Level of consciousness: Examine the baseline level of awakeness. If the patient is drowsy or asleep stimulate them and see if they can maintain arousal.
Attention: Determine if the patient attends to your voice and commands. Delirious patients will have fluctuating attention.
WORLD: Have the patient spell the word world forwards and backwards. People with normal attention can do this task.
Number repetition: Explain that you are going to say several numbers outloud. Ask the patient to listen for the numbers you are going to say and repeat them after you have finished. Give the patient a list of random numbers one digit every second. Start with three digits and increase one digit per trial until the patient consistently makes mistakes.
Now ask the patient to repeat the digits backwards. Start with three digits and increase by one digit per trial. Most people can repeat 5 digits.