Delirium Clinical Pathway, CICU, PICU, and PCU – CAPD Scale

Delirium Clinical Pathway — CICU, PICU, and PCU

Cornell Assessment of Pediatric Delirium (CAPD) Scale

Exclusions

  • Neuromuscular blockade
  • Documented SBS score -2 or -3
Answer the following questions based on your interactions with the patient over the course of your shift
  Never
4		 Rarely
3		 Sometimes
2		 Often
1		 Always
0		 Score
1. Does the child make eye contact with the caregiver?
  •  
  •  
  •  
  •  
  •  
  •  
2. Are the child's actions purposeful?
  •  
  •  
  •  
  •  
  •  
  •  
3. Is the child aware of his/her surroundings?
  •  
  •  
  •  
  •  
  •  
  •  
4. Does the child communicate needs and wants?
  •  
  •  
  •  
  •  
  •  
  •  
  Never
0		 Rarely
1		 Sometimes
2		 Often
3		 Always
4		 Score
5. Is the child restless?
  •  
  •  
  •  
  •  
  •  
  •  
6. Is the child inconsolable?
  •  
  •  
  •  
  •  
  •  
  •  
7. Is the child underactive — very little movement while awake?
  •  
  •  
  •  
  •  
  •  
  •  
8. Does it take the child a long time to respond to interactions?
  •  
  •  
  •  
  •  
  •  
  •  
TOTAL  

Interpreting the CAPD Score

The score communicates need for further evaluation.

CAPD Screen Value Comments
Positive ≥ 9
developmentally appropriate
  • Evaluate for other causes of acute agitation or hypoactivity
  • Modify environment, evaluate and consider discontinuing medications that contribute to delirium
  • If delirium persists or at risk of self-harm, consider a trial of pharmacological therapy
≥ 9
developmentally delayed
  • A trended score of ≥ 9 with a parental assessment that the child’s activity is different than normal may suggest delirium
  • Normal activity per parent report should not be considered delirious despite a trended score ≥ 9
  • Consider consult to Psychiatry
Negative < 9