Sedation - Levels of Sedation

Levels of Sedation

Sedation scales are used in medical situations in conjunction with a medical history in assessing the applicable degree of sedation in patients in order to avoid under-sedation (the patient risks experiencing pain or distress) and over-sedation (the patient risks side effects such as suppression of breathing, which might lead to death). Typically, levels are (i) agitation, (ii) calm, (iii) responsive to voice only, (iv) responsive to tactile stimulation, (v) responsive to painful stimulation only, and (vi) unresponsive to painful stimulation.

Examples of sedation scales include: MSAT (Minnesota Sedation Assessment Tool), UMSS (University of Michigan Sedation Scale), the Ramsay Scale (Ramsay, et al. 1974) and the RASS (Richmond Agitation Sedation Scale).

The American Society of Anesthesiologists defines the continuum of sedation as follows:

  • Minimal Sedation - Normal response to verbal stimuli.
  • Moderate Sedation - Purposeful response to verbal/tactile stimulation. (This is usually referred to as "conscious sedation")
  • Deep Sedation - Purposeful response to repeated or painful stimulation.
  • General Anesthesia - Unarousable even with painful stimulus.

In the United Kingdom, deep sedation is considered to be a part of the spectrum of general anesthesia, as opposed to conscious sedation.

Read more about this topic:  Sedation

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    “The country is fed up with children and their problems. For the first time in history, the differences in outlook between people raising children and those who are not are beginning to assume some political significance. This difference is already a part of the conflicts in local school politics. It may spread to other levels of government. Society has less time for the concerns of those who raise the young or try to teach them.”
    —Joseph Featherstone (20th century)