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The Confusion Assessment Method (CAM) is a diagnostic tool developed to allow physicians and nurses to identify delirium in the healthcare setting. [1] It was designed to be brief (less than 5 minutes to perform) and based on criteria from the third edition-revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R).
It is however mostly used in mechanically ventilated patients in order to avoid over and under-sedation. Obtaining a RASS score is the first step in administering the Confusion Assessment Method in the ICU (CAM-ICU), [4] a tool to detect delirium in intensive care unit patients. The RASS is one of many sedation scales used in medicine.
A positive score in those tests generally then requires a more detailed assessment with a tool like the 4AT. This is an area of delirium practice which requires additional research. The 4AT is one of several other delirium assessment tools in the literature. [ 48 ]
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A research study of 400 adult patients emerging from general anesthesia in the PACU were assessed for delirium using the Confusion Assessment Method for the ICU (CAM-ICU) found rates of emergence delirium of 31% at PACU admission with rates declining to 8% by 1 hour. [11]
The two most widely used are the Confusion Assessment Method for the ICU (CAM-ICU) [70] and the Intensive Care Delirium Screening Checklist (ICDSC). [71] Translations of these tools exist in over 20 languages and are used ICUs globally with instructional videos and implementation tips available. [69]