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The Case of the “Laboratory Code Blue”
Oct 17th, 2011 Headlines, Tales from the Clinic

At 2 o’clock in the afternoon, generic the loud announcement of “Code Blue Laboratory” is heard over the intercom. Two nurses and I rush to the lab on the first floor of the clinic, check where a 17-year-old boy has passed out.  According to the lab technician, stomach the boy was having his blood drawn when he suddenly turned “white as a sheet.”  He also became clammy, before slumping down in his chair.  When we arrived, the boy was thankfully breathing regularly with a regular pulse, but remained unconscious.  We slowly lowered him to the floor, and within a few seconds he opened his eyes and said, “What happened?”

Discussion

Fainting is the sudden, brief loss of consciousness where the person passes out, falls down. Once you are on the ground after you faint, the person recovers quickly.  One of the most common causes is the vasovagal reflex in which your heart rate drops, your blood vessels dilate, and you get a sudden drop in blood flow to the brain.  Once you’re lying flat, however, blood flow to the brain resumes, which allows you to wake up. It’s often triggered by fear, stress, or pain and is quite common during blood draws.

For an otherwise healthy person, fainting is not usually anything substantial to worry about.  If, however, you have a heart condition or other medical problems and have never fainted before, it is imperative to seek medical treatment right away.

If you know that you are prone to fainting in certain situations, (e.g. when needles are involved) there are some things you can do to try to prevent it.  For example, it will be beneficial to drink a sports drink beforehand. This will provide some extra salt and fluid to your bloodstream. Other helpful suggestions include wearing compression stockings.  Most importantly, if you start to feel faint, sit or lie down right away.

Follow-up

The young boy was transferred to the Urgent Care area where he was monitored for some time.  Fortunately, his exam and electrocardiogram were normal.  He was given some juice to drink, and within minutes he felt significantly better.  The boy’s mother explained that this is not the first time he has fainted while getting a blood test.  To prevent a situation like this in the future, the boy was sent home with instructions to follow-up with his pediatrician.

 



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