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@amaclullich.bsky.socialOct 6, 2026, 6:52 AM

Overnight confusion and agitation, clearer this morning.

The 4AT (a delirium test) includes the recent course: new restlessness and disorientation reported by night staff score 4 on item 4.

Alertness 0, questions 1, attention 1, acute change 4: 6 out of 12. Possible delirium.

#Delirium #4AT

Six-panel 4AT comic: Mr Hassan, 70, had a 4AT of 0 on admission with a chest infection. He was restless and disorientated overnight. This morning he is alert, makes one AMT4 error and skips July in months backwards. Night staff confirm the change was new. Scores 0, 1, 1, 4; total 6/12. The overnight change still counts.
@amaclullich.bsky.socialOct 2, 2026, 6:34 PM

“Months of the year backwards, starting with December?”

“December. November. October. September. No. Wait. I’ve lost it.”

Thirty seconds, no kit. Inattention is the core feature of delirium, and this is the 4AT's attention item. Her full score: 6 of 12; 4 or more is positive.

#delirium #4AT

@amaclullich.bsky.socialSep 29, 2026, 6:52 AM

The 4AT (a delirium test) needs no family informant.

Mr Williams is markedly drowsy, yet last week he collected his prescription in person: evidence of acute change.

Alertness 4, questions 2, attention 2, acute change 4: 12/12, possible delirium.

Score item 4 from the evidence.

#Delirium #4AT

@amaclullich.bsky.socialSep 24, 2026, 10:30 AM

The 4AT (a bedside delirium test scored 0 to 12) does not need a family informant.

Mr Williams is markedly drowsy. Evidence of recent independent activity supports an acute change: alertness 4, questions 2, attention 2, acute change 4: 12 out of 12.

Score item 4 from the evidence.

#Delirium #4AT

@amaclullich.bsky.socialSep 23, 2026, 10:30 AM

Overnight confusion and agitation, clearer this morning.

The 4AT (a delirium test) includes the recent course: new restlessness and disorientation reported by night staff score 4 on item 4.

Alertness 0, questions 1, attention 1, acute change 4: 6 out of 12. Possible delirium.

#Delirium #4AT

Six-panel 4AT comic: Mr Hassan, 70, had a 4AT of 0 on admission with a chest infection. He was restless and disorientated overnight. This morning he is alert, makes one AMT4 error and skips July in months backwards. Night staff confirm the change was new. Scores 0, 1, 1, 4; total 6/12. The overnight change still counts.
@amaclullich.bsky.socialSep 22, 2026, 3:30 PM

03:10. “Settled. Slept well.”

He was awake, watching men lower a net from the ceiling, keeping still so they would not see him.

Quiet is not asleep. Hypoactive delirium is about half of all cases and the half that gets missed.

#delirium #4AT

@amaclullich.bsky.socialSep 22, 2026, 10:30 AM

Before a planned hip replacement, Mrs Wilson scores 0/12 on the 4AT (a delirium test): normal alertness, correct AMT4 (age, date of birth, place, year) and months backwards, and no acute change.

This baseline gives the team a point of comparison. Repeat the 4AT after surgery.

#Delirium #4AT

4AT scoring comic: Mrs Wilson has a baseline assessment before planned hip replacement. She is alert, answers all four AMT4 questions correctly and says nine months backwards correctly. Her husband reports no change. All four items score 0; total 0/12. The closing message says to repeat the 4AT after surgery.
@amaclullich.bsky.socialSep 6, 2026, 12:08 PM

When “untestable” is part of the delirium assessment.

This short 4AT case shows how to score a patient who is too drowsy to respond verbally.

Think Delirium is my YouTube channel for short, practical videos on delirium and the 4AT.

youtube.com/shorts/_2Afg...

#delirium #4AT