Evaluation of agitation levels of patients admitted to emergency department of Akdeniz University Hospital with richmond agitation sedation scale (RASS) and analyzing its correlation with triage scores

Introduction: Knowing the anxiety-agitation levels of the patients presented to the emergency department in advance may increase the quality of patient care and the safety of healthcare personnel. The aim of this study was to determine the anxiety-agitation levels of outpatients in a tertiary university hospital emergency department using RASS. Material and Methods: This observational, cross-sectional, descriptive study was performed in adult patients who presented to the emergency department in 18 days period. During the study period, triage scores were given to all patients by triage nurses in the emergency department triage area and RASS results were recorded. Results: Of the total 4537 patients included in the study, 2271 were female (50.1%) and 2266 (49.9%) were male. 375 (8.3%) patients have had RASS score > 0 RASS and 4162 (91.7%) patients have not. The emergency group whose triage scores 1,2 or 3 are consisted of 2268 (49.9%) patients and the non-emergent group whose triage score 4 or 5 are consisted of 2269 (50.1%) patients. The chi-square test was compared with the agitated group and the non-agitated group according to gender, emergency triage score, patient outcome, blood pressure status, and referral periods during the day. In the emergency patient group, the risk of agitation was approximately 3 times higher by the means of RASS scores (OR 3.8 95% CI 2.9-4.9). It was found that the ratio of female gender in the RASS > 0 group was 9.9%, the male gender was 6.6%, the difference was approximately 3.5% and it was found that women had higher RASS scores (OR 1.5 95% CI 1.2-1, 9). There was a statistically significant difference between morning, evening and night groups according to RASS scores. Evening group had higher RASS scores (p <0.05). Hypertensive patients had also statistically significant higher RASS scores (p<0.05). Conclusion: RASS may be a useful tool to predict potential agitated patients in emergency departments. Pre-detection of potential agitated patients can prevent healthcare providers from violent acts and improve emergency department patient care quality. Key words: RASS, Emergency Department, Agitation, Anxiety