Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS).

@article{Ely2003MonitoringSS,
  title={Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS).},
  author={Eugene Wesley Ely and Brenda Truman and Ayumi Shintani and Jason W. W. Thomason and Arthur P. Wheeler and Sharon M. Gordon and Joseph Francis and Theodore Speroff and Shiva Gautam and Richard Margolin and Curtis N. Sessler and Robert S. Dittus and Gordon R. Bernard},
  journal={JAMA},
  year={2003},
  volume={289 22},
  pages={
          2983-91
        }
}
CONTEXT Goal-directed delivery of sedative and analgesic medications is recommended as standard care in intensive care units (ICUs) because of the impact these medications have on ventilator weaning and ICU length of stay, but few of the available sedation scales have been appropriately tested for reliability and validity. [] Key MethodDESIGN Prospective cohort study. SETTING Adult medical and coronary ICUs of a university-based medical center.

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References

SHOWING 1-10 OF 71 REFERENCES
Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients.
TLDR
SAS is both reliable (high interrater agreement) and valid (high correlation with the Harris and Ramsay scales) in assessing agitation and sedation in adult ICU patients.
Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU).
TLDR
The CAM-ICU appears to be rapid, valid, and reliable for diagnosing delirium in the ICU setting and may be a useful instrument for both clinical and research purposes.
The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients.
TLDR
RASS has high reliability and validity in medical and surgical, ventilated and nonventilated, and sedated and nonsedated adult ICU patients and is described as logical, easy to administer, and readily recalled.
Is the bispectral index appropriate for monitoring the sedation level of mechanically ventilated surgical ICU patients?
TLDR
BIS is correlated only in some ICU patients with the clinical assessment of their sedation level as based on various scores, and at deeper sedation levels the interindividual differences increase.
Motor Activity Assessment Scale: a valid and reliable sedation scale for use with mechanically ventilated patients in an adult surgical intensive care unit.
TLDR
The MAAS is a valid and reliable sedation scale for use with mechanically ventilated patients in the SICU and is supported by generalized estimating equations, which supported MAAS validity by finding a linear trend between MAAS and the visual analog scale.
Evaluation of delirium in critically ill patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)
TLDR
The CAM-ICU demonstrated excellent reliability and validity when used by nurses and physicians to identify delirium in intensive care unit patients and may be a useful instrument for both clinical and research purposes to monitor deliria in this challenging patient population.
Validating the Sedation-Agitation Scale with the Bispectral Index and Visual Analog Scale in adult ICU patients after cardiac surgery
TLDR
Sedation-Agitation Scale and BIS are valid measures of wakefulness after cardiac surgery, but EMG interference may affect the accuracy of BIS for a small percentage of patients not receiving neuromuscular blockade.
Effect of a scoring system and protocol for sedation on duration of patients’ need for ventilator support in a surgical intensive care unit*
TLDR
Relatively simple changes in sedation practice had significant effects on length of ventilator support and on doctors’ and nurses’ interest in identifying other areas for improvement.
Effect of a scoring system and protocol for sedation on duration of patients' need for ventilator support in a surgical intensive care unit
TLDR
Relatively simple changes in sedation practice had significant effects on length of ventilator support and the change process was well received by the staff and increased their interest in identifying other areas for improvement.
Using and understanding sedation scoring systems: a systematic review
TLDR
To help clinicians assess sedation at the bedside, to aid readers critically appraise the growing number of sedation studies in the ICU literature, and to inform the design of future investigations, additional information about the measurement properties of Sedation effectiveness instruments is needed.
...
1
2
3
4
5
...