Brief Alcohol Withdrawal Scale (BAWS)
Assesses alcohol withdrawal symptoms.
Next
Evidence
Next
ADVICE
BAWS <3:
Give diazepam 5 mg orally as needed for mild withdrawal or anxiety.
- Every 4 hrs up to 6 doses (day 1).
- Every 6 hrs up to 4 doses (day 2).
- Every 8 hrs up to 3 doses (day 3).
Reassess BAWS every 4 hrs for 24 hrs, then every 6 hrs.
BAWS 3-5:
- Give diazepam 10 mg orally every 4 hrs until BAWS <3 (up to 10 doses).
- Reassess BAWS every 4 hrs.
BAWS 6-8:
- Give diazepam 20 mg orally every 2 hrs until BAWS <6 (up to 3 doses).
- If the patient has not received any benzodiazepines, give an initial dose of 10 mg.
- Reassess BAWS every 2 hrs; notify physician if BAWS >5 after 6hrs.
BAWS >8:
- Give diazepam 20 mg orally and notify physician.
Evidence
FORMULA
| Variable | Points | |
|---|---|---|
| Tremor | No tremor | 0 |
| Not visble but can be felt | 1 | |
| Moderate, with arms extended | 2 | |
| At rest, without arms extended | 3 | |
| Diaphoresis/sweats | No sweats | 0 |
| Mild, barely visible | 1 | |
| Beads of sweat | 2 | |
| Drenching sweats | 3 | |
| Agitation RASS | Alert and calm (RASS = 0) | 0 |
| Restless, anxious, apprehensive, movements not aggressive (RASS = 1) | 1 | |
| Agitated, frequent non-purposeful movement (RASS = 2) | 2 | |
| Very agitated or combative, violent (RASS = 3 or 4) | 3 | |
| Confusion/orientation. e.g. time: by more than 2 days, wrong month, or wrong year place: name of building, city, state | Oriented to person, place, time | 0 |
| Disoriented to time or place, but not both | 1 | |
| Disoriented to time and place | 2 | |
| Disoriented to person | 3 | |
| Hallucinations Visual, auditory, tactile | None | 0 |
| Mild (vague report, reality testing intact) | 1 | |
| Moderate (more defined hallucinations) | 2 | |
| Severe (obviously responding to internal stimuli, poor reality testing) | 3 | |
FACTS & FIGURES
BAWS <3:
Give diazepam 5 mg orally as needed for mild withdrawal or anxiety.
- Every 4 hrs up to 6 doses (day 1).
- Every 6 hrs up to 4 doses (day 2).
- Every 8 hrs up to 3 doses (day 3).
Reassess BAWS every 4 hrs for 24 hrs, then every 6 hrs.
BAWS 3-5:
- Give diazepam 10 mg orally every 4 hrs until BAWS <3 (up to 10 doses).
- Reassess BAWS every 4 hrs.
BAWS 6-8:
- Give diazepam 20 mg orally every 2 hrs until BAWS <6 (up to 3 doses).
- If the patient has not received any benzodiazepines, give an initial dose of 10 mg.
- Reassess BAWS every 2 hrs; notify physician if BAWS >5 after 6hrs.
BAWS >8:
- Give diazepam 20 mg orally and notify physician.
