The VAMASS goal or target is to be established for each patient and included in sedation orders. The VAMASS goal will be reviewed during patient care rounds and prn.  The VAMASS goal should be recorded on the Kardex and 24-hour assessment record (CCTC).

Note: the VAMASS should be reassessed and modified prn.  For example, if the initial goal is 3A, but he patient cannot be maintained at this level, a more appropriate score should be selected.

Score all patients who are receiving sedation or who are mechanically ventilated or receiving sedatives (e.g. midazolam, propofol, haloperidol). If the patient is not on the ventilator, assess the motor portion of the score and report as 3, 2, or 4 instead of 3A, 2B or 4B).

Do not score patients receiving neuromuscular blocking agents.
 

To identify the most appropriate level of sedation and communicate to other members of the health care team.
 
 
 
 
 
 
 

Motor function assessment is contraindicated in patients receiving neuromuscular blocking agents; patients may feel pain but would be unable to respond.

If the plan requires modification or the patent varies significantly from the goal, complete a DAR note (e.g. additional sedation is ordered to achieve the target VAMASS; large doses of sedation are used during a procedure that causes increased sedation).

Note that sedation is a different parameter than "neuro".
 

Neurological assessment still needs to be performed to identify any focal or neurological findings.