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Richmond Agitation Sedation Scale

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1. The minimal clinically important difference of the Richmond Agitation-Sedation Scale in patients with cancer with agitated delirium. (PubMed)

The minimal clinically important difference of the Richmond Agitation-Sedation Scale in patients with cancer with agitated delirium. The Richmond Agitation-Sedation Scale (RASS) is commonly used to assess psychomotor activity; however, to the authors' knowledge, its minimal clinically important difference (MCID) has not been determined to date. The objective of the current study was to identify the MCID for RASS using 2 anchor-based approaches.The current study was a secondary analysis (...) of a randomized controlled trial to compare the effect of lorazepam versus placebo as an adjuvant to haloperidol for persistent agitation in patients with delirium. The primary outcome was change in RASS (10-point numeric rating scale ranging from -5 [unarousable] to +4 [combative]) from baseline to 8 hours after treatment administration. The sensitivity-specificity and within-patient change methods were used to identify the MCID, with the anchor being patient comfort after the study intervention as perceived

2018 Cancer

2. Correlation of bispectral index and Richmond agitation sedation scale for evaluating sedation depth: a retrospective study (PubMed)

Correlation of bispectral index and Richmond agitation sedation scale for evaluating sedation depth: a retrospective study This study aims to verify the correlation of bispectral index (BIS) and Richmond agitation sedation scale (RASS) for evaluating these and explore possibility of replacing RASS with BIS.This retrospective cohort study consisted of 74 patients who were collected from the third Intensive Care Unit (ICU) ward of XXX Hospital between May 2012 and June 2015 in this retrospective (...) study. Sedation levels were evaluated using the 10-grade RASS and were continuously monitored with a BIS monitor during the procedure every 5 minutes. BIS values and RASS scores were recorded.Patients were divided into dexmedetomidine (n=31) and midazolam (n=43) groups, and 342 paired data were collected. A statistically significant correlation existed between BIS values and RASS scores either in all patients undergoing flexible fiberoptic bronchoscopy (FFB) or in dexmedetomidine and midazolam

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2018 Journal of thoracic disease

3. Ramsay Sedation Scale and Richmond Agitation Sedation Scale: A Cross-sectional Study. (PubMed)

Ramsay Sedation Scale and Richmond Agitation Sedation Scale: A Cross-sectional Study. Many sedation scales and tools have been developed and compared for validity in critically ill patients. However, selection and use of sedation scales vary among intensive care units.The aim of this study is to compare the reliability of 2 sedation scales-Ramsay Sedation Scale and Richmond Agitation-Sedation Scale (RASS)-in the adult intensive care unit.Four hundred twenty-five patients were recruited (...) level of agreement. Cronbach α analysis showed that 10 items of RASS had an excellent level of internal consistency (α = .989) compared with good level of internal consistency of Ramsay scale (α = .828).Richmond Agitation-Sedation Scale showed excellent interrater agreement compared with weak interrater agreement of Ramsay scale. The results also support that RASS has consistent agreement with clinical observation and practice among different observers. The results suggest that use of RASS is linked

2017 Dimensions of critical care nursing

4. Performance of the modified Richmond Agitation Sedation Scale in identifying delirium in older emergency department patients. (PubMed)

Performance of the modified Richmond Agitation Sedation Scale in identifying delirium in older emergency department patients. Delirium in older emergency department (ED) patients is associated with severe negative patient outcomes and its detection is challenging for ED clinicians. ED clinicians need easy tools for delirium detection. We aimed to test the performance criteria of the modified Richmond Agitation Sedation Scale (mRASS) in identifying delirium in older ED patients.The mRASS

2017 American Journal of Emergency Medicine

5. Serial administration of a modified Richmond Agitation and Sedation Scale for delirium screening. (PubMed)

Serial administration of a modified Richmond Agitation and Sedation Scale for delirium screening. Because delirium is a common yet frequently unrecognized condition, this study sought to design a brief screening tool for a core feature of mental status and to validate the instrument as a serial assessment for delirium.Prospective cohort study.Tertiary VA Hospital in New England.A total of 95 veterans admitted to the medical service.A consensus panel developed a modified version of the Richmond (...) Agitation and Sedation Scale (RASS) to capture alterations in consciousness. Upon admission, and daily thereafter, patients were screened with a modified RASS (mRASS) and independently underwent a comprehensive mental status interview by a geriatric expert, who determined whether the criteria for delirium were met. The sensitivity, specificity, and positive likelihood ratio (LR) of the mRASS for delirium are reported.As a single assessment, the mRASS had a sensitivity of 64% and a specificity of 93

