Clinical Institute Withdrawal Assessment of Alcohol Scale Book Appointment Filll in the form Full Name Email NAUSEA AND VOMITING no nausea and no vomiting mild nausea with no vomiting intermittent nausea with dry heaves constant nausea, frequent dry heaves and vomiting TREMOR no tremor not visible, but can be felt fingertip to fingertip moderate, with patient's arms extended severe, even with arms not extended PAROXYSMAL SWEATS no sweat visible barely perceptible sweating, palms moist beads of sweat obvious on forehead drenching sweats ANXIETY no anxiety, at ease mild anxious 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 than normal activity moderately fidgety and restless paces back and forth during most of the interview, or constantly thrashes about TACTILE DISTURBANCES none very mild itching, pins and needles, burning or numbness mild itching, pins and needles, burning or numbness moderate itching, pins and needles, burning ornumbness moderately severe hallucinations severe hallucinations extremely severe hallucinations AUDITORY DISTURBANCES not present 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 not present very mild sensitivity mild sensitivity moderate sensitivity moderately severe hallucinations severe hallucinations extremely severe hallucinations continuous hallucinations HEADACHE, FULLNESS IN HEAD no present very mild mild moderate moderately severe severe very severe extremely severe ORIENTATION AND CLOUDING OF SENSORIUM oriented and can do serial additions cannot do serial additions or is uncertain about date disoriented for date by no more than 2 calendar days disoriented for date by more than 2 calendar days disoriented for place/or person I accept the Terms of Service Submit
