CAM (Non-ICU Delirium Assessment)

CAM (Confusion Assessment Method, Non-ICU)

Original non-ICU Confusion Assessment Method (Inouye) for general wards, ED, and primary care that detects delirium from four observed features; use CAM-ICU instead for intubated or non-verbal ICU patients.

Feature 1 — Acute onset AND fluctuating course

(usually obtained from a family member, caregiver, or nurse: is the change from baseline acute? does the disturbance come and go through the day?)

0 - No (absent) 1 - Yes (present)

Feature 2 — Inattention

(difficulty focusing attention — e.g., easily distracted, has trouble keeping track of what is said; bedside test: months of the year backward, digit-span backward, or serial subtraction)

0 - No (absent) 1 - Yes (present)

Feature 3 — Disorganized thinking

(rambling or irrelevant conversation, unclear or illogical flow of ideas, unpredictable switching from subject to subject)

0 - No (absent) 1 - Yes (present)

Feature 4 — Altered level of consciousness

(anything other than alert — vigilant / hyperalert, lethargic, stuporous, or comatose)

0 - No (alert) 1 - Yes (not alert)