CIWA-Ar (Alcohol Withdrawal)
Calculate the CIWA-Ar score to assess severity of alcohol withdrawal syndrome.
Formula
Sum of 10 domains (max 67). <8: mild; 8–14: moderate; ≥15: severe
- Scores < 8: usually manageable without benzodiazepines. 8–15: PRN or scheduled benzodiazepines. ≥15: intensive management; delirium tremens risk.
- Reassess every 1–4 hours during active withdrawal.
Mild withdrawal
Inputs
- Nausea/Vomiting (0–7): 1
- Tremor (0–7): 2
- Paroxysmal Sweats (0–7): 1
- Anxiety (0–7): 2
- Agitation (0–7): 1
- Tactile Disturbances (0–7): 0
- Auditory Disturbances (0–7): 0
- Visual Disturbances (0–7): 0
- Headache/Fullness in Head (0–7): 1
- Orientation/Clouding (0–4): 0
Total = 8. Moderate range — consider PRN benzodiazepine.
Frequently asked questions
When is CIWA-Ar used?
CIWA-Ar is used in medically supervised alcohol detoxification to guide the frequency and dose of benzodiazepines (or barbiturates) for symptom-triggered therapy.