Janet source rebuild

Alcohol and Opioid Withdrawal Scoring

A presenter deck preserving the original scoring-first workflow: identify risk, score symptoms, verify protocol, medicate only within orders, monitor, and escalate.

Sources: Alcohol Withdrawal, Opioid Withdrawal, pharmacotherapy decks

Alcohol withdrawal

Withdrawal is CNS overexcitation

Sustained intakeAlcohol depressant effect becomes expected. Decrease/stopInhibition is removed. Excitation risesTremor, sweating, anxiety, tachycardia. ComplicationsHallucinations, seizure, delirium tremens.

PAWSS and GMAWS

Separate prediction from current symptom scoring

PAWSS

Predicts risk for complicated alcohol withdrawal using history, objective signs, and risk factors.

GMAWS

Scores current symptoms and supports local medication-protocol navigation.

GMAWS bands from source deck

Score, verify, reassess

0No benzodiazepine; monitor and reassess per protocol. 1-3Mild withdrawal; ordered medication pathway may apply. 4-8Moderate withdrawal; notify/consider IV, telemetry, medical causes. 9-10Severe withdrawal; urgent MRP/team escalation.

Source visuals

Alcohol deck images as reconstruction references

Extracted visual from Janet alcohol withdrawal deck Extracted visual from Janet alcohol withdrawal deck Extracted visual from Janet alcohol withdrawal deck

Images are draft reconstruction references pending rights/provenance review.

Opioid withdrawal

COWS structures observable withdrawal

AutonomicPulse, sweating, pupil size, gooseflesh. MotorRestlessness, tremor, aches. GI/ENTRunny nose, tearing, yawning, nausea, diarrhea. AffectAnxiety, irritability, distress. TimingLast opioid, opioid type, prior inductions. SafetyPOSS, respirations, O2 saturation, vitals.

Induction caution

Precipitated withdrawal is preventable harm

Risk

Buprenorphine may displace full agonists and rapidly intensify withdrawal if started too early.

Response

Notify provider, advocate for adjuncts and protocol-specific buprenorphine response, comfort measures, and frequent reassessment.

Source visuals

Opioid deck images as reconstruction references

Extracted visual from Janet opioid withdrawal deck Extracted visual from Janet opioid withdrawal deck Extracted visual from Janet opioid withdrawal deck

Images are draft reconstruction references pending rights/provenance review.

Web adaptation

Build the score-verify-escalate lab

  • Vitals trend and last-use timeline.
  • PAWSS/GMAWS/COWS selector with local-policy warning.
  • Order verification and hold-parameter checks.
  • SBAR handoff builder.
The web version should force learners to verify protocol and order conditions before selecting any medication action.