Preschool Confusion Assessment Method for the ICU (psCAM-ICU)
What It Measures
The psCAM-ICU checks whether a critically ill infant or preschool-aged child has delirium. It exists because the two existing tools stopped short: the adult CAM-ICU relies on conversation, and the pediatric pCAM-ICU requires a developmental age of at least five.
Arousal is assessed first with the RASS sedation scale — a child at -4 or -5 is too deeply sedated to continue. If arousable, four features follow. Feature 1 asks whether mental status has changed from baseline or fluctuated. Feature 2 tests attention using bold picture cards and simple visual tasks. Feature 3 asks whether the level of consciousness is anything other than alert and calm. Feature 4 asks about sleep-wake cycle disturbance. Features 1 and 2 must both be present, plus either 3 or 4.
Further Reading
Additional Notes
Licensing Notes: Materials are downloadable free from icudelirium.org. As with the adult CAM-ICU and the pCAM-ICU, related materials carry Vanderbilt copyright and reproductions use "adapted with permission" language — confirm before reproducing the flowsheet or building it into an EHR.
Learn More: Two versions exist. The short form is for clinical use and requires fewer components within Features 2 and 4; the long form is for research. The validated range is 6 months to 5 years.