Confusion Assessment Method for the ICU (CAM-ICU)
Professional instrument reference.
Reference information · Questionnaire
- Last content update
- 2026-10-26
- Clinical review
- Not independently reviewed
- Source jurisdiction
- See individual sources
- Coverage
- Questionnaire
| Field | Instrument context |
|---|---|
| Version | Vanderbilt CAM-ICU 2023 worksheet; auditory SAVEAHAART and first thinking-question set |
| Population | Adult ICU patients assessable at RASS −3 or above |
| Respondent | Trained clinician examination |
Use the standardized CAM-ICU training manual and RASS examination. RASS −4 or −5: unable to assess; reassess when appropriate. Assess acute change or fluctuation before attention. For attention say: “I am going to read you a series of 10 letters. Whenever you hear the letter A, indicate by squeezing my hand.” Read S A V E A H A A R T in a normal tone three seconds apart. Record each response below. Count failures to squeeze on A and squeezes on any other letter. Squeezing on every letter or on no letters counts as ten errors. With 0–2 errors stop; otherwise assess altered consciousness and, if needed, disorganized thinking. Thinking errors combine incorrect answers and failure to complete the entire command. The full source protocol and training remain required for competent examination.
Copyright © 2002, E. Wesley Ely, MD, MPH and Vanderbilt University, all rights reserved.
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Interpretation & limitations
- The source rule requires acute change/fluctuation AND inattention AND either altered consciousness or disorganized thinking.
- This workflow reports a screen-rule finding for clinician interpretation; it does not generate a diagnosis or declaration of safety.
- Alternate visual attention testing, alternate letter sequences and alternate thinking questions require their own validated form; they are not interchangeable within this recorded edition.
References · 4
- Developer 2023 exact CAM-ICU worksheet
- Developer 2023 flowsheet and source-defined stop rules
- Developer complete training manual, RASS examination and assessability gate
- Developer permission and standardized training resources · The developer states the CAM-ICU educational materials are deliberately unrestricted in terms of use and no written permission is required for implementation and clinical use, with the copyright retained. Other uses require developer permission.