Anaesthesia / Critical Care Emergency Medicine General Medicine Strong — Crit Care Med 2001

Confusion Assessment Method for ICU (CAM-ICU)

Validated delirium assessment for ICU patients. CAM-ICU is POSITIVE if Feature 1 AND Feature 2 are present, PLUS Feature 3 OR Feature 4. Only assess if RASS ≥ −3 (not deeply sedated).

Feature 1: Acute Onset or Fluctuating Course*

Is there an acute change in mental status from baseline? OR did it fluctuate (better/worse) in the past 24 hours?

Feature 2: Inattention*

Did the patient have difficulty focusing attention? Use Attention Screening Exam (ASE): ask patient to squeeze hand only when you say 'A' — read SAVEAHAART. Score <8/10 = inattention present.

Feature 3: Altered Level of Consciousness*

Is the current RASS score anything other than 0 (alert and calm)?

Feature 4: Disorganised Thinking*

Does the patient have disorganised or incoherent thinking? Rambling conversation, illogical flow of ideas, unpredictable topic switching, or incoherent responses to simple questions (e.g. Does a stone float on water? Are there fish in the sea?)

References

Ely EW et al. Evaluation of delirium in critically ill patients: validation of the CAM-ICU. Crit Care Med. 2001;29(7):1370–1379.
Devlin JW et al. PADIS Clinical Practice Guidelines. Crit Care Med. 2018.

Curated clinical cross-links plus same-class fallbacks.

Calculators

PICU Delirium Assessment (pCAM-ICU) · Delirium Assessment

Drugs

Pathways

Decision support only — verify against MDCalc, NICE, or your local guideline before clinical use.

References

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