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2017 Journal of Hospital Medicine

6. Effect of using Richmond Agitation Sedation Scale on duration of mechanical ventilation, type and dosage of sedation on hospitalized patients in intensive care units. (PubMed)

Effect of using Richmond Agitation Sedation Scale on duration of mechanical ventilation, type and dosage of sedation on hospitalized patients in intensive care units. Mechanical ventilation is one of the supporting treatments that are used for different reasons. To reduce patients' inconvenience caused due to using tracheal tube and ventilator, sedation is routinely used. Using scales for the sedation, for example, Richmond Agitation Sedation Scale (RASS), may reduce dose of sedation and length (...) of mechanical ventilation.This study is a randomized clinical trial on 64 patients selected from three intensive care units (ICUs) in Isfahan, Iran. Through random allocation, 32 patients were assigned to each of the study and control groups. In the control group, patients' level of consciousness and the amount of drug consumption in every shift, based on physician order, were recorded. In the study group, RASS score was recorded every hour and sedation was administered based on that. The purpose

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2016 Iranian journal of nursing and midwifery research

7. Utility of the Richmond Agitation-Sedation Scale in evaluation of acute neurologic dysfunction in the intensive care unit (PubMed)

Utility of the Richmond Agitation-Sedation Scale in evaluation of acute neurologic dysfunction in the intensive care unit 27162685 2016 05 10 2018 11 13 2072-1439 8 5 2016 May Journal of thoracic disease J Thorac Dis Utility of the Richmond Agitation-Sedation Scale in evaluation of acute neurologic dysfunction in the intensive care unit. E292-4 10.21037/jtd.2016.03.71 Trivedi Vrinda V Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. Iyer Vivek N VN Division

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2016 Journal of thoracic disease

8. Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children (PubMed)

Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children The Richmond Agitation-Sedation Scale (RASS) is a single tool that is intuitive, is easy to use, and includes both agitation and sedation. The RASS has never been formally validated for pediatric populations. The objective of this study was to assess inter-rater agreement and criterion validity of the RASS in critically ill children.To evaluate validity, the RASS score was compared to both a visual analog scale (...) (VAS) scored by the patient's nurse, and the University of Michigan Sedation Scale (UMSS), performed by a researcher. The nurse completed the VAS by drawing a single line on a 10-cm scale anchored by "unresponsive" and "combative." The UMSS was used to validate the sedation portion of the RASS only, as it does not include grades of agitation. For inter-rater agreement, one researcher and the patient's nurse simultaneously but independently scored the RASS.One hundred patient encounters were

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2016 Journal of intensive care

9. A modified Sequential Organ Failure Assessment score using the Richmond Agitation-Sedation Scale in critically ill patients (PubMed)

A modified Sequential Organ Failure Assessment score using the Richmond Agitation-Sedation Scale in critically ill patients 27076924 2016 04 14 2018 11 13 2072-1439 8 3 2016 Mar Journal of thoracic disease J Thorac Dis A modified Sequential Organ Failure Assessment score using the Richmond Agitation-Sedation Scale in critically ill patients. 311-3 10.21037/jtd.2016.02.61 Viglino Damien D 1 Department of Emergency Medicine, University Hospital of Grenoble Alps, France ; 2 University Grenoble

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2016 Journal of thoracic disease

10. Richmond Agitation Sedation Scale

Richmond Agitation Sedation Scale Richmond Agitation Sedation Scale Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Richmond Agitation (...) Sedation Scale Richmond Agitation Sedation Scale Aka: Richmond Agitation Sedation Scale , RASS , Modified RASS , mRASS II. Indications Intensive care monitoring of sedation evaluation in the Emergency Department Score other than 0, has a of 64% and of 93% for in ED III. Scoring Score +4: Combative Combative or violent Danger to care team Score +3: Very Agitated Pulls or removes tubes or catheters Aggressive Score +2: Agitated Frequent non-purposeful movements Fights Score +1: Restless Anxious

