Cornell Assessment of Pediatric Delirium (CAPD)
Nursing-administered observational delirium screening tool for children in PICU. Validated for all ages including non-verbal and pre-verbal children. Score >= 9 indicates delirium.
Score interpretation
CAPD < 9 -- delirium not indicated; continue monitoring
→ Continue routine CAPD screening every 8-12 hours while in PICU; delirium prevention bundle: adequate sleep, daily awakening trials, optimise analgesia, early mobilisation, environmental cues (day/night lighting, clocks, familiar objects from home), family presence, minimise sedation; document CAPD in nursing notes.
CAPD >= 9 -- paediatric delirium likely; further assessment and management required
→ Notify PICU medical team; confirm with clinical assessment (PICU consultant review); identify and treat underlying causes: pain (review analgesia), infection (blood cultures, CRP, antibiotics if appropriate), metabolic (glucose, Na, Ca, Mg, PO4), medication review (benzodiazepines, opioids, anticholinergics, steroids), sleep deprivation, constipation, urinary retention; non-pharmacological ABCDEF bundle intensification; pharmacological treatment if hyperactive delirium causing safety risk: quetiapine 0.1-0.5 mg/kg/dose BD (off-label), haloperidol 0.025-0.05 mg/kg/dose (max 0.5 mg/dose) cautiously; avoid benzodiazepines if possible (worsen delirium); daily CAPD monitoring; family engagement; document diagnosis and management plan; psychology/child life specialist referral.
Interpretation bands for the CAPD. Apply clinical judgement and local guidance.
References
- 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.
- Schieveld JN et al. Pediatric delirium: a practical approach. Paediatr Drugs. 2013;15(5):351-356.
Related
Curated clinical cross-links plus same-class fallbacks.
- Ibuprofen (Paediatric) · NSAID / Analgesic / Antipyretic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Vancomycin (Paediatric) · Glycopeptide Antibiotic — MRSA / Severe Gram-Positive Infections in Children
- Iron Supplementation (Paediatric) · Iron Supplement — Iron Deficiency Anaemia in Children
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.