Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar)
Calculator
When to use
Nausea/vomiting - Do you feel sick to your stomach? Have you vomited?
Neither nausea nor vomiting
Mild nausea, no vomiting
More severe symptoms)
Intermittent nausea with dry heaves
Constant nausea, frequent dry heaves and vomiting
Tremor (arms extended and fingers spread apart)
No tremor
Not visible, but can be felt fingertip to fingertip
More severe symptoms)
Moderate, with patient's arms extended
Severe, even with arms not extended
Paroxysmal sweats
No sweat visible
Barely perceptible sweating, palms moist
More severe symptoms)
Beads of sweat obvious on forehead
Drenching sweats
Anxiety - Do you feel nervous?
No anxiety, at ease
Mildly anxious
More severe symptoms)
Moderately anxious, or guarded, so anxiety is inferred
Equivalent to acute panic states as seen in severe delirium or acute schizophrenic reactions
Agitation
Normal activity
Somewhat more activity than normal activity
More severe symptoms)
Moderately fidgety and restless
Paces back and forth during most of the interview, or constantly thrashes about
Tactile disturbances - Have you any itching, pins and needles sensations, any burning, any numbness or do you feel bugs crawling on or under your skin?
None
Very mild itching, pin and needles, burning, or numbness
Mild itching, pin and needles, burning, or numbness
Moderate itching, pin and needles, burning, or numbness
Moderately severe hallucinations
Severe hallucinations
Extremely severe hallucinations
Continuous hallucinations
Auditory disturbances - Are you more aware of sounds around you? Are they harsh? Do they frighten you? Are you hearing anything that is disturbing to you? Are you hearing things you know are not there?
None
Very mild harshness or ability to frighten
Mild harshness or ability to frighten
Moderate harshness or ability to frighten
Moderately severe hallucinations
Severe hallucinations
Extremely severe hallucinations
Continuous hallucinations
Visual disturbances - Does the light appear to be too bright? Is its color different? Does it hurt your eyes? Are you seeing anything that is disturbing to you? Are you seeing things you know are not there?
None
Very mild sensitivity
Mild sensitivity
Moderate sensitivity
Moderately severe hallucinations
Severe hallucinations
Extremely severe hallucinations
Continuous hallucinations
Headache/fullness in head - Does your head feel different? Does it feel like there is a band around your head? Do not rate for dizziness or lightheadedness.
None
Very mild
Mild
Moderate
Moderately severe
Severe
Very severe
Extremely severe
Orientation/clouding of sensorium - What day is this? Where are you? Who am I?
Oriented, can do serial additions
Can't do serial additions or is uncertain about date
Disoriented for date by ≤ 2 calendar days
Disoriented for date by > 2 calendar days
Disoriented to place or person
Calculation
Please enter all the required inputs.