Richmond Agitation-Sedation Scale
Score | Term | Description |
|---|---|---|
+4 | Combative | Overtly combative or violent; immediate danger to staff |
+3 | Very agitated | Pulls on or removes tube(s) or catheter(s) or has aggressive behavior toward staff |
+2 | Agitated | Frequent nonpurposeful movement or patient-ventilator dyssynchrony |
+1 | Restless | Anxious or apprehensive but movements not aggressive or vigorous |
0 | Alert and calm— | — |
-1 | Drowsy | Not fully alert, but has sustained (more than 10 seconds) awakening, with eye contact, to voice |
-2 | Light sedation | Briefly (less than 10 seconds) awakens with eye contact to voice |
-3 | Moderate sedation | Any movement (but no eye contact) to voice |
-4 | Deep sedation | No response to voice, but any movement to physical stimulation |
-5 | Unarousable | No response to voice or physical stimulation |
Adapted from Sessler CN, Gosnell MS, Grap MJ, et al: The Richmond Agitation-Sedation Scale: Validity and reliability in adult intensive care unit patients. American Journal of Respiratory and Critical Care Medicine 166(10)1338–1344, 2002. doi: 10.1164/rccm.2107138 | ||