🍷 CIWA-Ar (Alcohol Withdrawal)
UseTitrate benzodiazepines and monitor alcohol withdrawal.
SourceSullivan JT, et al. Br J Addict 1989
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
≥ 8–10 typically triggers benzodiazepine dosing.
When to use
Titrate benzodiazepines and monitor alcohol withdrawal.
How it works
Ten items (nine scored 0–7, orientation 0–4); total 0–67. < 8 minimal, 8–15 mild–moderate, > 15 severe.
Key points
- ≥ 8–10 typically triggers benzodiazepine dosing.
- Unreliable in delirium, intubation or communication barriers.
- Use fixed-dose/phenobarbital protocols where CIWA-Ar can't be applied.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Nausea/vomiting (0–7) | 3 |
|---|---|
| Tremor (0–7) | 3 |
| Paroxysmal sweats (0–7) | 3 |
| Anxiety (0–7) | 3 |
| Agitation (0–7) | 3 |
| Tactile disturbances (0–7) | 3 |
| Auditory disturbances (0–7) | 3 |
| Visual disturbances (0–7) | 3 |
| Headache/fullness in head (0–7) | 3 |
| Orientation/clouding of sensorium (0–4) | 2 |
→CIWA-Ar29/67
- Interpretation：Severe — high risk of seizures/DTs
- Note：≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.
| Nausea/vomiting (0–7) | 0 |
|---|---|
| Tremor (0–7) | 0 |
| Paroxysmal sweats (0–7) | 0 |
| Anxiety (0–7) | 0 |
| Agitation (0–7) | 0 |
| Tactile disturbances (0–7) | 0 |
| Auditory disturbances (0–7) | 0 |
| Visual disturbances (0–7) | 0 |
| Headache/fullness in head (0–7) | 0 |
| Orientation/clouding of sensorium (0–4) | 0 |
→CIWA-Ar0/67
- Interpretation：Minimal/absent withdrawal
- Note：≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using CIWA-Ar (Alcohol Withdrawal)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does CIWA-Ar (Alcohol Withdrawal) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is CIWA-Ar (Alcohol Withdrawal) calculated in practice? Can you show a worked example?
- Inputs: Nausea/vomiting (0–7) 3, Tremor (0–7) 3, Paroxysmal sweats (0–7) 3, Anxiety (0–7) 3, Agitation (0–7) 3, Tactile disturbances (0–7) 3, Auditory disturbances (0–7) 3, Visual disturbances (0–7) 3… → Result: CIWA-Ar 29 /67（Interpretation: Severe — high risk of seizures/DTs, Note: ≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.） Inputs: Nausea/vomiting (0–7) 0, Tremor (0–7) 0, Paroxysmal sweats (0–7) 0, Anxiety (0–7) 0, Agitation (0–7) 0, Tactile disturbances (0–7) 0, Auditory disturbances (0–7) 0, Visual disturbances (0–7) 0… → Result: CIWA-Ar 0 /67（Interpretation: Minimal/absent withdrawal, Note: ≥ 8–10 usually triggers benzodiazepine dosing; reassess on a schedule.）