IPD: De-addiction

Withdrawal Monitoring (CIWA-Ar & COWS)

Nurses withdrawal ciwa-ar cows alcohol-withdrawal opioid-withdrawal

Withdrawal Monitoring (ipd/pages/withdrawal_monitoring.php) uses two standardized scales to track withdrawal severity: CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol) and COWS (Clinical Opiate Withdrawal Scale). Requires ipd_nursing_charts.

Step-by-step

  1. Go to Withdrawal Monitoring for the admission.
  2. Select the applicable scale based on the substance (alcohol → CIWA-Ar, opioids → COWS).
  3. Score each symptom domain as prompted by the scale.
  4. Save — the total score and severity guide clinical decisions (e.g., medication dosing, escalation of care).
  5. Repeat scoring at the frequency clinically indicated (often several times per day during acute withdrawal).

Common issues & fixes

requires ipd_nursing_charts.
CIWA-Ar is alcohol-specific, COWS is opioid-specific; using the wrong scale for the substance produces clinically meaningless scores.
acute withdrawal typically needs frequent reassessment; check your ward's protocol for expected intervals.

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