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CIWA Calculator

Clinical Institute Withdrawal Assessment for Alcohol - Revised (CIWA-Ar)

CIWA-Ar Assessment Scale

Instructions: This scale assesses 10 symptoms of alcohol withdrawal. Rate each symptom based on current severity. The assessment should be conducted by trained healthcare professionals.

1. Nausea and Vomiting

2. Tremor

3. Paroxysmal Sweats

4. Anxiety

5. Agitation

6. Tactile Disturbances

7. Auditory Disturbances

8. Visual Disturbances

9. Headache, Fullness in Head

10. Orientation and Clouded Sensorium

CIWA-Ar Assessment Results

0/67
CIWA-Ar Score
Mild
Withdrawal Severity

Assessment: Minimal/Mild Withdrawal

Clinical Indication: Pharmacological treatment typically not indicated

Recommendation: Monitor symptoms. Supportive care and observation may be sufficient.

🚨 Critical Medical Information

• CIWA assessment must be performed by trained healthcare professionals

• This tool is for clinical use in hospital/medical settings only

• Alcohol withdrawal can be life-threatening and requires medical supervision

• Severe withdrawal symptoms may require immediate emergency care

• Do not use this tool for self-assessment or treatment decisions

• Always consult qualified medical professionals for alcohol withdrawal management

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CIWA-Ar Components

Nausea/Vomiting0/7
Tremor0/7
Sweats0/7
Anxiety0/7
Agitation0/7
Tactile Disturbances0/7
Auditory Disturbances0/7
Visual Disturbances0/7
Headache0/7
Orientation0/4
Total Score0/67

CIWA Score Interpretation

0-9: Minimal
No pharmacological treatment typically needed
10-15: Moderate
Clinical judgment required
16-20: Severe
Treatment likely indicated
≥21: Very Severe
Immediate intervention required

Understanding the CIWA Scale

What is CIWA?

The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) is a validated 10-item scale used to assess and monitor alcohol withdrawal syndrome severity. Developed by Sullivan et al. in 1989, it's the most widely used tool in clinical practice.

Clinical Applications

  • Quantify withdrawal symptom severity
  • Guide pharmacological treatment decisions
  • Monitor treatment response and progression
  • Standardize care across healthcare settings

Alcohol Withdrawal Syndrome

Early Symptoms (6-24 hours)

Tremor, anxiety, nausea, sweating, headache, and insomnia

Intermediate (24-72 hours)

Hallucinations (visual, auditory, tactile), disorientation, and agitation

Severe (48-96 hours)

Delirium tremens (DTs) with confusion, hyperthermia, seizures, and cardiovascular instability

Warning: Alcohol withdrawal can be life-threatening. Severe cases require immediate medical intervention and hospitalization.

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