//fpnotebook.com/
bCAM
Aka: bCAM, Brief Confusion Assessment Method
- See Also
- Confusion Assessment Method
- CAM-S (Confusion Assessment Method Short Form)
- CAM-ICU (Confusion Assessment Method of the Intensive Care Unit)
- Delirium
- Indications
- Delirium Evaluation
- Technique
- Step 1: Altered Mental Status change from baceline or fluctuating course over prior 24 hours
- Positive
- Go to Step 2
- Negative
- Stop - Negative for Delirium
- Step 2: Inattention present
- Technique
- Examiner: "Can you name the months backwards from December to July?"
- Positive (More than 1 error)
- Go to step 3
- Negative
- Stop - Negative for Delirium
- Step 3: Altered Level of Consciousness present
- Assess alertness
- Alert (normal)
- Hyperalert or vigilant
- Lethargic or drowsy (easily aroused)
- Stuporous (difficult to arouse)
- Comatose (unarousable)
- Positive (not alert)
- Stop - POSITIVE for Delirium
- Negative (alert)
- Go to Step 4
- Step 4: Disorganized Thinking
- Questions
- "Will a stone float on water?"
- "Are there fish in the sea?"
- "Does one pound weigh more than two pounds?"
- "Can you use a hammer to pound a nail?"
- Command
- Examiner: "Hold up this many fingers"
- Examiner holds up 2 fingers
- Patient should hold up 2 fingers with one hand
- Examiner: "Now do the same thing with the other hand"
- Examiner does not demonstrate this time
- Patient should hold up 2 finger on the opposite hand
- Alternatively (if patient unable to move both hands): "Now hold up 3 fingers"
- Positive (2 or more errors)
- POSITIVE for Delirium
- Negative (0 or 1 error)
- Negative for Delirium
- Efficacy: Delirium Diagnosis
- Test Sensitivity: 84% (78% if non-physician performs)
- Test Specificity: 96%
- Resources
- Vanderbilt ICU Delirium
- http://icudelirium.org/delirium/monitoring.html
- References
- Ely (2001) Crit Care Med 29:1370-9
-Inouye (1990) Ann Intern Med 113: 941-8 [PubMed]