RASS (Richmond Agitation-Sedation Scale) — Free Online Calculator
Assessment
RASS Score
0
Alert and calm — ideal for most ICU patients
About This Calculator
The Richmond Agitation-Sedation Scale (RASS) is a validated 10-point scale used to assess the level of agitation or sedation in ICU patients. It ranges from +4 (combative) to -5 (unarousable). RASS is commonly used to titrate sedative medications and set sedation targets. For most mechanically ventilated ICU patients, the target RASS is 0 to -2 (alert and calm to light sedation).
Formula
Interpretation
| RASS Score | Term | Interpretation |
|---|---|---|
| +4 to +1 | Agitated | Combative to restless |
| 0 | Alert & Calm | Ideal target |
| -1 to -2 | Light Sedation | Acceptable target range |
| -3 | Moderate Sedation | May be appropriate in some cases |
| -4 to -5 | Deep Sedation | Assess need for this depth |
References
- Sessler CN, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166(10):1338-1344.
- Ely EW, et al. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289(22):2983-2991.
Frequently Asked Questions
What is the ideal RASS target for most ICU patients?
For most mechanically ventilated ICU patients, the target RASS is 0 (alert and calm) to -2 (light sedation). Deeper sedation (RASS -3 to -5) is associated with longer ICU stays, prolonged mechanical ventilation, and increased delirium.
How often should RASS be assessed?
RASS should be assessed regularly, typically every 2–4 hours in mechanically ventilated patients, and more frequently when titrating sedative medications. It should be documented as part of routine nursing assessment.
What is the difference between RASS and Ramsay Sedation Scale?
Both measure sedation depth, but RASS also assesses agitation (+1 to +4), while Ramsay focuses only on sedation levels. RASS has been more extensively validated for reliability and is recommended by the SCCM Pain, Agitation, and Delirium (PAD) guidelines.
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⚠ Medical Disclaimer
This tool is for educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for clinical decisions.