ARCHETYPE Clinical Opiate Withdrawal Scale (COWS) (openEHR-EHR-OBSERVATION.cow_score.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.cow_score.v0
ConceptClinical Opiate Withdrawal Scale (COWS)
DescriptionAssessment tool used to measures the severity of opiate withdrawal.
UseUse to record individual COWS parameters and total score as part of an objective and subjective opiate withdrawal assessment.
PurposeTo record individual COWS parameters and total score.
ReferencesTompkins DA, Bigelow GE, Harrison JA, Johnson RE, Fudala PJ, Strain EC. Concurrent validation of the Clinical Opiate Withdrawal Scale (COWS) and single-item indices against the Clinical Institute Narcotic Assessment (CINA) opioid withdrawal instrument. Drug Alcohol Depend. 2009 Nov 1;105(1-2):154-9. doi: 10.1016/j.drugalcdep.2009.07.001. Epub 2009 Aug 3. PMID: 19647958; PMCID: PMC2774236.

Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs. 2003 Apr-Jun;35(2):253-9. doi: 10.1080/02791072.2003.10400007. PMID: 12924748.
Copyright© Cambio Healthcare Systems, openEHR Foundation
AuthorsAuthor name: Syeeda S Farruque
Organisation: Cambio Healthcare Systems
Email: models@cambiocds.com
Date originally authored: 2017-02-20
Other Details LanguageAuthor name: Syeeda S Farruque
Organisation: Cambio Healthcare Systems
Email: models@cambiocds.com
Date originally authored: 2017-02-20
Other Details (Language Independent)
  • Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.
  • Custodian Organisation: openEHR Foundation
  • References: Tompkins DA, Bigelow GE, Harrison JA, Johnson RE, Fudala PJ, Strain EC. Concurrent validation of the Clinical Opiate Withdrawal Scale (COWS) and single-item indices against the Clinical Institute Narcotic Assessment (CINA) opioid withdrawal instrument. Drug Alcohol Depend. 2009 Nov 1;105(1-2):154-9. doi: 10.1016/j.drugalcdep.2009.07.001. Epub 2009 Aug 3. PMID: 19647958; PMCID: PMC2774236. Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs. 2003 Apr-Jun;35(2):253-9. doi: 10.1080/02791072.2003.10400007. PMID: 12924748.
  • Original Namespace: org.openehr
  • Original Publisher: openEHR Foundation
  • Custodian Namespace: org.openehr
  • MD5-CAM-1.0.1: 4BC979782EEC8BA1B81546657C76C1A3
  • Build Uid: c5af18fe-4674-4058-a8c1-852b861091c2
  • Revision: 0.0.1-alpha
Keywords
Lifecyclein_development
UID5de4453a-8c11-4e39-9a3e-2fbb97118ad4
Language useden
Citeable Identifier1246.145.2689
Revision Number0.0.1-alpha
protocol
ExtensionExtension: Additional information required to extend the model with local content or to align with other reference models or formalisms.
For example: local information requirements; or additional metadata to align with FHIR.
Include:
All not explicitly excluded archetypes
data
Resting pulse rate (BPM)Resting pulse rate (BPM): Measure pulse rate after patient is sitting or lying down for 1 minute.
0: ≤ 80
1: 81-100
2: 101-120
4: > 120
SweatingSweating: Sweating not accounted for by room temperature or patient activity over the last 0.5 hours.
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 assessmentRestlessness 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 sizePupil 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 achesBone or joint aches: If patient was having pain previously, only the additional component attributed to opiate withdrawal is scored.
0: Not present
1: Mild diffuse discomfort
2: Patient reports severe diffuse aching of joints/ muscles
4: Patient is rubbing joints or muscles and is unable to sit still because of discomfort
Runny nose or tearingRunny 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 upsetGI upset: Over last 0.5 hours.
0: No GI symptoms
1: Stomach Cramps
2: Nausea or loose stool
3: Vomiting or diarrhea
5: Multiple episodes of vomiting or diarrhea
Tremor observation of outstretched handsTremor 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 assessmentYawning 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 irritabilityAnxiety or irritability: 0: None
1: Patient reports increasing irritability or anxiousness
2: Patient obviously irritable/anxious
4: Patient so irritable or anxious that participation in the assessment is difficult
Gooseflesh skinGooseflesh skin: 0: Skin is smooth
3: Piloerection of skin can be felt or hairs standing up on arms
5: Prominent piloerection
Total scoreTotal score: The total sum of each component parameter for COWS.
min: >=0; max: <=48

events
Any eventAny event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Other contributors
Translators
  • Swedish: Dennis Forslund, Cambio Healthcare Systems