← Back to All Calculators
RASS — Richmond Agitation-Sedation Scale
Validated 10-level sedation/agitation scale for ICU patients — guides sedation management
Instructions: Observe the patient. Select the RASS level that best describes their current state. This is an observational scale — no input required beyond selecting the observed behaviour.
RASS Quick Reference
| Score | Level | Description |
|---|---|---|
| +4 | Combative | Violent; immediate danger to staff |
| +3 | Very agitated | Pulls tubes; aggressive |
| +2 | Agitated | Frequent nonpurposeful movement |
| +1 | Restless | Anxious, not aggressive |
| 0 | Alert & calm | Normal target |
| −1 | Drowsy | Eye contact >10 sec to voice |
| −2 | Light sedation | Eye contact <10 sec to voice |
| −3 | Moderate sedation | Movement to voice, no eye contact |
| −4 | Deep sedation | Response to physical stim only |
| −5 | Unarousable | No response |
RASS is observational — no formula
Standard targets: Mechanically ventilated = 0 to −2 | Procedure sedation = −2 to −3
Paired with CAM-ICU for delirium assessment (RASS ≥−2 required for CAM-ICU)
Standard targets: Mechanically ventilated = 0 to −2 | Procedure sedation = −2 to −3
Paired with CAM-ICU for delirium assessment (RASS ≥−2 required for CAM-ICU)
Sedation Protocol: Daily sedation awakening trials (SATs) target RASS 0 to −1. Over-sedation (RASS ≤−3) prolongs mechanical ventilation, ICU stay, and increases delirium risk. Propofol/dexmedetomidine preferred for light sedation. Benzodiazepines should be minimised (associated with delirium). Always re-assess pain before increasing sedation.
For clinical decision support only. Not a substitute for professional medical judgment.
