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Chapter-19 Monitoring Sedation Using Scales in Intensive Care Unit and Operating Room

BOOK TITLE: Monitoring in Anesthesia and Critical Care

Author
1. Sampath Sriram
2. Krishna Bhuvana
ISBN
9789352700431
DOI
10.5005/jp/books/18044_20
Edition
1/e
Publishing Year
2018
Pages
11
Author Affiliations
1. St. John’s Medical College and Hospital, Bengaluru, Karnataka, India, St John’s Medical College and Hospital, Bengaluru, Karnataka, India
2. St. John’s Medical College and Hospital, Bengaluru, Karnataka, India, St John’s Medical College and Hospital, Bengaluru, Karnataka, India
Chapter keywords
Sedation assessment, subjective sedation assessment, sedation-agitation scale, SAS, Richmond agitation-sedation scale, RASS, Ramsay sedation scale, RSS

Abstract

The quality and quantity of sedation needs to be titrated in all ICU patients receiving sedation, as given in the recent 2013 Pain Agitation and Delirium (PAD) guidelines, published by the Society of Critical Care Medicine (SCCM). In general, a sedation assessment tool measures the patient’s response to verbal or physical stimuli to various degrees of agitation. An ideal sedation assessment tool would meet the following requirements—easy to score, requiring minimal training, scores both agitation and sedation, good reliability and validity, should be applicable to a wide range of patient population, and have well-defined sedation targets. There are both subjective and objection sedation assessment tools. The RASS and SAS are the most valid and reliable sedation tools. The objective sedation tools can be used on patients to assess the depth of anesthesia in the OR. But their use in ICU on critically ill patients is still not validated.

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