Run the List Sedation and Anesthesia in the ICU
14 snips
Sep 8, 2025 Dr. Maria Sunseri, a critical care attending and clinical assistant professor, and Dr. Brynna Crovetto, a critical care pharmacist focused on optimizing medication in the ICU, share their expertise on sedation and analgesia. They discuss assessing agitation in patients and using the Richmond Agitation and Sedation Scale for tailored sedation levels. The duo compares various sedative agents like fentanyl and dexmedetomidine, emphasizing individualized protocols. They also offer insights on safely weaning sedation and the importance of interdisciplinary collaboration during extubation.
AI Snips
Chapters
Transcript
Episode notes
Agitation Is A Symptom, Not A Diagnosis
- Agitation is a nonspecific observed behavior that can stem from pain, delirium, withdrawal, hypoxia, ventilator dyssynchrony, thirst, or electrolytes.
- Treat the underlying cause while addressing safety with sedation rather than reflexively increasing sedatives.
Use RASS To Target Sedation Depth
- Use the Richmond Agitation and Sedation Scale (RASS) from +4 to -5 to quantify sedation and agitation.
- Pick and document an appropriate RASS target each day based on the patient's clinical needs.
Aim For Light Sedation When Safe
- Keep most ventilated patients as lightly sedated as safely possible, typically RASS 0 to -1.
- Deep sedation is reserved for status epilepticus, severe ARDS with lung-protective ventilation, or when paralysis is required.