Clinical Institute Withdrawal Assessment for Alcohol.
Symptom Assessment
Withdrawal Severity
CIWA-Ar Total0/ 67
ClassificationMild Withdrawal
Withdrawal is mild. No medication usually indicated.
Clinical Action Plan
Score Reference
0 - 8Mild
9 - 15Moderate
> 15Severe
About this calculator
Overview
The CIWA-Ar is the most widely used and validated clinical scale for assessing the severity of alcohol withdrawal. It allows healthcare providers to monitor symptoms and provide symptom-triggered medication (typically benzodiazepines) to prevent severe complications like seizures or delirium tremens.
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Pro Tips
Base scores on objective observation and patient report.
If the patient is asleep and easily rousable, do not score; if difficult to rouse, use other trauma/GCS scales.
Vitals (Pulse/BP) are clinical markers but NOT included in the CIWA-Ar total score.
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Fun Facts
"A score of 8-10 or more is often used as a threshold to begin pharmacotherapy."
"Symptoms usually peak around 48-72 hours after the last drink."
"Delirium Tremens (DTs) is a medical emergency with up to 5% mortality."
"Frequent assessment (every 1-4 hours) is essential during the acute phase."
Formula: Sum of scores across 10 clinical symptoms (range 0 - 67).
