1. For PAWWS (> or = 4) or CIWA (> or = 9)
CIWA PROTOCOL
CIWA - AR
ATIVAN DOSAGE
Severity
Score PO IV
Monitoring
Documentation
Mild
0-8
None
Monitor every H until CIWA-Ar less than or equal to 8 x 4H consecutively, then every 4 hours
Document CIWA QH until CIWA is < or = 8 x 4H, then Q4H.
Document RASS prior to any dose administration.
Moderate
9-15
2mg or ____mg
Monitor every 30 minutes per CIWA–Ar until CIWA–Ar is less than or equal to 8
Document CIWA every 30 minutes until CIWA < or = 8.
Severe
Greater than 15
4mg or ____mg
Monitor every 15 minutes per CIWA–Ar until CIWA–Ar is less than or equal to 15
Document CIWA every 15 minutes until CIWA < or = 15.
CIWA - AR
PHENOBARBITAL DOSAGE
For PAWWS (> or = 4) or CIWA (> or = 9)
Severity
Score PO IV
Monitoring
Documentation
Mild
0-8
None
Monitor every H until CIWA-Ar less than or equal to 8 x 4H consecutively, then every 4 hours
Document CIWA QH until CIWA is < or = 8 x 4H, then Q4H.
Document RASS prior to any dose administration.
Moderate
9-15
130mg IV
(Notify MD if 4 doses of 130mg are given)
Monitor every 30 minutes per CIWA–Ar until CIWA–Ar is less than or equal to 8
Document CIWA every 30 minutes until CIWA < or = 8.
Severe
Greater than 15
Monitor every 15 minutes per CIWA–Ar until CIWA–Ar is less than or equal to 15
Document CIWA every 15 minutes until CIWA < or = 15.
If patient was transferred to the floor and PAWWS becomes (> or = 4) or CIWA (> or = 9) and no loading dose was originally given, ok to give a bolus of 260mg IV x 1, then continue with symptom triggered dosing per table (dilute in 10ml NS and push over 2-3 min per MAR instructions).
Discontinue CIWA-Ar assessment when CIWA-Ar is less than 8 for 72 Hours