4AT: delirium screen

Two minutes, no training, no equipment. The screen NICE and the UK acute-care standards recommend for delirium at admission and on any change.

What you enter

• Alertness: Normal (fully alert, not agitated) / Mild sleepiness <10 s after waking, then normal / Clearly abnormal (drowsy or agitated)
• AMT4 (age, date of birth, place, current year): No mistakes / 1 mistake / 2 or more mistakes / untestable
• Attention (months of the year backwards): 7 or more correct / Starts but scores <7 / refuses / Untestable (cannot start)
• Acute change or fluctuating course: No / Yes