Richmond Agitation-Sedation Scale (RASS)
Standard ICU sedation and agitation scale.
Inputs
0 of 1Patient state
When to use
- Every sedation assessment in the ICU.
Pearls and pitfalls
- PADIS guideline target: light sedation (RASS −2 to 0) for most patients.
Why use
The most widely used ICU sedation scale.
| Criterion | Points |
|---|---|
| Patient state: +4 Combative | +4 |
| +3 Very agitated (pulls tubes) | +3 |
| +2 Agitated (fights ventilator) | +2 |
| +1 Restless | +1 |
| 0 Alert and calm | 0 |
| −1 Drowsy (eye opening 10 s or more to voice) | -1 |
| −2 Light sedation (eye contact under 10 s to voice) | -2 |
| −3 Moderate sedation (movement to voice, no eye contact) | -3 |
| −4 Deep sedation (movement to physical stimulation) | -4 |
| −5 Unarousable | -5 |