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anaesthesia critical-care

Ramsay Sedation Scale

Assesses sedation depth in ICU and procedural settings. Level 2-3 is optimal for most ICU patients; level 5-6 indicates deep sedation.

Score interpretation

Under-sedated / agitated (Level 1)

→ Increase sedation: titrate propofol or midazolam; assess pain (CPOT); analgesia first (analgesia-first sedation); exclude delirium; consider dexmedetomidine for light sedation target

Optimal sedation for most ICU patients (Level 2-3)

→ Maintain current sedation; SAT (spontaneous awakening trial) daily; SBT (spontaneous breathing trial) when ready; minimise benzodiazepines; promote sleep hygiene

Deep sedation (Level 4-6)

→ Review indication for deep sedation (status epilepticus, ARDS, raised ICP); if no specific indication: target lighter sedation (Level 2-3); daily SAT; reduce sedation infusion rate; assess for paralysis reversal if NMB used

Interpretation bands for the Ramsay Sedation. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.