so much. Most of them seemed to be probing for mines.

I always tried to let the other guy go first, just in case there should be any need for payback.

TR

NCgunlover · 10-10-2006, 20:33

I hate to admit it but that sounds like the best advice out there. I had to give my wife a shot a couple years back and ran five of the fastest miles of my life first. My heart rate was extremely high until that needle touched the skin. We're still married so I did okay, but she won't be coming to me for that kind of doctoring again.

mugwump · 10-11-2006, 07:29

Quote:

Originally Posted by NCgunlover

Any advice? Has anybody worked with troops that have a similar problem?

In Phase I research (my arena) we sometimes have protocols that require blood draws every 15 mins for hours (no locks allowed).

Clear your mind, go to your happy place, and don't look. "Combat breathing" helps some: five count in through the nose - pause - five count out through pursed lips. If you can be warm and "barrel up" your veins it can make things easier -- less crochet needle work.

V V response is a powerful reaction, especially if you're very fit. It's usually the very fit males who gork. Nothing to be ashamed of, you big wuss.

AF IDMT · 10-11-2006, 08:38

Quote:

Originally Posted by mugwump

V V response is a powerful reaction, especially if you're very fit. It's usually the very fit males who gork. Nothing to be ashamed of

Which explains why a great many of the infantrymen (both Marine and Army) I have worked on has gotten lightheaded.

mugwump · 10-11-2006, 09:14

Quote:

Originally Posted by AF IDMT

Which explains why a great many of the infantrymen (both Marine and Army) I have worked on has gotten lightheaded.

The only asystole we ever had -- touch wood -- was seconds after an IV push. Festivities and excitement ensued, but he started up again quickly. He was flatline for about 40 seconds. We stopped the trial and broke the blind. It was normal saline (placebo, confirmed by analysis) -- the guy had a vasovagal. He was an incredibly fit young South African trooper.

AF IDMT · 10-11-2006, 13:12

Quote:

Originally Posted by mugwump

The only asystole we ever had -- touch wood -- was seconds after an IV push. Festivities and excitement ensued, but he started up again quickly. He was flatline for about 40 seconds. We stopped the trial and broke the blind. It was normal saline (placebo, confirmed by analysis) -- the guy had a vasovagal. He was an incredibly fit young South African trooper.

I've never heard of one THAT bad. I probably would have had to check my own pulse right after his.

Funny thing about the term "quickly." In hindsight 40 seconds doesn't seem like much, but when it was going on I bet it felt like 4 minutes.

mugwump · 10-11-2006, 14:09

Quote:

Originally Posted by AF IDMT

I've never heard of one THAT bad. I probably would have had to check my own pulse right after his.

Funny thing about the term "quickly." In hindsight 40 seconds doesn't seem like much, but when it was going on I bet it felt like 4 minutes.

I was talking to a nurse in the central station when it happened. The monitor alarmed and she sort of groped around behind herself to turn it off without looking while continuing the conversation -- basically completely ignored it. The hubub in the ward alerted us there was a problem. The 40 seconds was measured off the trace.

I was not amused, especially after having coughed up a quarter mil to outfit all the beds with state-of-the-art monitoring. That said, the monitors false-alarmed all the time.

Aequitas · 10-11-2006, 15:11

One of our instructors mentioned a good way to combat the stick from the needle. Next time you go in for a shot try having the nurse step on your foot nice and firm so you won't even notice the needle. It helped with some of the guys in class that had phobias over needles during Med Admin days. The breathing mentioned above seemed to help too. Good Luck.

PSM · 10-11-2006, 15:28

Quote:

Originally Posted by mugwump

Clear your mind, go to your happy place, and don't look.

I had a dentist who snuck up on me once and started tweaking my nose rapidly. I asked him why he did it. He said it was to distract me from the needle. I have no problem with needles and told him to knock it off because it was damned annoying.

Pat

x SF med · 10-11-2006, 15:31

NCgunlover-
In 18 D training we had a guy who actually dropped for that reason - he would freak when he had to give or receive a needle (we were each other's practice dummies). It wasn't pretty when he was shaking while trying to hit a vein, and hee gouged me really well just giving a saline injection in the upper arm, never bled from a 22 ga shortie before or after that one time...

It just happens, look away, distract yourself - don't go 18D.

NCgunlover · 10-11-2006, 17:17

More great advice. I have a lot of respect for all in the medical community but don't intend on ever including myself in their ranks. I am actually starting the Qualification Course for 18A in JAN after ICCC. I just don't want to be any sort of hindrance to my team and see this as my biggest weakness. Most of the other stuff can be improved with good old fashion hard work such as studying more or extra PT.