CAM-ICU (Confusion Assessment Method for the ICU)

When it activates

Scribeable activates a calculator from the encounter. The CAM-ICU (Confusion Assessment Method for the ICU) can activate when the transcript or pasted chart context documents any of these:

• ICU delirium screening
• Altered mental status in ICU
• Confusion assessment in ventilated patient
• Delirium monitoring
• Sedation-related mental status assessment

Inputs the note needs

4 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.

Scoring

Feature 1: Acute onset or fluctuating course (yes/no). Feature 2: Inattention — ASE letters (SAVEAHAART squeeze on A) or pictures test with >=2 errors (yes/no). Feature 3: Altered LOC — RASS anything other than 0 (yes/no). Feature 4: Disorganized thinking — <4 correct on 4 yes/no questions AND/OR unable to follow command (yes/no). CAM-ICU positive (delirium present) = Feature 1 + Feature 2 + (Feature 3 OR Feature 4). Score: 0 (negative) or 1 (positive).

Interpretation

CAM-ICU Positive: Delirium present — implement delirium bundle (ABCDEF): assess/manage pain, both SAT and SBT daily, choice of sedation (avoid benzodiazepines), delirium assessment and management, early mobility, family engagement. Sensitivity 80%, specificity 96% for delirium. Cannot be assessed if RASS -4 or -5 (comatose). Assess every shift minimum. Subtypes: hyperactive (agitated, RASS+), hypoactive (withdrawn, RASS-; more common, worse prognosis), mixed. Non-pharmacologic prevention most effective. Antipsychotics have not shown mortality benefit.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Ely 2001.

• Ely EW et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the ICU (CAM-ICU)Ely et al. (CAM-ICU) 2001 · 2001 · Level I · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the CAM-ICU (Confusion Assessment Method for the ICU) at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.

The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a CAM-ICU (Confusion Assessment Method for the ICU) value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

Related calculators

• Richmond Agitation-Sedation Scale (RASS)Standardizes sedation and agitation level assessment in ICU patients to guide sedation titration and enable delirium screening
• Ideal Body Weight (Devine)Calculates ideal body weight for lung-protective ventilation tidal volume and medication dosing
• Mean Arterial Pressure (MAP)Calculates mean arterial pressure to assess end-organ perfusion adequacy
• NUTRIC Score (Nutrition Risk in the Critically Ill)Identifies ICU patients most likely to benefit from aggressive nutritional support to guide nutrition therapy escalation
• ARISCAT ScorePredicts postoperative pulmonary complications to guide perioperative respiratory optimization
• Berlin Questionnaire for OSAScreens for obstructive sleep apnea risk to guide polysomnography referral

Can activate in: Neurology, Pulmonology, Anesthesiology, Critical Care / ICU, Geriatrics.