The Elizabeth Hospice Palliative Reference Cards

DELIRIUM SCREENING

CAM: Confusion Assessment Method

3) DISORGANIZED THINKING

A diagnosis of delirium is suggested if question 1 and 2 are YES with either • YES from 3 or • Anything other than alert in 4

Is the patient’s thinking disorganized or incoherent, as evidenced by rambling or relevant conversation, unclear or illogical flow of ideas, unpredictable switching from subject to subject?  Yes  No  Uncertain 4) ALTERED LEVEL OF CONSCIOUSNESS Overall, how would you rate this patient’s level of consciousness?  Alert  Vigilant (hyperalert, overly sensitive to environmental stimuli, startled very easily)  Lethargic (drowsy, easily aroused)  Stuporous (difficult to arouse)  Comatose (unarousable)  Uncertain

1) ACUTE ONSET

Is there sudden onset of mental status change?  Yes  No  Uncertain 2) INATTENTION Does the patient had difficulty focusing attention, for example, is easily distracted or has difficulty keeping track of what is being said?  Yes  No  Uncertain

Adapted from Inouye et al. 1990. PMID 2240918. Used with permission.

26 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024

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