RASS DESCRIPTORS

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RASS HELP

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This app is intended to help students learn the descriptors of the Richmond Agitation-Sedation Scale (RASS). RASS is a medical scale used to measure the agitation or sedation level of a person.

The criteria are:

ScoreTerm
+4Overtly combative or violent; immediate danger to staff
+3Pulls on or removes tube(s) or catheter(s) or has aggressive behavior toward staff
+2Frequent non-purposeful movement or patient-ventilator dyssynchrony*
+1Anxious or apprehensive but movements not aggressive or vigorous
0Spontaneously pays attention to caregiver
-1Not fully alert, but has sustained (more than 10 seconds) awakening, with eye contact, to voice
-2Briefly (less than 10 seconds) awakens with eye contact to voice
-3Any movement (but no eye contact) to voice
-4 No response to voice, but any movement to physical stimulation
-5No response to voice or physical stimulation

*According to the (US) National Institute of Health, ventilator dyssynchrony is defined as the inappropriate timing and delivery of a mechanical breath in response to patient effort. It may cause ventilator-induced lung injury (VILI).

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