😷ICU SEDATION & THE NEURO EXAM🧠 To be clear, there are situations when you can’t or shouldn’t

Added: 2026-06-01

[00:00:00]This may seem a bit obvious, but just so we're all on the same page, trying to reliably do a neurological exam at the bedside in a patient who is on the ventilator and on IV sedatives is not really a great idea. You know, whenever your patient is getting systemic sedation, it's going to affect your neurological exam. It's going to affect, you know, their alertness, their reflexes, their pupillary response, all that kind of stuff. And I know it sounds like a bit of a no-brainer, but I can't tell you how many times someone has come up and started to report a neuro exam to me on a patient who is on a high dose of propofol, etc. We need to really stop all of our sedatives and give them enough time to clear from the system before we actually say what the patient's neurologic status is and try to make some accurate prediction of their brain function. And since that has so many important implications, especially to patients' families, one of the most important questions you get asked is, you know, are they alert? Are they okay? Are they going to wake up from all this? You really don't want to be making conclusions and telling family members things unless you're sure that the patient is not on any sedatives, you've given enough time for those sedatives to clear from their system.