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Document RASS score every 4 hours, PRN, and when titrating sedative infusions. F. Decrease the sedative medication to a point where a neurological assessment can be completed every 24 hours (unless otherwise ordered by the practitioner).
In most cases, the target level of sedation to aim for post-sedation is: SAT 0 to 1. ( 1 Calver, L.A., Stokes, B. Isbister, G.K. (2011). Sedation assessment tool to score acute behavioural disturbance in the emergency department.
Richmond Agitation-Sedation Scale (RASS) ScoreTermDescription 0 Alert and calm -1 Drowsy Not fully alert but has sustained awakening (eye opening/eye contact) to voice ( 10 seconds) -2 Light sedation Briefly awakens to voice with eye contact (
Sedation should be assessed, via the RASS score, and documented at least once every 2 hours while patients are mechanically ventilated. The guideline recommends a goal RASS score of 0 to 1 for most patients, although specific exceptions exist (ie, neuromuscular blockade).
RASS is one of the most commonly used scales to determine the sedation level, and it measures the severity of agitation and sedation with a score of +4 to 5: +4: combative, +3: very agitated, +2: agitated, +1: restless, 0: alert and calm, 1: drowsy, 2: light sedation, 3: moderate sedation, 4: deep sedation, and 5
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The Richmond Agitation and Sedation Scale (RASS) was created to optimize sedation. The Glasgow Coma Scale (GCS) was developed for head trauma patients12 and is now a standardized assessment tool in intensive care units,13 the emergency department,14 and the pre-hospital setting.
Richmond Agitation-Sedation Scale ScoreLevel of agitation 3 Moderate sedationany movement (but no eye contact to voice) 4 Deep sedationno response to voice, but any movement to physical stimulation 5 Unarousableno response to voice or physical stimulation2 more rows

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