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Why Does The Body Jerk When A Patient Is On Ventilator? Are Patients Sedated Before Being Intubated?

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Posted on Tue, 15 Oct 2013
Question: why does the body jerk when a patient is on a ventilator. when we entered the room and was talking to the nurse my mother's body jerked and I did not understand. also, are patients sedated before being intubated.
doctor
Answered by Dr. Anjana Rao Kavoor (1 hour later)
Brief Answer:
Jerk due to spinal motor reflexes

Detailed Answer:
Hi,

Thanks for writing in to us.

There is a scale called GCS (Glasgow coma scale) which tells us the alertness and consciousness of a person. Normally it is 15/15 and this is calculated by scoring eye opening, verbal response and motor activity. This tells us about the brain function. Ventilator support is usually provided to patients having a score of 8 or below.

The body jerk (motor activity) in ventilator patients is due to muscle reflexes which originate from the spine cord nerve cells. This is not an absolute indicator of the prognosis of such patients.

Most patients are unaware of surroundings when being intubated. In conscious and restless patients, a short acting sedation may help.

Wishing your mother an early recovery.
Do write back in case of doubts.

Dr.A.Rao Kavoor
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Anjana Rao Kavoor (52 minutes later)
What do u mean unaware of the surroundings? She was not unconscious. I am having issues with my mental state as to why I allowed this. I can find no peace because outwardly she appeared to not be in distress and now you say there is a scale to determine the necessity of intubation. If I did not allow this what could have happened. Please be honest no matter how painful.
doctor
Answered by Dr. Anjana Rao Kavoor (11 hours later)
Brief Answer:
Ventilation is life saving procedure.

Detailed Answer:
Hi XXXXX,
Thanks for writing in to us with an update.

I understand the situation you are presently facing and would like to make a few clarifications.

You have not mentioned the need for intubation and hence I assumed that the standard critical care protocol was followed.

Intubation and ventilation are different but always ventilation reqquires intubation. Intubation is the procedure by which an endotracheal tube is inserted. Ventilation is the artificial respiratory support given. Intubation is done for totally conscious patients just prior to surgery and in those who need artificial respiratory support due to their weak general condition.

Regarding consciousness, there is this medical scale followed and the score tells us how conscious the patient exactly might be. Unaware of surroundings does not mean that a person is totally unconscious but there are many stages of consciousness.

I am guessing that the oxygen saturation might not be enough to sustain the normal body functions and that is why ventilation was started. If ventilation is not given, there is a possibility that the oxygen saturation drops and the brain can get damaged irreversibly due to lack of oxygen. Ventilation is a life saving procedure.

The doctor might have taken a decision after weighing the risks and benefits of ventilator support in your mother. Ventilation is given to save a patient and not to worsen the condition.

Wishing your mother an early recovery.
Do write back in case of doubts.

Dr.A.Rao Kavoor
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Anjana Rao Kavoor

Psychiatrist

Practicing since :2008

Answered : 1197 Questions

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Why Does The Body Jerk When A Patient Is On Ventilator? Are Patients Sedated Before Being Intubated?

Brief Answer:
Jerk due to spinal motor reflexes

Detailed Answer:
Hi,

Thanks for writing in to us.

There is a scale called GCS (Glasgow coma scale) which tells us the alertness and consciousness of a person. Normally it is 15/15 and this is calculated by scoring eye opening, verbal response and motor activity. This tells us about the brain function. Ventilator support is usually provided to patients having a score of 8 or below.

The body jerk (motor activity) in ventilator patients is due to muscle reflexes which originate from the spine cord nerve cells. This is not an absolute indicator of the prognosis of such patients.

Most patients are unaware of surroundings when being intubated. In conscious and restless patients, a short acting sedation may help.

Wishing your mother an early recovery.
Do write back in case of doubts.

Dr.A.Rao Kavoor