Richmond Agitation-Sedation Scale (RASS)
| Score | Term | Description |
|---|
| +4 | Combative | Overly combative, violent, immediate danger to staff | | +3 | Very agitated | Pulls or removes tubes or catheters; aggressive | | +2 | Agitated | Frequent nonpurposeful movement, fights ventilator | | +1 | Restless | Anxious but movement not aggressive | | 0 | Alert, calm | | | −1 | Drowsy | Awakens to voice (eye opening/contact) >10 seconds | | −2 | Light sedation | Briefly awakens to voice (eye opening/contact) <10 seconds | | −3 | Moderate sedation | Movement or eye opening to voice (but no eye contact) | | −4 | Deep sedation | No response to voice but movement or eye opening to physical stimulation | | −5 | Unarousable | No response to voice or physical stimulation |
|