2018 FP Notebook

11. Detecting Delirium Superimposed on Dementia: Evaluation of the Diagnostic Performance of the Richmond Agitation and Sedation Scale. (PubMed)

Detecting Delirium Superimposed on Dementia: Evaluation of the Diagnostic Performance of the Richmond Agitation and Sedation Scale. Delirium disproportionately affects patients with dementia and is associated with adverse outcomes. The diagnosis of delirium superimposed on dementia (DSD), however, can be challenging due to several factors, including the absence of caregivers or the severity of preexisting cognitive impairment. Altered level of consciousness has been advocated as a possible (...) useful indicator of delirium in this population. Here we evaluated the performance of the Richmond Agitation and Sedation Scale (RASS) and the modified-RASS (m-RASS), an ultra-brief measure of the level of consciousness, in the diagnosis of DSD.Multicenter prospective observational study. RASS and m-RASS results were analyzed together, labeled RASS/m-RASS.Acute geriatric wards, in-hospital rehabilitation, emergency department.Patients 65 years and older with dementia.Delirium was diagnosed

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2016 Journal of the American Medical Directors Association

12. Clinical practice guidelines for pain, agitation, delirium, sedation and mobilisation in the intensive care unit: A Rapid Review

with an increased incidence of myocardial ischemia. Moderate iii. The association between depth of sedation and psychological stress in these patients remains unclear. Low iv. We recommend that sedative medications be titrated to maintain a light rather than a deep level of sedation in adult ICU patients, unless clinically contraindicated. Moderate ICU pain, agitation, delirium, sedation and mobilisation CPGs: A Rapid Review 7 Monitoring depth of sedation and brain function i. The Richmond Agitation-Sedation (...) Scale (RASS) and Sedation-Agitation Scale (SAS) are the most valid and reliable sedation assessment tools for measuring quality and depth of sedation in adult ICU patients. Moderate ii. We do not recommend that objective measures of brain function (e.g., auditory evoked potentials [AEPs], Bispectral Index [BIS], Narcotrend Index [NI], Patient State Index [PSI], or state entropy [SE]) be used as the primary method to monitor depth of sedation in noncomatose, nonparalyzed critically ill adult patients

2019 Monash Health Evidence Reviews

13. The Diagnostic Performance of the Richmond Agitation Sedation Scale for Detecting Delirium in Older Emergency Department Patients (PubMed)

The Diagnostic Performance of the Richmond Agitation Sedation Scale for Detecting Delirium in Older Emergency Department Patients Delirium is frequently missed in older emergency department (ED) patients. Brief (<2 minutes) delirium assessments have been validated for the ED, but some ED health care providers may consider them to be cumbersome. The Richmond Agitation Sedation Scale (RASS) is an observational scale that quantifies level of consciousness and takes less than 10 seconds to perform

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2015 EvidenceUpdates

14. Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

(such as those with neuromuscular diseases); research on the application of the BPAT in ICU practice is encouraged. However, situations exist for which behavioral scales are impossible to use (e.g., unresponsive patients with a Richmond Agitation- Sedation Scale [RASS] ≤ −4). In such situations, no alternative methods are currently available to ICU clinicians. Other technology that may be useful in the ICU pain assessment process should be explored. Technology measuring HR variability (e.g., the Analgesia (...) Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU Clinical Practice Guidelines for the Prevention and Manageme... : Critical Care Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me

2018 Society of Critical Care Medicine

15. Evaluation of Richmond Agitation Sedation Scale According to Alveolar Concentration of Sevoflurane During a Sedation With Sevoflurane in ICU Patients

Evaluation of Richmond Agitation Sedation Scale According to Alveolar Concentration of Sevoflurane During a Sedation With Sevoflurane in ICU Patients Evaluation of Richmond Agitation Sedation Scale According to Alveolar Concentration of Sevoflurane During a Sedation With Sevoflurane in ICU Patients - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved (...) Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Evaluation of Richmond Agitation Sedation Scale According to Alveolar Concentration of Sevoflurane During a Sedation With Sevoflurane in ICU Patients (SEVORASS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read

2014 Clinical Trials

16. The Diagnostic Performance of the Richmond Agitation Sedation Scale for Detecting Delirium in Older Emergency Department Patients. (PubMed)

