CIWA Assessment: Understanding Alcohol Withdrawal Severity

The CIWA (pronounced SEE-WAH), or Clinical Institute Withdrawal Assessment, protocol is an observational tool ordered by a physician to determine the severity of a patient's alcohol withdrawal. By assessing a patient's withdrawal symptoms, health care providers are better able to create a treatment plan that is specifically tailored to the patient's needs.

Function

• The protocol functions as an assessment tool to determine the level of care that a patient who is in active withdrawal from alcohol should receive. Based on a scoring system, certain treatment plans will be initiated and the patient will be monitored and medicated as needed. This assessment can be performed in a hospital setting or in an addiction treatment program.

Features

• The protocol is comprised of a set of 10 assessments, both objective and subjective, each of which deals with a specific aspect of withdrawal. Examples include level of nausea/vomiting; tactile, auditory or visual disturbances; tremors; sweating; anxiety and orientation. Each assessment section uses a scoring system that is tabulated at the end and gives the assessor the ability to rank the patient's symptoms

Treatment

• Once a score has been tabulated, the patient is categorized in a specific level, and a treatment plan is initiated. Treatment can include specific medications for anxiety or nausea, frequency of nurse visits and monitoring of sleep patterns. In general, any score from 8 to 15 will initiate immediate treatment with specific protocols, and a score from 0 to 8 will initiate discontinuation of the protocol.