Adapted from Ramsay MA, Savage TM, Simpson B, et al: Controlled sedation with alphaxalone-alphadolone. British Medical Journal 22;2 (5920):656–659. doi: 10.1136/bmj.2.5920.656.

Adapted from Ramsay MA, Savage TM, Simpson B, et al: Controlled sedation with alphaxalone-alphadolone. British Medical Journal 22;2 (5920):656–659. doi: 10.1136/bmj.2.5920.656.

Currently two frequently used scoring systems exist to assess sedation in the ICU. These are the Ramsay Sedation Score and the Riker Sedation-Agitation Scale (Tables 33-1 and 33-2).

The Ramsay Sedation Scale (RSS) is a standardized tool for assessing the depth of sedation in patients. Below is the scale, adapted from Ramsay MA, Savage TM, Simpson B, et al: Controlled sedation with alphaxalone-alphadolone. British Medical Journal 22;2(5920):656–659. DOI: 10.1136/bmj.2.5920.656. MSD Manuals. (n.d.). The Ramsay Sedation Scale.

The Ramsay Scale4 is straightforward to complete and provides three levels of ‘awake’ states (score 1-3) and three levels of ‘asleep’ states (score 4-6). A score of 2 (patient is cooperative, orientated and tranquil) best fits an optimum sedation level based on the criteria of a calm, comfortable, communicative and co-operative patients.

Modified atter Ramsay Savege I.M., Simpson Goodwm K Controlled sedation with alphaxalone-alphadolone. BMJ 1974, 2:656- 659, and van Dishoeck A.M. et al. Reliable assessment of sedation level in routine clinical practice by adding an instruction to the Ramsay Scale. Eur J Cardiovasc Nurs. 2009 125-8. The Ramsay Sedation Scale (RSS) (modified)

Titration of sedative therapy is generally based on both objective and subjective data (Ramsay Sedation Scale (RSS) rating, and Richmond Agitation-Sedation Scale (RASS) have been employed). The subjective component can be translated to an objective numerical score, which is used for drug therapy and dosage modification.

Measurement and results: Analysis of 105 paired Ramsay scores showed an almost perfect agreement between observers (weighted K (Kw)= 0.90). In both ICC patients and ICT patients, agreement between Ramsay scores was high (Kw=0.95 and Kw=0.86, respectively).