🧠 ICU Delirium Assessment (CAM-ICU)
Confusion Assessment Method for the ICU (CAM-ICU), a bedside tool to detect delirium in critically ill patients including those who are ventilated.
ICU Delirium Assessment (CAM-ICU)
Sedation/arousal level (assess RASS first)
Feature 1: acute onset or fluctuating course
Feature 2: inattention (attention test > 2 errors)
Feature 3: altered level of consciousness (current RASS ≠ 0)
Feature 4: disorganized thinking (yes/no or command errors)
When to use
Use to screen for ICU delirium once the patient is arousable (RASS ≥ −3), applying the four-feature algorithm.
How it works
Delirium present when Feature 1 (acute change/fluctuating mental status) AND Feature 2 (inattention) are present, plus either Feature 3 (altered level of consciousness, RASS ≠ 0) OR Feature 4 (disorganized thinking).
Key points
- CAM-ICU is validated for nonverbal/ventilated patients, unlike many delirium tools that require speech (original synthesis · not guideline verbatim).
- Assess arousal with RASS first; a deeply sedated patient (RASS −4/−5) cannot be assessed and is recorded as 'unable to assess'.
- Routine screening pairs with the ABCDEF bundle to reduce delirium duration and improve outcomes.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.