Modified Ramsay Sedation Scale

Level 1

Awake and alert, minimal or no cognitive impairment, may be anxious or agitated.

Level 2

Awake but tranquil, purposeful responses to verbal commands at conversation level.

Level 3

Appears asleep, purposeful responses to verbal commands at conversation level.

Level 4

Appears asleep, purposeful responses to verbal commands but at louder than usual conversation level or requiring light glabellar tap.

Level 5

Asleep, sluggish purposeful responses only to loud verbal commands or strong glabellar tap.

Level 6

Asleep, sluggish purposeful responses to painful stimuli only.

Level 7

Asleep, reflex withdrawal to painful stimuli only (no purposeful response).

Level 8

Unresponsive to external stimuli, including pain.