Confusion Assessment Method for the ICU (CAM-ICU)
What It Measures
The CAM-ICU is a bedside check for delirium in critically ill patients, including those on a ventilator who cannot speak. This assessment was built to assess even patients who could not participate in conversation, since other delirium assessments require verbal communication from the patient.
Assessment happens in two stages. First, arousal is checked with the RASS sedation scale — someone at RASS -4 or -5 is too deeply sedated to assess. If they are arousable, four features follow. Feature 1 asks whether mental status has changed from baseline or fluctuated in the past 24 hours. Feature 2 tests attention: the patient squeezes the clinician's hand at each letter A in a 10-letter sequence. Feature 3 is any RASS other than zero. Feature 4 tests reasoning with simple questions and a two-step command.
Further Reading
Additional Notes
Licensing Notes: Materials are downloadable free from icudelirium.org. Confirm with Vanderbilt's CIBS Center before reproducing the flowsheet or building it into an EHR.