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7 - Constant nausea and frequent dry heaves and vomiting. 7 - severe, even w/ arms not extended. Anxiety - Rate on scale 0 - 7. Agitation - Rate on scale 0 - 7. 0 - no anxiety, patient at ease.
The CIWA-Ar scale can measure 10 symptoms. Scores of less than 8 to 10 indicate minimal to mild withdrawal. Scores of 8 to 15 indicate moderate withdrawal (marked autonomic arousal); and scores of 15 or more indicate severe withdrawal (impending delirium tremens).
The CIWA-Ar is not copyrighted and may be reproduced freely. This assessment for monitoring withdrawal symptoms requires approximately 5 minutes to administer. The maximum score is 67 (see instrument). Patients scoring less than 10 do not usually need additional medication for withdrawal.
Cumulative scores of less than 8-10 indicate mild withdrawal. Next, scores of 8-15 indicate moderate withdrawal, and scores of 15 or more than 15 indicate severe withdrawal with impending possible delirium tremens.
The Clinical Institute Withdrawal Assessment for Alcohol (often called CIWA or CIWA-Ar (an updated version)), is a scale used to measure alcohol withdrawal symptoms. The scale lists ten common symptoms of alcohol withdrawal. Based on how bad a person's symptoms are, each of these is assigned a number.
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The CIWA-Ar should used in all patients suspected of being at risk to have alcohol withdrawal. Because it takes only a minute or two to administer, the scale can be used as frequently (i.e., every 1-2 hours) and can be used early when alcohol withdrawal is viewed only as a clinical risk.
The CIWA-Ar is not copyrighted and may be reproduced freely. This assessment for monitoring withdrawal symptoms requires approximately 5 minutes to administer. The maximum score is 67 (see instrument). Patients scoring less than 10 do not usually need additional medication for withdrawal.
The CIWA scale is validated, which means it is proven to measure what it means to measure - alcohol withdrawal symptoms. It also has high inter-rater reliability. This means that if more than one medical professional used the CIWA on the same patient, they would get very similar results.
The CIWA-Ar is not copyrighted and may be reproduced freely. This assessment for monitoring withdrawal symptoms requires approximately 5 minutes to administer. The maximum score is 67 (see instrument). Patients scoring less than 10 do not usually need additional medication for withdrawal.
The Clinical Institute Withdrawal Assessment for Alcohol\u2013Revised (CIWA-Ar) protocol (Figure 1)1 is the most common method of treating alcohol withdrawal in our institution and it is frequently used by family physicians.

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