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Clinical Institute Withdrawal Assessment for Alcohol

Aka: Clinical Institute Withdrawal Assessment for Alcohol, CIWA-Ar

Indications: Alcohol Detoxification
1. Alcohol Withdrawal assessment
2. Scale used to direct Benzodiazepine protocol
Scale Criteria
1. General
  1. Each rated on scale of 0 to 7 (except orientation)
  2. Maximum score: 67
2. Nausea, Vomiting (0 none, 4, intermittent, 7 constant)
3. Tremor (4 Tremor with arms extended, 7 Tremor at rest)
4. Paroxysmal sweating (1 palms, 4 forehead, 7 drenched)
5. Anxiety (1 mild, 4 moderate, 7 severe Panic Attack)
6. Agitation (4 fidgets, 7 paces)
7. Tactile Dysfunction (3 Paresthesias, 7 continuous)
8. Auditory Disturbances (4 hallucinations, 7 continuous)
9. Visual Disturbances (4 hallucinations, 7 continuous)
10. Headache (0 none, 3 moderate, 5 severe, 7 extreme)
11. Orientation (0 serial addition, 4 disoriented to place)
Resources
1. CIWA-Ar Html version
  1. http://addiction-medicine.org/files/15doc.html
2. CIWA-Ar Pdf version (select CIWAAR.pdf)
  1. http://adai.washington.edu/instruments/pdf/
References
1. Sullivan (1989) Br J Addict 84:1353-7

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 10/21/2007 and last published on 5/14/2013.

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