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The CIWA scale has 11 symptoms that are evaluated and scored. The COWS scale evaluates 12 symptoms with a value placed on heart rate. The values are added up and the total score represents the patients withdrawal level. Librium is administered if the score falls within a range established by the medical staff.
The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale designed to be administered by a clinician. This tool can be used in both inpatient and outpatient settings to reproducibly rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time.
COWS Score for Opiate Withdrawal Resting Pulse Rate (BPM) Measure pulse rate after patient is sitting or lying down for 1 minute. Sweating. Restlessness observation during assessment. Pupil size. Bone or joint aches. Runny nose or tearing. GI Upset. Tremor observation of outstretched hands.
This step often has its own mini-steps, including its own acronyms to remember such as COWS (for Can you hear me?, Open your eyes, What is your name? and Squeeze my hand).
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