Clinical Institute Withdrawal Assessment for Alcohol

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

1. Indications: Alcohol Detoxification
   1. Alcohol Withdrawal assessment
   2. Scale used to direct Benzodiazepine protocol
2. Technique
   1. Each criteria rated on scale of 0 to 7 (except orientation)
   2. Maximum score: 67
3. Evaluation: Criteria
   1. Nausea, Vomiting
      1. Score 0: None
      2. Score 4: Intermittent
      3. Score 7: Constant
   2. Tremor
      1. Score 0: None
      2. Score 4: Tremor with arms extended
      3. Score 7: Tremor at rest
   3. Paroxysmal sweating
      1. Score 0: None
      2. Score 1: Palms
      3. Score 4: Forehead
      4. Score 7: Drenched
   4. Anxiety
      1. Score 0: None
      2. Score 1: Mild
      3. Score 4: Moderate
      4. Score 7: Severe Panic Attack
   5. Agitation
      1. Score 0: None
      2. Score 4: Fidgets
      3. Score 7: Paces
   6. Tactile Dysfunction
      1. Score 0: None
      2. Score 3: Paresthesias
      3. Score 7: Continuous
   7. Auditory Disturbances
      1. Score 0: None
      2. Score 4: Hallucinations
      3. Score 7: Continuous
   8. Visual Disturbances
      1. Score 0: None
      2. Score 4: Hallucinations
      3. Score 7: Continuous
   9. Headache
      1. Score 0: None
      2. Score 3: Moderate
      3. Score 5: Severe
      4. Score 7: Extreme
   10. Orientation
       1. Score 0: Serial Addition
       2. Score 4: Disoriented to Place
4. Resources
   1. CIWA-Ar Html version
      1. http://addiction-medicine.org/files/15doc.html
5. References
   1. Sullivan (1989) Br J Addict 84:1353-7 [PubMed]