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  2. Levels +1 to +4 describe increasing levels of agitation. The lowest level of agitation starts with apprehension and anxiety, and peaks at combative and violent. RASS level 0 is “alert and calm.”

  3. Richmond Agitation-Sedation Scale (RASS) is a medical scale used to measure the agitation or sedation level of a person. It was developed with efforts of different practitioners, represented by physicians, nurses and pharmacists.

  4. For alert and calm patients, RASS is 0. For agitated patients, scores are positive and the higher the score, the higher the agitation level. For sedated patients, scores are negative, where -5 points indicate unarousable sedation.

  5. A score of 0 signifies a calm and alert patient. Positive RASS scores denote levels of aggressive behavior, and negative RASS scores denote less responsiveness, and differentiate between response to verbal (–1 to –3) and physical stimuli (–4 and –5).

  6. For most patients a RASS of 0 to -2 is desirable. RASS = 0 means the patient is alert and calm. RASS = -2 means they awaken to voice (eyes open for <10 seconds).

  7. Jul 25, 2001 · RASS is a 10-point scale, with four levels of anxiety or agitation (+1 to +4 [combative]), one level to denote a calm and alert state (0), and 5 levels of sedation (−1 to −5) culminating in unarousable (−5).

  8. The RASS score. There are lots of ways to assess sedation in critical care. In our unit we use the RASS scoring system. By recording the score on the chart we can also see trends in how the patient has been sedated. Positive scores of +1 to +4 are based on observing the patient.

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