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COWS Scale

Discussion in '~ Articles ~ Info ~ Links ~ Data ~' started by Info, Feb 18, 2009.

  1. Info

    Info Administrator

    Resting Pulse Rate: (record beats per minute)
    Measured after sitting or lying for one minute

    0 pulse rate 80 or below

    1 pulse rate 81-100

    2 pulse rate 101-120

    4 pulse rate greater than 120

    Sweating: over past ? hour not accounted for by room temperature or patient activity.
    0 no report of chills or flushing

    1 subjective report of chills or flushing

    2 flushed or observable moistness on face

    3 beads of sweat on brow or face

    4 sweat streaming off face

    Restlessness Observation during assessment
    0 able to sit still

    1 reports difficulty sitting still, but is able to do so

    3 frequent shifting or extraneous movements of legs/arms

    5 Unable to sit still for more than a few seconds

    Pupil size
    0 pupils pinned or normal size for room light

    1 pupils possibly larger than normal for room light

    2 pupils moderately dilated

    5 pupils so dilated that only the rim of the iris is visible

    Bone or Joint aches If having pain previously, only the additional component attributed to opiates withdrawal is scored
    0 not present

    1 mild diffuse discomfort

    2 severe diffuse aching of joints/ muscles

    4 rubbing joints or muscles and is unable to sit still because of discomfort

    Runny nose or tearing Not accounted for by cold symptoms or allergies
    0 not present

    1 nasal stuffiness or unusually moist eyes

    2 nose running or tearing

    4 nose constantly running or tears streaming down cheeks

    GI Upset: over last ? hour
    0 no GI symptoms

    1 stomach cramps

    2 nausea or loose stool

    3 vomiting or diarrhea

    5 Multiple episodes of diarrhea or vomiting

    Tremor observation of outstretched hands
    0 No tremor

    1 tremor can be felt, but not observed

    2 slight tremor observable

    4 gross tremor or muscle twitching

    Yawning Observation during assessment
    0 no yawning

    1 yawning once or twice during assessment

    2 yawning three or more times during assessment

    4 yawning several times/minute

    Anxiety or Irritability
    0 none

    1 reports increasing irritability or anxiousness

    2 obviously irritable anxious

    4 so irritable or anxious that participation in the assessment is difficult

    Gooseflesh skin
    0 skin is smooth

    3 piloerrection of skin can be felt or hairs standing up on arms

    5 prominent piloerrection

    Total scores:

    5-12 = mild;

    13-24 = moderate;

    25-36 = moderately severe;

    more than 36 = severe withdrawal

    taken from thread in the bup forum;

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