Agitation and sedation should be routinely monitored using a validated assessment tool. The Richmond Agitation-Sedation Scale (RASS) and the Sedation-Agitation Scale (SAS) are most validated and are recommended.

Causes of agitation should be identified/treated and sedation should be titrated to target sedation scores.

An alert, comfortable, co-operative and interactive patient should be our aim in most circumstances.

There are many other objective measures of sedation depth, e.g. EEG, BIS, evoked potentials. None of these monitors have been shown to be beneficial for routine use in the ICU. They may be useful in select patient groups, such as those requiring deep sedation/anaesthesia for, e.g. periods of neuromuscular blockade.

The CAM ICU score is an objective measurement of delirium and is explained in the Delirium PDF.