Richmond Agitation-Sedation Scale

Sessler, Curtis N.; Gosnell, Mark S.; Grap, Mary Jo; Brophy, Gretchen M.; O'Neal, Pam V.; Keane, Kimberly A.; Tesoro, Eljim P.; Elswick, R. K.

doi:10.1037/t65546-000

Cited by 36 publications

(46 citation statements)

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“…A 2-phase study was conducted to test validity and reliability of the RASS. 27 Phase 1 consisted of patients admitted to the medical respiratory, neuroscience, coronary, surgical trauma, or cardiac surgery ICUs; sedation assessments were performed by 5 investigators (2 physicians, 2 nurses, 1 pharmacist). Phase 1 demonstrated moderate inter-rater reliability among the observers.…”

Section: Recently Published Sedation Scalesmentioning

confidence: 99%

“…The subjective sedation assessment instruments discussed in this article include the Richmond Agitation–Sedation Scale (RASS), 27,28 Adaptation to the Intensive Care Environment (ATICE), 29 Luer, 30 MAAS, 25 Bloomsbury sedation scale, 31 and a scale developed by Avripas et al 32 The objective tools discussed are the Bispectral Index (BIS), auditory evoked potentials (AEP), and Patient State Index (PSI). Since the publication by Devlin et al, 26 updated information on each of these instruments has been published, with the exception of one scale, the Luer, which was not mentioned in the previous review possibly due to the lack of reliability and validity testing.…”

mentioning

confidence: 99%

“…35 In addition, the values for reliability and validity for the studies described are provided in Table 2. 27,29,32,36–38…”

mentioning

confidence: 99%

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Sedation Assessment in Critically Ill Adults: 2001–2004 Update

Watson

Kane‐Gill

2004

Ann Pharmacother

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Section: Recently Published Sedation Scalesmentioning

confidence: 99%

mentioning

confidence: 99%

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Sedation Assessment in Critically Ill Adults: 2001–2004 Update

Watson

Kane‐Gill

2004

Ann Pharmacother

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“…We further assessed the level of sedation during anesthesia emergence with the Richmond Agitation-Sedation Scale-RASS. 13…”

Section: Cognitive Assessmentmentioning

confidence: 99%

Intraoperative electroencephalographic burst suppression may help to indentify patients at risk for long-term adverse outcome: Findings from a homozygous twins case

Linassi

Maran

Kreuzer

et al. 2019

Preprint

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Background: Postoperative cognitive dysfunction (POCD) presents a risk factor after general anesthesia, especially for old or cognitively impaired patients. Hence, strategies to identify possible patients at risk could help to decrease the rate of POCD. In this case report we relate the occurrence of electroencephalographic burst suppression and low bispectral indices to the development of neurocognitive decline after 12 months in one homozygous twin, whereas the other twin exhibited neither burst suppression nor neurocognitive decline. Case presentation: Two 68-year-old homozygous twins underwent the same surgical procedure with the same anesthetic regimens in comparable concentrations. For cognitive assessment, we applied a battery of neurocognitive tests at baseline (one day before surgery), at hospital discharge (three days after surgery), and 12 months after the procedure. The twins performed similarly in preoperative and discharge testing, but one twin showed worse test performance after 12 months. During surgery, we tested for possible connected consciousness by applying the isolated forearm technique (IFT). For assessment of the level of anesthesia and visual inspection of the EEG, we used the bispectral index (BIS). Neither of the twins showed signs of connected consciousness during anesthesia and the emergence tone to the return of a positive IFT response were similar. We observed lower intraoperative BIS indices for one twin. Furthermore, this twin also had two episodes of Burst Supppression. Vital parameters, particularly mean blood pressure, were stable and comparable during the entire duration of anaesthesia. The twin who exhibited Burst Suppression and lower BIS indices showed distinctly worse cognitive test scores after 12 months compared to baseline and discharge testing, indicating serious neurocognitive decline. The other twin’s cognitive performance did not decrease. Conclusions: We present findings from a unique scenario of homozygous twins with comparable lifestyles undergoing the same surgical intervention. The twin with neurocognitive decline had lower BIS values and multiple episodes of BSupp. These findings suggest that EEG monitoring under general anesthesia could help to identify frail brains that may be at increased risk of developing cognitive impairments.

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“…I retningslinjene er det anbefalt å vurdere pasientens sedasjonsdybde. 12 Richmond Agitation-Sedation Scale (RASS), 16 Sedation-Agitation Scale (SAS) 17 og MAAS er testet for validitet og reliabilitet og anbefalt for å vurdere sedasjonsdybde hos voksne intensivpasienter. 7,18 Behavioral Pain Scale (BPS) 19 og Critical Care Pain Observation Tool (CPOT) 20 er anbefalte smertevurderingsinstrumenter for voksne intensivpasienter som ikke kan svare for seg selv.…”

Section: Bakgrunnunclassified

Norske intensivavdelingers praksis rundt søvn og sedasjon

Dahl

Foss

Fossum

2015

Nordic Journal of Nursing Research

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Aim To get an insight into 1) how Norwegian intensive care registered nurses (RNs) assess patients’ sleep and sedative needs, and 2) to survey factors of importance for critically ill patients in Norwegian intensive care units to promote sleep. Background Patients in intensive care units suffer from sleep disturbances. The lack of sleep may cause physical and psychological disturbances, increased morbidity and prolonged stay. The nurses evaluate patients’ sleep mainly based on their own perception. Method All nurse managers of the adult intensive care units in Norway were contacted to answer a survey. Data were analysed using descriptive statistics, and teaching and non-teaching hospitals were compared. Findings RNs were aware of sleep disturbances and used several strategies to promote sleep. The most commonly used interventions were to turn off lights, to shield the patient with curtains, to reduce noise from staff, to use a clock and to reduce nursing interventions during the nights. Nurses felt that they had a great influence on patients’ sleeping practices. Conclusion RNs reported to have an influence on sleep practice and to actively promote sleep in the intensive care unit. Sleep-assessment tools were not routinely used, but the use of sedation-assessment tools were common.

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Richmond Agitation-Sedation Scale

Cited by 36 publications

References 0 publications

Sedation Assessment in Critically Ill Adults: 2001–2004 Update

Sedation Assessment in Critically Ill Adults: 2001–2004 Update

Intraoperative electroencephalographic burst suppression may help to indentify patients at risk for long-term adverse outcome: Findings from a homozygous twins case

Norske intensivavdelingers praksis rundt søvn og sedasjon

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