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Discussion

Sedation scales

What sedation scale do you use during conscious sedation? My hospital is using a PAR (recovery) scale which is not really appropriate for intra-procedure, and I'm going to replace it with a better scale. Any recommendations?

Featured Replies

There is no scale that I know of.

  • Author

There are several sedation scales that I have found. I'm just wondering what others use and recommend.

  • Experts

Riker Scale is the one that we use most of the time and have used it in several different facilities. We also use it for sedation drips in the ICU.

We use the UCLH sedation scale in ICU which is

The UCLH Sedation Score3Agitated and restless2Awake and uncomfortable1Aware but calm0Roused by voice, remains calm-1Roused by movement-2Roused by noxious or painful stimuli-3Unrousable-4Deep sleep

The idea is to keep the patient as near to 0 as possible.

Hope that helps

Oops, sorry about that. I pasted in a neat little table and it went all over the place!

  • Author

Thanks for the UCLH scale, scarymary! I have never seen that one, and I like it quite a lot. Thanks to you too, Suzanne - I have seen the Riker one, and I'm not crazy about it because it's designed for intubated patients (has "biting ET tube" as one of the descriptors). A lot of the scales are designed for critical care, not procedural sedation, but some translate better than others.

I'm going to bring the UCLH scale to work tomorrow and see what my co-workers think. :)

Thanks for the UCLH scale, scarymary! I have never seen that one, and I like it quite a lot. Thanks to you too, Suzanne - I have seen the Riker one, and I'm not crazy about it because it's designed for intubated patients (has "biting ET tube" as one of the descriptors). A lot of the scales are designed for critical care, not procedural sedation, but some translate better than others.

I'm going to bring the UCLH scale to work tomorrow and see what my co-workers think. :)

Don't know if this helps, from some work I am currently doing on sedation:

The literature states over-sedation is common (Brochard, 2008). It is indicated as a humane measure to ‘allay anxiety, relieve discomfort and aid sleep’ in the critically ill (Adam and Osbourne, 2005). It may also be required to allow the patient to tolerate ventilation, undergo procedures (CT scanning, for instance) or to blunt stress responses such as tachycardia, hypertension or raised intracranial pressure. Confused patients...may require sedation. If this is needed it should be as light as possible and both reassessed and documented hourly using a formal assessment tool, such as the UCLH Sedation Score (Adams and Osbourne, 2005).

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