Table 3 Six-point Pediatric Sedation State Scale (PSSS) [40]

5

Patient is moving (purposefully or non-purposefully) in a manner that impedes the proceduralist and requires forceful immobilization. This includes crying or shouting during the procedure, but vocalization is not required. Score is based on movement.

4

Moving during procedure (awake or sedated0 that requires gentle immobilization for positioning, may verbalize some discomfort or stress, but there is no crying or shouting that expresses stress or objection.

3

Expression of pain or anxiety on face (may verbalize discomfort), but not moving or impending completion of the procedure. May require help positioning (as with a lumbar puncture) but does not require restraint to stop movement during the procedure.

2

Quiet (asleep or awake), not moving during procedure, and no frown (or brow furrow) indicating pain or anxiety. No verbalization of any complaint.

1

Deeply asleep with normal vital signs, but requiring airway intervention and/or assistance (e.g., central or obstructive apnea, etc.)

0

Sedation associated with abnormal physiologic parameters that require acute intervention (i.e., oxygen saturation < 90%, blood pressure 30% lower than baseline, bradycardia receiving therapy)