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Clinical Institute Withdrawal Assessment for AlcoholAka: CIWA-Ar

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  1. Indications: Alcohol Detoxification
    1. Alcohol Withdrawal assessment
    2. Scale used to direct Benzodiazepine protocol
  2. 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)
  3. 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/
  4. References
    1. Sullivan (1989) Br J Addict 84:1353

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