Brief Confusion Assessment Method (bCAM)

The Brief Confusion Assessment Method (bCAM) is a two-minute bedside check for delirium — the sudden, fluctuating confusion that often follows illness, surgery, or medication changes, and that is missed in hospitals more often than not. It was adapted from the CAM-ICU for patients who are not critically ill.

Four features are checked in order: whether mental status has changed from baseline or is fluctuating, inattention, altered level of consciousness, and disorganized thinking. Inattention is the cardinal feature and is tested objectively, by asking the person to say the months backward from December to July. The algorithm stops early once the answer is settled. Delirium is flagged when the first two features are present plus either of the last two.

• bCAM Training Manual with the Full Algorithm and FAQs

Licensing Notes: The bCAM flow sheet, training manual, and supporting materials are posted for free download.

Learn More: Reported accuracy in older emergency department patients is 84% sensitivity and 96% specificity when performed by a physician, and 78% sensitivity and 97% specificity by a non-physician.