# RASS (Richmond Agitation-Sedation Scale)

RASS

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/rass`
HTML: https://magentlab.com/docs/rass
Markdown: https://magentlab.com/docs/rass.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Return the Sessler 2002 Richmond Agitation-Sedation Scale term and description from a caller-assigned integer -5 to +4.

## When to use

When an agent already has a RASS integer assigned as in Sessler 2002 and needs the published term and description. magent does not observe the patient, administer voice or physical stimulation, or titrate sedation. Not a CAM-ICU feature and not a sedation order.

## When not to use

- Not a medical device. magent does not examine the patient, administer voice or physical stimulation, or observe the ICU.
- Not a CAM-ICU administration and not a CAM-ICU feature. Feature 4 of CAM-ICU is assigned separately.
- Not a sedation order or dose. magent does not titrate sedation.
- The caller assigns RASS -5 to +4. magent does not observe the patient.

## Formula

```
RASS integer -5 to +4 as assigned by the caller; Sessler 2002 ten levels (Combative through Unarousable)
```

## Citation

[The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients](https://doi.org/10.1164/rccm.2107138)
Sessler CN, Gosnell MS, Grap MJ, et al.
Am J Respir Crit Care Med. 2002;166(10):1338-1344
DOI: [10.1164/rccm.2107138](https://doi.org/10.1164/rccm.2107138)

## Worked example

### RASS 0 alert and calm

Given: `rass=0`

1. rass 0 → Alert and calm


## Also searched as

- RASS
- Richmond Agitation-Sedation Scale
- Richmond sedation scale
- Sessler RASS
- ICU agitation scale
- RASS score
- agitation-sedation scale

## Parameters

- `rass` (integer, required): Sessler 2002 RASS integer -5 to +4 as assigned by the caller (+4 Combative; +3 Very agitated; +2 Agitated; +1 Restless; 0 Alert and calm; -1 Drowsy; -2 Light sedation; -3 Moderate sedation; -4 Deep sedation; -5 Unarousable). magent does not observe the patient, administer voice or physical stimulation, or titrate sedation.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/rass`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "rass": "0"
    },
    {
      "rass": "0"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/rass

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/rass",
  "items": [
    {
      "term": "Alert and calm",
      "description": "Alert and calm",
      "components": [
        {
          "factor": "rass",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Sessler CN, Gosnell MS, Grap MJ, et al.",
        "doi": "10.1164/rccm.2107138",
        "id": "sessler-2002",
        "pmid": "12421743",
        "source": "Am J Respir Crit Care Med. 2002;166(10):1338-1344",
        "title": "The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients"
      },
      "formula": "rass",
      "formula_expression": "RASS integer -5 to +4 as assigned by the caller; Sessler 2002 ten levels (Combative through Unarousable)",
      "max_score": 4,
      "score": 0,
      "rass": 0
    },
    {
      "term": "Alert and calm",
      "description": "Alert and calm",
      "components": [
        {
          "factor": "rass",
          "points": 0,
          "present": true
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Sessler CN, Gosnell MS, Grap MJ, et al.",
        "doi": "10.1164/rccm.2107138",
        "id": "sessler-2002",
        "pmid": "12421743",
        "source": "Am J Respir Crit Care Med. 2002;166(10):1338-1344",
        "title": "The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients"
      },
      "formula": "rass",
      "formula_expression": "RASS integer -5 to +4 as assigned by the caller; Sessler 2002 ten levels (Combative through Unarousable)",
      "max_score": 4,
      "score": 0,
      "rass": 0
    }
  ]
}
```

## Response fields

- `formula` (string): rass
- `formula_expression` (string): Published RASS rule
- `rass` (integer): Caller-assigned RASS integer -5 to +4
- `score` (integer): Same as rass
- `max_score` (integer): 4
- `term` (string): Sessler 2002 term for that integer
- `description` (string): Sessler 2002 wording for that integer
- `components` (array): rass component
- `citation` (object): Sessler 2002
- `disclaimer` (string): Not a medical device

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "term": "Alert and calm",
  "description": "Alert and calm",
  "components": [
    {
      "factor": "rass",
      "points": 0,
      "present": true
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Sessler CN, Gosnell MS, Grap MJ, et al.",
    "doi": "10.1164/rccm.2107138",
    "id": "sessler-2002",
    "pmid": "12421743",
    "source": "Am J Respir Crit Care Med. 2002;166(10):1338-1344",
    "title": "The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients"
  },
  "formula": "rass",
  "formula_expression": "RASS integer -5 to +4 as assigned by the caller; Sessler 2002 ten levels (Combative through Unarousable)",
  "max_score": 4,
  "score": 0,
  "rass": 0
}
```

## Errors

- HTTP 400 `invalid_rass`: rass must be an integer from -5 to 4 (Sessler 2002 Richmond Agitation-Sedation Scale). Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [CAM-ICU](https://magentlab.com/docs/cam-icu) — Apply the Ely 2001 CAM-ICU algorithm and return whether delirium is present from four caller-assigned features.
- [Glasgow Coma Scale](https://magentlab.com/docs/gcs) — Compute the Glasgow Coma Scale as the sum of caller-assigned eye, verbal, and motor integers. The 1974 or 1976 edition is required.
- [FOUR score](https://magentlab.com/docs/four-score) — Compute the FOUR score as the sum of caller-assigned eye, motor, brainstem, and respiration integers 0-4.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.