The Diagnostic Performance of the Richmond Agitation Sedation Scale for Detecting Delirium in Older Emergency Department Patients. Delirium is frequently missed in older emergency department (ED) patients. Brief (<2 minutes) delirium assessments have been validated for the ED, but some ED health care providers may consider them to be cumbersome. The Richmond Agitation Sedation Scale (RASS) is an observational scale that quantifies level of consciousness and takes less than 10 seconds to perform

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2015 Academic Emergency Medicine

17. Validity of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale. (PubMed)

Validity of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale. The Sequential Organ Failure Assessment and other severity of illness scales rely on the Glasgow Coma Scale to measure acute neurologic dysfunction, but the Glasgow Coma Scale is unavailable or inconsistently applied in some institutions. The objective of this study was to assess the validity of a modified Sequential Organ Failure Assessment that uses the Richmond Agitation-Sedation (...) Scale instead of Glasgow Coma Scale.Prospective cohort study.Medical and surgical ICUs within a large, tertiary care hospital.Critically ill medical/surgical ICU patients.We calculated daily Sequential Organ Failure Assessment scores by using electronic medical record-derived data. By using bedside nurse-recorded Glasgow Coma Scale and Richmond Agitation-Sedation Scale measures, we calculated neurologic Sequential Organ Failure Assessment scores using the original Glasgow Coma Scale-based approach

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2015 Critical Care Medicine

18. Premedication With Midazolam or Haloperidol to Prevent Recovery Agitation in Adults Undergoing Procedural Sedation With Ketamine: A Randomized Double-Blind Clinical Trial

1 of the following 3 interventions in double-blind fashion 5 minutes before receiving intravenous ketamine at 1 mg/kg: intravenous distilled water, intravenous midazolam at 0.05 mg/kg, or intravenous haloperidol at 5 mg. Our main study outcomes were recovery agitation as assessed by the maximum observed Pittsburgh Agitation Scale score and by the Richmond Agitation-Sedation Scale score at 5, 15, and 30 minutes after ketamine administration. Our secondary outcomes were clinician satisfaction (...) and recovery duration.We enrolled 185 subjects. The maximum Pittsburgh Agitation Scale score was significantly less with midazolam compared with placebo (difference 3; 95% confidence interval 1.27 to 4.72) and with haloperidol compared with placebo (difference 3; 95% confidence interval 1.25 to 4.75), and Richmond Agitation-Sedation Scale scores at 5, 15, and 30 minutes trended lower with the active agents. Midazolam and haloperidol significantly delayed recovery but did not alter overall clinician

2019 EvidenceUpdates

19. "Between the fixed and the changing": examining and comparing reliability and validity of 3 sedation-agitation measuring scales. (PubMed)

"Between the fixed and the changing": examining and comparing reliability and validity of 3 sedation-agitation measuring scales. The goal of the study was to compare the reliability and validity of 3 Sedation Agitation Scale. Two nurses and a physician conducted 130 observations simultaneously. They found an excellent interrater reliability in the Richmond Agitation Sedation Scale (r>0.86), and high correlations between the Richmond Agitation Sedation Scale and the Sedation Agitation Scale (...) and Visual Analog Scale scales (r=0.92, r=0.85). The research findings will help to assert Richmond Agitation Sedation Scale as a daily assessment tool in the intensive care unit, and it will pave the way for construction a sedation protocol according to the Richmond Agitation Sedation Scale level.

2017 Dimensions of critical care nursing

20. The Richmond Agitation-Sedation Scale modified for palliative care inpatients (RASS-PAL): a pilot study exploring validity and feasibility in clinical practice. (PubMed)

The Richmond Agitation-Sedation Scale modified for palliative care inpatients (RASS-PAL): a pilot study exploring validity and feasibility in clinical practice. The Richmond Agitation-Sedation Scale (RASS), which assesses level of sedation and agitation, is a simple observational instrument which was developed and validated for the intensive care setting. Although used and recommended in palliative care settings, further validation is required in this patient population. The aim of this study (...) was to explore the validity and feasibility of a version of the RASS modified for palliative care populations (RASS-PAL).A prospective study, using a mixed methods approach, was conducted. Thirteen health care professionals (physicians and nurses) working in an acute palliative care unit assessed ten consecutive patients with an agitated delirium or receiving palliative sedation. Patients were assessed at five designated time points using the RASS-PAL. Health care professionals completed a short survey

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2014 BMC Palliative Care

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