What is the target range for the Richmond Agitation-Sedation Scale (RASS) in most mechanically ventilated patients?

• A. -2 to 0
• B. -3 to -1
• C. 0 to +1
• D. -1 to -4

Answer: (A)

The goal in most mechanically ventilated patients is light sedation that allows the patient to be calm but easily awake and interactive. The Richmond Agitation-Sedation Scale describes a spectrum from combative or agitated at higher positive scores to deep sedation and unresponsiveness at very low negative scores. A target around zero to mildly negative scores means the patient is alert or softly sedated, can participate in care, and can be reassessed neurologically or for spontaneous breathing trials. Going deeper into sedation (more negative) can suppress airway protective reflexes and hinder weaning, while allowing agitation (positive scores) increases the risk of self-extubation and other complications. Therefore, maintaining a target near -2 to 0 balances comfort with the ability to assess and mobilize the patient, supporting safer and faster weaning from ventilation.