PICU Delirium Assessment (pCAM-ICU)
Paediatric adaptation of CAM-ICU for delirium assessment in mechanically ventilated children ≥5 years. Positive if Features 1+2 AND (3 or 4).
Score interpretation
Delirium not present.
→ Continue monitoring. Prevent modifiable risk factors (early mobilisation, sleep hygiene, avoid unnecessary benzodiazepines).
Features 1+2 without 3 or 4.
→ Close monitoring. Non-pharmacological delirium prevention bundle. Reassess in 4–6 hours.
Paediatric delirium confirmed.
→ Non-pharmacological interventions first. Review sedation — minimise benzodiazepines. Treat pain. Maintain sleep-wake cycle. Consider pharmacological treatment (melatonin, low-dose quetiapine) in consultation with paediatric intensivist.
Interpretation bands for the pCAM-ICU. Apply clinical judgement and local guidance.
References
- Smith HA et al. Delirium: an emerging frontier in the management of critically ill children. Crit Care Clin. 2009;25(3):593-614.
- Traube C et al. Cornell Assessment of Pediatric Delirium: a valid, rapid observational tool for screening delirium in the PICU. Crit Care Med. 2014;42(3):656-663.
Related
Curated clinical cross-links plus same-class fallbacks.
- Melatonin · Melatonin Receptor Agonist
- Haloperidol (Delirium) · Typical Antipsychotic (Butyrophenone)
- Phytomenadione (Vitamin K1) · Vitamin K (clotting factor cofactor)
- Phytomenadione (Vitamin K1) · Vitamin K (Coagulation Factor Synthesis)
- Ibuprofen (Orthopaedic Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor
- Vitamin K (Phytomenadione) · Vitamin / Haemostatic
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.