Diagnosing delirium

Could your patient be more confused, agitated or drowsy than usual?

If yes: delirium is likely

1. Alertness

   • Wake your patient and ask them their name and address. Are they

     1. Normal (0)

     2. Mildly sleepy (<10 seconds)(0)

     3. Clearly abnormal (4)

2. AMT-4

   • Ask your patient their Age, DOB, current place, current year

     1. No mistakes (0)

     2. 1 mistake (1)

     3. 2 or more mistakes/untestable (2)

3. Attention

   • "Tell me the months of the year, backwards, starting with December

     1. 7 or more correct (0)

     2. Starts but cannot do 7 (1)

     3. Untestable (eg too drowsy)(2)

4. Acute or fluctuating course?

   • 1. No (0)

     2. Yes (4)

4 or more suggests delirium