• Randy Pigg
    September 7, 2016 at 7:04 pm #622

    Which of the sedation scales do you use in your practice?

    Ramsay sedation scale

    Score Response
    1 Anxious or restless or both
    2 Cooperative, orientated and tranquil
    3 Responding to commands
    4 Brisk response to stimulus
    5 Sluggish response to stimulus
    6 No response to stimulus

    Sedation-agitation scale

    Score Level of sedation-agitation Response
    7 Dangerous agitation Pulling at endotracheal tube, thrashing, climbing over bed rails
    6 Very agitated Does not calm, requires restraints, bites endotracheal tube
    5 Agitated Attempts to sit up but calms to verbal instructions
    4 Calm and cooperative Obeys commands
    3 Sedated Difficult to rouse, obeyss simple commands
    2 Very sedated Rouses to stimuli. Does not obey commands
    1 Unarousable Minimal or no response to noxious stimuli

    Richmond Agitation Sedation Scale

    Score Term Description
    +4 Combative Overtly combative, violent, immediate danger to staff
    +3 Very agitated Pulls or removes tube(s) or catheter(s); aggressive
    +2 Agitated Frequent non-purposeful movement, fights ventilator
    +1 Restless Anxious but movements not aggressive vigorous
    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 with eye contact to voice (<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

    Glasgow Coma Score

    The Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in a coma. The total score is the sum of the scores in three categories. For adults the scores are as follows:

    Eye Opening Response
    Spontaneous--open with blinking at baseline 4 pts
    Opens to verbal command, speech, or shout 3 pts
    Opens to pain, not applied to face 2 pts
    None 1 pt

    Verbal Response
    Oriented 5 pts
    Confused conversation, but able to answer questions 4 pts
    Inappropriate responses, words discernible 3 pts
    Incomprehensible speech 2 pts
    None 1 pt

    Motor Response
    Obeys commands for movement 6 pts
    Purposeful movement to painful stimulus 5 pts
    Withdraws from pain 4 pts
    Abnormal (spastic) flexion, decorticate posture 3 pts
    Extensor (rigid) response, decerebrate posture 2 pts
    None 1 pt

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