Richmond Agitation-Sedation Scale

RASS +4: Combative

Overtly combative, violent, immediate danger to staff

RASS +3: Very agitated

Pulls or removes tube(s) or catheter(s); aggressive

RASS +2: Agitated

Frequent nonpurposeful movement, fights ventilator

RASS +1: Restless

Anxious but movements not aggressive or vigorous

RASS 0: Alert and calm

RASS -1: Drowsy

Not fully alert, but has sustained awakening (eye opening/eye contact) to voice (>10 seconds)

RASS -2: Light sedation

Briefly awakens with eye contact to voice (<10 seconds)

RASS -3: Moderate sedation

Movement or eye opening to voice (but no eye contact)

RASS -4: Deep sedation

No response to voice, but movement or eye opening to physical stimulation

RASS -5: Unarousable

No response to voice or physical stimulation


Ely EW, Truman B, Shintani A, Thomason JWW, Wheeler AP, Gordon S, et al. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003 Jun. 11;289(22):2983-2991.