Table 3.

The Preschool (psCAM-ICU)⁹ and Pediatric (pCAM-ICU)⁴⁸ Confusion Assessments for the ICU^a

	Preschool CAM-ICU (psCAM-ICU)a Less Than 5 Years of Age	Pediatric CAM-ICU (pCAM-ICU)a ≥ 5 Years of Age	Feature Present?c
Feature 1: Mental Statusb	Acute change in mental status? OR Fluctuation in mental status?	Acute change in mental status? OR Fluctuation in mental status?	NO → STOP - Delirium Absent YES → Assess Feature 2
Feature 2: Inattentionb	Show 10 pictures/mirror and count number patient has eye contact. Inattention present ≥ 3 no eye contact	Vigilance A: ABADBADAAY “Squeeze my hand every time you hear the letter ‘A’.” Inattention present ≥ 3 errors	NO → STOP - Delirium Absent YES → Assess Feature 3
Feature 3: Altered level of consciousness	Does the patient currently have an altered level of consciousness?	Does the patient currently have an altered level of consciousness?	YES → STOP - Delirium Present NO → Assess Feature 4
Feature 4: Disorganized Brain	1) Sleep-wake cycle disturbance? OR 2) Patient unaware of surroundings and inconsolable?	Ask 4 yes/no questions and give 1 two-step command Feature 4 present ≥ 2 errors	YES → STOP - Delirium Present NO → STOP - Delirium Absent

Notes: ^aThe Preschool Confusion Assessment Method for the ICU (psCAM-ICU) and the Pediatric CAM-ICU (pCAM-ICU) are highly valid and reliable pediatric delirium screening tools used in preschool (neonate – 5 years) and school-aged (≥ 5 years) critically ill patients who are at least responsive to voice. ^bThe cardinal features (acute change or fluctuating mental status and inattention) are required for delirium diagnosis using the hierarchal structure of these tools. ^cFollowing the ps/pCAM-ICU algorithm, once three features have been identified as “YES” or “PRESENT” then delirium is present and the assessment is complete.