Assessment of delirium in intensive care using the CAM-ICU
© Shetty and Reid 2011
Published: 1 March 2011
Delirium remains a common but poorly diagnosed condition in the ICU . Delirium is an independent predictor of cognitive decline and mortality . The aims of this audit were: to measure the incidence of delirium in our unit; to consider the practicalities of using the CAM-ICU; whether a positive CAM-ICU test would change management; and the attitude of senior intensive care staff regarding the usefulness of CAM-ICU.
The CAM-ICU was used for 5 weeks in a mixed general ICU (14 beds) at Queen's Hospital, Romford. Patients were included into the study after 24 hours of admission; they were tested once daily. If the test was positive, a senior physician responsible for the patient's care was asked whether they would change the management of the patient. A survey was conducted to understand the attitude of intensive care consultants regarding the usefulness of the CAM-ICU test.
The incidence in our unit was lower than in other studies. Daily assessment with the CAM-ICU had no effect on management. It is possible to implement use of the CAM-ICU daily after a short period of training. There is a difference in attitude and practice in senior staff with regard to use of the CAM-ICU. As most cases are short lived and occurred in the first 48 hours, prevention should be emphasized before admission to critical care.
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