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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).
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]
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]
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.
The following questions are put to the patient. Each question correctly answered scores one point. A score of 7–8 or less suggests cognitive impairment at the time of testing, [4] although further and more formal tests are necessary to confirm a diagnosis of dementia, delirium or other causes of cognitive impairment. Culturally-specific ...
The incidence of emergence delirium after halothane, isoflurane, sevoflurane or desflurane ranges from 2–55%. [10] Most emergence delirium in the literature describes agitated emergence. Unless a delirium detection tool is used, it is difficult to distinguish if the agitated emergence from anesthesia was from delirium or pain or fear, etc.
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As such, she developed the Confusion Assessment Method as a new tool for the identification of delirium in 1990, now the most widely used tool for identification of delirium worldwide. [7] In 1999, she published a landmark study in the New England Journal of Medicine demonstrating a 40% reduction in delirium using a multi-component non ...