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Public Health/Unexpected Fainting


Okay, so I'm sorry if this is dumb or I'm overreacting, I'm just concerned. I want to go into the medical field, I'm a junior in high school right now, and two of the times I've interned at a hospital, I've fainted or almost fainted. This has never happened to me before.
The first time I was observing someone getting numbed with a needle, but there was no blood, and I was just talking to the guy next to me, not even watching the needle or anything. I had been at a conference all day and barely ate anything, it was nearing 5-6pm at the time. I felt really light headed and my vision spotted black and I wound up on the floor. I ate some crackers, sat down for a little bit, drank some water, and I was perfectly fine within minutes.
The second time it happened was yesterday, I was just observing a patient with the flu being discharged. No blood, no needles, no nothing. Same thing as before, lightheadedness followed by spotty vision. I caught it ahead of time, this time, and sat down until my head cleared. Took me a few minutes, then once again I ate crackers, apple juice, and sat down. This time it took me a few more minutes than usual to go back to completely normal, and I was still a little shaky. That day I had lunch, but it wasn't a huge lunch, and I had skipped breakfast and dinner. It was nearing 9:30pm this time.
I've gone to never fainting, to twice in a short time period of a few months. Both at a hospital, which makes me nervous about my chosen profession. I've seen a dead guy, and watched bloody stitches up very close while restraining a screaming and hysterical child, and I never batted an eyelash. I thought it was the coolest thing ever. The common denominator seems to be lack of food and water, and standing on my feet for too long.
I really love volunteering at the hospital, and I can't imagine going into a field other than medical, what's your opinion? I've skipped meals before (only when I'm really busy, I do love food and eating) and nothing like this ever happened. Once again, I'm sorry if this is stupid and I'm bothering you, I'm just worried and nervous.

I'm sorry to hear you're the one who's fainting because it can be alarming.  Most important:  You *must*, *must* see a provider who looks for an answer.  (I'd recommend a Cardiologist).

I don't think where you were had anything to do with why you fainted, based on how I read the rest of your message.  (I volunteered at hospitals, too.)

Generally-speaking causes of fainting include an over-reactive vaso-vagal reflex, orthostatic hypotension, stroke (maybe others).  In someone your age they also include congenital anomalies in the heart muscle, of which many can be treated.  Do I'm wondering about the latter and about the orthostatic hypotension.  

I don't believe it has anything to do with eating. Giving crackers shouldn't do anything unless you're hypoglycemic.  (I don't believe one's blood glucose level can vary enough to cause hyperactive behavior but I've experienced a lift in my mood if I've forgotten to eat for 8 or 12 hours, then eat something.)  We're each a bit different in this regard.

A doctor (or PA; they have the same classroom training as a doctor) may or may not think the common elements you mentioned are related.  

Given your interested in the field, here's some info that may also interest you.

Possible tests are: a) Echo Cardiogram.  This let's someone see the heart working, and can reveal certain anomalies.  b) Stress test.  This lets the doc see how your heart responds under stress.  c) Holter monitor.  This records your rhythm for about 24 hours.

The clinical process:

1. Patient says what the chief complaint is, gives background info about the complaint and about general medical history, and answers questions.  Includes your opinion about mitigating factors like eating and standing for long periods.  (SUBJECTIVE)

2. The doc describes appearance: skin (pale, reddish, warm, cool, etc; and complexion, moles, warts, etc), heart rate, respiration, temperature, age, sex, etc.  Order labs, imaging, draw blood, etc. (OBJECTIVE)

3. They create a list of things that can cause symptoms you mentioned (SUBJECTIVE) and narrow it down or expand it based on what is revealed by your answers and their findings (OBJECTIVE).  Making a diagnosis is part of this step (ASSESSMENT).

4. They determine what to do: Treat? or more tests? or both?  (PLAN)

The four steps are what is described in SOAP notes.  

Hope this helps:  Please talk to a provider. :-)
- John

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