CAM Delirium Helper

Step through the four CAM criteria to determine whether a patient meets the clinical criteria for delirium.

CAM Assessment

Answer all four features based on your clinical observation.

1

Acute Onset or Fluctuating Course

Is there evidence of an acute change in mental status from baseline, OR does the behavior fluctuate during the day?

2

Inattention (Required)

Does the patient have difficulty focusing attention — e.g., easily distracted, cannot follow a conversation, or fails digit-span / letter-A tests?

3

Disorganized Thinking

Is the patient's thinking disorganized or incoherent — e.g., rambling, irrelevant conversation, unclear flow of ideas, or unpredictable topic switching?

4

Altered Level of Consciousness

Is the patient's level of consciousness anything other than alert — e.g., vigilant/hyperalert, lethargic, stuporous, or comatose?

Answer all four features and click
Evaluate CAM Result to see the diagnosis.

CAM Algorithm

Delirium is present when all of the following are met:

  1. 1 Acute onset or fluctuating course — Yes
  2. 2 Inattention — Yes
  3. + Disorganized thinking (Feature 3) — Yes OR Altered consciousness (Feature 4) — Yes

Source: Inouye SK et al., Ann Intern Med. 1990;113(12):941–948.

Summary

Step through the four CAM criteria to determine whether a patient meets the clinical criteria for delirium.

How it works

  1. Answer whether the patient shows an acute onset or fluctuating course of mental status change.
  2. Assess whether the patient demonstrates inattention (difficulty focusing, easily distracted).
  3. Determine whether thinking is disorganized (rambling, incoherent, or illogical conversation).
  4. Evaluate the level of consciousness (anything other than alert = abnormal).
  5. The tool applies the CAM algorithm: Features 1 + 2 must both be present, plus Feature 3 OR Feature 4.
  6. Review the result and clinical notes, then document your assessment in the patient record.

Use cases

  • Rapid delirium screening on admission to hospital wards or the ICU.
  • Serial assessments to track delirium resolution during recovery.
  • Teaching medical students and residents the CAM algorithm at the bedside.
  • Nursing-led delirium surveillance programs in post-operative units.
  • Emergency department triage of confused elderly patients.
  • Long-term care settings where delirium is frequently under-recognized.

Frequently Asked Questions

Last updated: 2026-06-09 · Reviewed by Nham Vu