The Cardiovascular
ToolsCalculators

Confusion Assessment Method for the ICU (CAM-ICU)

Bedside diagnosis of delirium in ventilated or non-verbal ICU patients.

Confusion Assessment Method for the ICU (CAM-ICU)
Feature 1: Acute change or fluctuating course of mental status
Feature 2: Inattention (errors on attention testing)
Feature 3: Altered level of consciousness (RASS other than 0)
Feature 4: Disorganised thinking
ResultCAM-ICU negative

Criteria for delirium not met.

Result
No delirium

When to use

  • Screening for delirium in ICU patients, including those who are intubated or unable to speak.

Formula

CAM-ICU is positive when Feature 1 (acute/fluctuating mental status) AND Feature 2 (inattention) are present, together with either Feature 3 (altered consciousness) OR Feature 4 (disorganised thinking).

Pearls and pitfalls

  • Assess only if the patient is arousable (RASS ≥ −3); deeply sedated patients cannot be assessed.
  • Pair with a validated sedation scale such as RASS at each evaluation.

References

  1. Ely EW, et al. JAMA. 2001;286(21):2703-10.