Correct Answer: B — CAM-ICU

The CAM-ICU (Confusion Assessment Method for the ICU) is the gold-standard bedside tool for delirium assessment in ICU patients, including those on mechanical ventilation who cannot speak.

CAM-ICU has FOUR features:

1. Acute onset or fluctuating course of mental status
2. Inattention — patient cannot follow commands or complete attention tests
3. Altered level of consciousness — RASS other than zero
4. Disorganized thinking — cannot answer logic questions or follow commands

CAM-ICU positive (delirium present): Features 1 AND 2 PLUS either Feature 3 OR Feature 4

Types of ICU Delirium:

• Hyperactive: Agitation, pulling lines — most recognized
• Hypoactive: Quiet, withdrawn — most common, often missed
• Mixed: Fluctuates between both

Non-pharmacological management: Reorientation, early mobilization, sleep protocols, family presence.