CAM-ICU (Delirium Assessment)

CAM-ICU (Confusion Assessment Method for ICU)

Algorithmic bedside screen for ICU delirium combining acute/fluctuating mental change, inattention, altered consciousness, and disorganized thinking; the patient must first be arousable (RASS ≥ −3) — RASS −4 or −5 cannot be assessed.

Feature 1 — Acute change OR fluctuating course of mental status

(compared to baseline, in the last 24 h)

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

Feature 2 — Inattention

(attention screening exam: e.g., letters / pictures / squeeze-on-A test; ≥ 2 errors out of 10)

0 - No (< 2 errors) 1 - Yes (≥ 2 errors)

Feature 3 — Altered level of consciousness

(current RASS ≠ 0, i.e., anything other than alert and calm; if RASS ≤ −4, the patient cannot be assessed)

0 - RASS = 0 (alert and calm) 1 - RASS ≠ 0

Feature 4 — Disorganized thinking

(yes/no questions and simple commands; ≥ 2 errors out of 5)

0 - No (< 2 errors) 1 - Yes (≥ 2 errors)