🧒 WAT-1 Pediatric Withdrawal Assessment
UseWhen to use: PICU patients weaning continuous opioids/benzodiazepines.
StrataScore ≥3 commonly flags clinically important withdrawal needing assessment/treatment.
LimitsWhen not to use: without performing the stimulus components as publis… · Pitfall: mistaking pain/delirium for withdrawal alone. · Follow institutional weaning protocols.
SourceFranck LS, et al. Pediatr Crit Care Med 2008 (WAT-1)
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
Threshold often ≥3.
When to use
When to use: PICU patients weaning continuous opioids/benzodiazepines.
How it works
11 indicators (stool, vomit, fever, state, tremor, sweat, movements, yawn/sneeze, startle, tone, time-to-calm 0–2). Total 0–12.
Key points
- Threshold often ≥3.
- Paired with taper plans.
- Next: SOS / local PICU withdrawal pathway.
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.
| Loose / watery stools | No (0) |
|---|---|
| Vomiting / wretching / gagging | No (0) |
| Temperature > 37.8 °C | No (0) |
| State from pre-stimulus observation | Asleep / awake calm (0) |
| Tremor | None / mild when disturbed (0) |
| Sweating | No (0) |
| Uncoordinated / repetitive movements | No (0) |
| Yawning or sneezing | No (0) |
| Startle to touch | No (0) |
| Muscle tone increased | No (0) |
| Time to regain calm state | 2–5 min (1) |
→WAT-11/12
- Screen：<3 — below common threshold
- Timing：Typically q12h from weaning start until 72 h after last opioid/benzo
| Loose / watery stools | No (0) |
|---|---|
| Vomiting / wretching / gagging | No (0) |
| Temperature > 37.8 °C | No (0) |
| State from pre-stimulus observation | Asleep / awake calm (0) |
| Tremor | None / mild when disturbed (0) |
| Sweating | No (0) |
| Uncoordinated / repetitive movements | No (0) |
| Yawning or sneezing | No (0) |
| Startle to touch | No (0) |
| Muscle tone increased | No (0) |
| Time to regain calm state | < 2 min (0) |
→WAT-10/12
- Screen：<3 — below common threshold
- Timing：Typically q12h from weaning start until 72 h after last opioid/benzo
Verification & sources · governance
FAQ
Frequently asked questions
- Does WAT-1 Pediatric Withdrawal Assessment 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 WAT-1 Pediatric Withdrawal Assessment calculated in practice? Can you show a worked example?
- Inputs: Loose / watery stools No (0), Vomiting / wretching / gagging No (0), Temperature > 37.8 °C No (0), State from pre-stimulus observation Asleep / awake calm (0), Tremor None / mild when disturbed (0), Sweating No (0), Uncoordinated / repetitive movements No (0), Yawning or sneezing No (0)… → Result: WAT-1 1 /12（Screen: <3 — below common threshold, Timing: Typically q12h from weaning start until 72 h after last opioid/benzo） Inputs: Loose / watery stools No (0), Vomiting / wretching / gagging No (0), Temperature > 37.8 °C No (0), State from pre-stimulus observation Asleep / awake calm (0), Tremor None / mild when disturbed (0), Sweating No (0), Uncoordinated / repetitive movements No (0), Yawning or sneezing No (0)… → Result: WAT-1 0 /12（Screen: <3 — below common threshold, Timing: Typically q12h from weaning start until 72 h after last opioid/benzo）