What are the six levels of the Ramsay Sedation Scale?

Level 1: Anxious, agitated, restless. Level 2: Cooperative, oriented, tranquil. Level 3: Responds to commands only. Level 4: Brisk response to light glabellar tap or loud sound. Level 5: Sluggish response to glabellar tap or loud sound. Level 6: No response. Levels 2–3 represent the typical target range for most ICU patients requiring sedation for comfort without excessive suppression.

How does the Ramsay Scale compare to RASS?

The Ramsay Scale is simpler (6 levels) but lacks granularity for distinguishing degrees of agitation, which are clinically important. The Richmond Agitation-Sedation Scale (RASS) extends from -5 (unarousable) to +4 (combative) with 10 levels, providing better discrimination of agitation states and better inter-rater reliability in validation studies. Most ICU guidelines now prefer RASS, though Ramsay remains in wide use due to historical familiarity.

Ramsay Sedation Scale

Assess depth of sedation using the Ramsay Sedation Scale (1–6) in ICU patients. Target level 2–3 (cooperative, oriented, and tranquil, or responds to commands only).

Use the full interactive calculator below, or

Related Calculators

RASS

Medical

CPOT

Medical

BPS

Medical

Ramsay Sedation Scale

Related Calculators

Frequently Asked Questions

What are the six levels of the Ramsay Sedation Scale?

How does the Ramsay Scale compare to RASS?