Editing Delirium (section)

===Intensive care unit===
People who are in the ICU are at greater risk of delirium, and ICU delirium may lead to prolonged ventilation, longer stays in the hospital, increased stress on family and caregivers, and an increased chance of death.<ref name="Burry_2019">{{cite journal | vauthors = Burry L, Hutton B, Williamson DR, Mehta S, Adhikari NK, Cheng W, Ely EW, Egerod I, Fergusson DA, Rose L | title = Pharmacological interventions for the treatment of delirium in critically ill adults | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | issue = 9 | pages = CD011749 | date = September 2019 | pmid = 31479532 | pmc = 6719921 | doi = 10.1002/14651858.CD011749.pub2 }}</ref> In the ICU, international guidelines recommend that every person admitted gets checked for delirium every day (usually twice or more a day) using a validated clinical tool.<ref name="pmid11902253">{{cite journal | vauthors = Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, Chalfin DB, Masica MF, Bjerke HS, Coplin WM, Crippen DW, Fuchs BD, Kelleher RM, Marik PE, Nasraway SA, Murray MJ, Peruzzi WT, Lumb PD | title = Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult | journal = Critical Care Medicine | volume = 30 | issue = 1 | pages = 119–141 | date = January 2002 | pmid = 11902253 | doi = 10.1097/00003246-200201000-00020 | s2cid = 16654002 }}</ref> Key elements of detecting delirium in the ICU are whether a person can pay attention during a listening task and follow simple commands.<ref name="www.icudelirium.org">{{cite web|url=https://www.icudelirium.org/medical-professionals/delirium/monitoring-delirium-in-the-icu|title=Critical Illness, Brain Dysfunction, and Survivorshpi (CIBS) Center|website=www.icudelirium.org|access-date=2019-03-22|archive-date=2019-03-22|archive-url=https://web.archive.org/web/20190322044929/https://www.icudelirium.org/medical-professionals/delirium/monitoring-delirium-in-the-icu|url-status=live}}</ref> The two most widely used are the Confusion Assessment Method for the ICU (CAM-ICU)<ref name="Ely2001">{{cite journal | vauthors = Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, Truman B, Speroff T, Gautam S, Margolin R, Hart RP, Dittus R | title = Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) | journal = JAMA | volume = 286 | issue = 21 | pages = 2703–2710 | date = December 2001 | pmid = 11730446 | doi = 10.1001/jama.286.21.2703 | hdl-access = free | doi-access = free | hdl = 10818/12438 }}</ref> and the Intensive Care Delirium Screening Checklist (ICDSC).<ref name="Bergeron2001">{{cite journal | vauthors = Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y | title = Intensive Care Delirium Screening Checklist: evaluation of a new screening tool | journal = Intensive Care Medicine | volume = 27 | issue = 5 | pages = 859–864 | date = May 2001 | pmid = 11430542 | doi = 10.1007/s001340100909 | s2cid = 24997942 }}</ref> Translations of these tools exist in over 20 languages and are used ICUs globally with instructional videos and implementation tips available.<ref name="www.icudelirium.org" /> For children in need of intensive care there are validated clinical tools adjusted according to age. The recommended tools are preschool and pediatric Confusion Assessment Methods for the ICU (ps/pCAM-ICU) or the Cornell Assessment for Pediatric Delirium (CAPD) as the most valid and reliable delirium monitoring tools in critically ill children or adolescents.<ref>{{cite journal | vauthors = Smith HA, Besunder JB, Betters KA, Johnson PN, Srinivasan V, Stormorken A, Farrington E, Golianu B, Godshall AJ, Acinelli L, Almgren C, Bailey CH, Boyd JM, Cisco MJ, Damian M, deAlmeida ML, Fehr J, Fenton KE, Gilliland F, Grant MJ, Howell J, Ruggles CA, Simone S, Su F, Sullivan JE, Tegtmeyer K, Traube C, Williams S, Berkenbosch JW | title = 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility | journal = Pediatric Critical Care Medicine | volume = 23 | issue = 2 | pages = e74–e110 | date = February 2022 | pmid = 35119438 | doi = 10.1097/PCC.0000000000002873 | s2cid = 246530757 | doi-access = free }}</ref>

More emphasis is placed on regular screening over the choice of tool used. This, coupled with proper documentation and informed awareness by the healthcare team, can affect clinical outcomes.<ref name="www.icudelirium.org" /> Without using one of these tools, 75% of ICU delirium can be missed by the healthcare team, leaving the person without any likely interventions to help reduce the duration of delirium.<ref name="www.icudelirium.org" /><ref>{{cite journal | vauthors = Jones SF, Pisani MA | title = ICU delirium: an update | journal = Current Opinion in Critical Care | volume = 18 | issue = 2 | pages = 146–151 | date = April 2012 | pmid = 22322260 | doi = 10.1097/MCC.0b013e32835132b9 | s2cid = 404583 }}</ref>