Slide 1: Fick MyPlick practice
Using the CAM for delirium screening
Slide 2: CAM-4 Delirium Features
CONFUSION ASSESSMENT METHOD (CAM) WORKSHEET EVALUATOR: DATE: BOX 1 YES YES NO NO I. ACUTE ONSET AND FLUCTUATNG COURSE
a) Is there evidence of an acute change in mental status from the patient’s baseline? b) Did the (abnormal) behavior fluctuate during the day, that is, tend to come and go or increase and decrease in severity?
II. INATTENTION
Did the patient have difficulty focusing attention, for example, being easily distractible or having difficulty keeping track of what was being said?
YES
NO
III. DISORGANIZED THINKING BOX 2
Was the patient’s thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable, switching from subject to subject?
YES
NO
IV. ALTERED LEVEL OF CONSCIOUSNESS
Overall, how would you rate the patient’s level of consciousness? Alert (normal) Vigilant (hyperalert) Lethargic (drowsy, easily aroused) Stupor (difficult to arouse) Coma (unarousable)
Do any checks appear in this box?
YES
NO
Positive for delirium per CAM (based on above CAM)
YES
NO
If all items in Box 1 are checked and at least 1 item in Box 2 is checked a diagnosis of delirium is suggested. They have to have both items 1 and 2 present and either 3 or 4 Adapted from Inouye, SK et al Clarifying Confusion: The Confusion Assessment Method. A New Method for Detection of Delirium. Ann Intern Med. 1990; 113: 941-8
Slide 3: How To ASSESS for Delirium
• • • • • Confusion Assessment Method Mini-Mental State Examination (MMSE) SPMSQ Blessed Depression Scale
