It depends on the depth of sedation. In most patients, we’re aiming to keep a patient calm, but awake, or at most drowsy. If they made the decision for cooling to 32-34 C, he would be more deeply sedated. You can still check reflexes under those circumstances. If they had to use a paralytic to control shivering, then most of those reflexes won’t be there. The pupils will still react to light, so those are still checked. When we do temperature control at 36 C, I keep sedation pretty light, because there tends to be a lot less shivering, and I can greatly reduce the amount of drugs the patient is exposed to.