Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Richmond Agitation-Sedation Scale (RASS) assigns a numerical score to a patient's level of agitation or sedation based on their behavior. The patient's behavior is assessed using predefined descriptions, and each description corresponds to a specific RASS score.

To determine the RASS score:

1. The calculator receives an input which is the patient's description based on observed behavior.
2. The available options for patient description range from combative behavior to unarousable sedation.
3. Each description is mapped to a corresponding RASS score as follows:

   | Patient Description                                                                              | RASS Score |
   |--------------------------------------------------------------------------------------------------|------------|
   | Combative: overtly combative or violent; immediate danger to staff                               | RASS +4    |
   | Very agitated: pulls on or removes tube(s) or catheter(s) or has aggressive behavior             | RASS +3    |
   | Agitated: frequent non-purposeful movement or patient-ventilator dyssynchrony                    | RASS +2    |
   | Restless: anxious or apprehensive, but movements not aggressive or vigorous                      | RASS +1    |
   | Alert and calm                                                                                   | RASS 0     |
   | Drowsy: not fully alert, but has sustained (> 10 seconds) awakening, with eye contact, to voice  | RASS -1    |
   | Light sedation: briefly (< 10 seconds) awakens with eye contact to voice                         | RASS -2    |
   | Moderate sedation: any movement (but no eye contact) to voice                                    | RASS -3    |
   | Deep sedation: no response to voice, but any movement to physical stimulation                    | RASS -4    |
   | Unarousable sedation: no response to voice or physical stimulation                               | RASS -5    |

4. For the computation process, the patient's description is checked against each possible condition. When a match is found, the corresponding RASS score is assigned..

The Richmond Agitation-Sedation Scale (RASS) is a clinical tool used primarily in intensive care units (ICUs) to assess the level of sedation and agitation in patients. It is particularly useful in monitoring the sedation status of mechanically ventilated patients, helping to guide sedation therapy and ensure optimal patient comfort without over-sedation. The RASS score ranges from -5 (indicating unarousable sedation) to +4 (indicating combative agitation). It is not applicable to patients who are not in an ICU setting or those who are not at risk of over- or under-sedation.

Pediatric critical care

Guidelines

Key sources