{"id":2377,"date":"2014-01-30T14:02:14","date_gmt":"2014-01-30T14:02:14","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/sspicu\/"},"modified":"2025-05-13T20:27:30","modified_gmt":"2025-05-13T20:27:30","slug":"sspicu","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/sspicu\/","title":{"rendered":"Sedation Scales for Patients in the ICU"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Of the sedation scales described, the Riker\u00a0Sedation\u2013Agitation Scale and the Richmond\u00a0Agitation\u2013Sedation Scale are the most commonly reported, but in head-to-head comparison,\u00a0neither is demonstrably superior\u00a0Sedation Scales for Patients in the intensive care unit (ICU).<br \/>\n<!--more--><br \/>\n<strong>Sedation Scales for Patients in the ICU<\/strong><\/p>\n<table border=\"1\" width=\"100%\" cellspacing=\"0\" cellpadding=\"4\">\n<colgroup>\n<col width=\"46*\" \/>\n<col width=\"76*\" \/>\n<col width=\"135*\" \/><\/colgroup>\n<tbody>\n<tr>\n<td colspan=\"3\" valign=\"TOP\" width=\"100%\"><strong>Riker Sedation\u2013Agitation Scale (SAS)<\/strong><\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\"><strong>Scoring<\/strong><\/td>\n<td width=\"30%\"><strong>Scale<\/strong><\/td>\n<td width=\"53%\"><strong>Description<\/strong><\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 7<\/td>\n<td width=\"30%\">Dangerous agitation<\/td>\n<td width=\"53%\">Pulling at endotracheal tube, trying to remove catheters, climbing over bed rail, striking at staff, thrashing from side to side<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 6<\/td>\n<td width=\"30%\">Very agitated<\/td>\n<td width=\"53%\">Requiring restraint and frequent verbal reminding of limits, biting endotracheal tube<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 5<\/td>\n<td width=\"30%\">Agitated<\/td>\n<td width=\"53%\">Anxious or physically agitated, calming at verbal instruction<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 4<\/td>\n<td width=\"30%\">Calm and cooperative<\/td>\n<td width=\"53%\">Calm, easily rousable, follows commands<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 3<\/td>\n<td width=\"30%\">Sedated<\/td>\n<td width=\"53%\">Difficult to arouse but awakens to verbal stimuli or gentle shaking; follows simple commands but drifts off again<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 2<\/td>\n<td width=\"30%\">Very sedated<\/td>\n<td width=\"53%\">Arouses to physical stimuli but does not communicate or follow commands, may move spontaneously<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 1<\/td>\n<td width=\"30%\">Cannot be aroused<\/td>\n<td width=\"53%\">Minimal or no response to noxious stimuli, does not communicate or follow commands<\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\" valign=\"TOP\" width=\"100%\"><strong>Richmond Agitation\u2013Sedation Scale (RASS)<\/strong><\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\"><strong>Scoring<\/strong><\/td>\n<td width=\"30%\"><strong>Scale<\/strong><\/td>\n<td width=\"53%\"><strong>Description<\/strong><\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 4<\/td>\n<td width=\"30%\">Combative<\/td>\n<td width=\"53%\">Overtly combative, violent, immediate danger to staff<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 3<\/td>\n<td width=\"30%\">Very agitated<\/td>\n<td width=\"53%\">Pulls or removes tubes or catheters; aggressive<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 2<\/td>\n<td width=\"30%\">Agitated<\/td>\n<td width=\"53%\">Frequent non purposeful movement, fights ventilator<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 1<\/td>\n<td width=\"30%\">Restless<\/td>\n<td width=\"53%\">Anxious but movements not aggressive or vigorous<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of 0<\/td>\n<td width=\"30%\">Alert and calm<\/td>\n<td width=\"53%\">Alert and calm<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of -1<\/td>\n<td width=\"30%\">Drowsy<\/td>\n<td width=\"53%\">Not fully alert but has sustained awakening (eye opening or eye contact) to voice (&gt;\/=10 sec)<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of -2<\/td>\n<td width=\"30%\">Light sedation<\/td>\n<td width=\"53%\">Briefly awakens with eye contact to voice (&lt;10 sec)<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of -3<\/td>\n<td width=\"30%\">Moderate sedation<\/td>\n<td width=\"53%\">Movement or eye opening to voice but no eye contact<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of -4<\/td>\n<td width=\"30%\">Deep sedation<\/td>\n<td width=\"53%\">No response to voice but movement or eye opening to physical stimulation<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"18%\">score of -5<\/td>\n<td width=\"30%\">Cannot be aroused<\/td>\n<td width=\"53%\">No response to voice or physical stimulation<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Reade MC, Finfer S. Sedation and delirium in the intensive care unit. N Engl J Med. 2014 Jan 30;370(5):444-54.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24476433\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Brummel NE, Girard TD. Preventing delirium in the intensive care unit. Crit Care Clin. 2013 Jan;29(1):51-65.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23182527\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Riker RR, Picard JT, Fraser GL. Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients. Crit Care Med. 1999 Jul;27(7):1325-9.<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10446827\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O&#8217;Neal PV, Keane KA, Tesoro EP, Elswick RK. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002 Nov 15;166(10):1338-44.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12421743\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Feb 21, 2014.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[148],"tags":[629,995,1000,978,990,973,999,998,997,996,1001],"class_list":["post-2377","post","type-post","status-publish","format-standard","hentry","category-critical-care","tag-care","tag-critical","tag-escalas","tag-icu","tag-pacientes","tag-patients","tag-richmond","tag-riker","tag-scales","tag-sedacion","tag-sedation"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2377","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2377"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2377\/revisions"}],"predecessor-version":[{"id":9292,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2377\/revisions\/9292"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2377"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2377"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2377"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}