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anaesthesia-icu

Riker Sedation-Agitation Scale (SAS)

Single 7-point clinical score of sedation–agitation in adult ICU patients (Riker 1999). Target SAS 3–4 typical for routine sedation.

Score interpretation

Over-sedated 1–2

→ Reduce sedative infusions; consider daily sedation hold; assess for delirium with CAM-ICU.

Target sedation 3–4

→ Maintain. Reassess hourly and titrate to lightest tolerable level.

Agitated 5

→ Address pain (CPOT/BPS), bladder, hypoxia, delirium triggers; reorientate; consider dexmedetomidine; small benzodiazepine bolus only if necessary.

Dangerous agitation 6–7

→ Immediate sedative bolus (propofol or dexmedetomidine); ensure airway/IV access protected; rule out hypoxia, hypoglycaemia, intracranial event; consider physical restraint with documented review per local policy.

Interpretation bands for the Riker SAS. 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.