The Ramsay Sedation Scale is used to measure different levels of sedation in medical patients. Of the various sedation scales used in anesthesiology, the Ramsay Sedation Scale has been one of the most widely adopted since its introduction in 1974. The scale monitors stages of sedation using a six-level scale—level one representing the least amount of sedation and six the most. The Ramsay Sedation Scale is divided into two parts: levels one through three monitor waking levels, and levels four through six monitor sleeping levels.
Of the waking levels, level one represents the most awake, with patients displaying a combination of being restless, anxious and agitated. Level two patients are more peaceful, patient and cooperative. Level three patients are the least responsive while still retaining consciousness, responding only to commands.
Of the sleeping levels, level four represents the least asleep, with patients able to quickly respond to a light tap or loud noise. Level five patients respond sluggishly. Level six patients are completely sedated, unable to respond to any stimulus.
Dr. Michael A.E. Ramsay, an anesthesiologist who became president of the Baylor Research Institute, developed the Ramsay Sedation Scale during a clinical study that monitored the various sedation levels of patients using a sedative called alphaxalone-alphadolone, or Althesin. The study attempted to optimize levels of sedation in various patients, with satisfactory levels ranging between two and five. The results of the study were published in the British Medical Journal, in an article titled "Controlled Sedation with Alphaxalone-Alphadolone."
The use of sedation scales has become commonplace in the field of anesthesiology. The Ramsay Sedation Scale is commonly used, but there are several other scales used as well, such as the Richmond Agitation Assessment Scale, the Motor Activity Assessment Scale and the Sedation Agitation Scale. All scales are used to ensure that a patient is receiving the optimal dose of a sedative.
Sedation scales are an important tool in the medical industry, used by anesthesiologists, doctors and nurses alike. Medical professionals train staff members to recognize and assess different levels of sedation to ensure optimal treatment. Excessive and insufficient doses of a sedative can lead to unwanted effects—too little and the patient may experience discomfort and pain; too much and the patient may be too sedated and take an excessive amount of time to recover. Sedation scales are used in concert with other tools to track patients' health and comfort levels during sedation.