Fig. 1

Illustration of acute brain dysfunction (coma and delirium). The sun represents the investigator. The sunbeam represents the interview or tests (i.e., CAM-ICU) used to assess inattention. The clouds (i.e., RASS score of ≤−4) represent cover on some levels of arousal required to maintain cognition. RASS −3 the patient opens their eyes or moves in response to a voice but does not make eye contact. RASS −1 the patient is not fully alert but opens their eyes and makes eye contact, which is sustained for more than 10 s in response to a voice