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Glasgow Modified Alcohol Withdrawal Scale (GMAWS)

Glasgow Modified Alcohol Withdrawal Scale (GMAWS)
Tremor
Sweating
Hallucinations
Orientation
Agitation
Result0 points

Alcohol withdrawal severity (range 0-10). No diazepam; repeat score in 2 hours.

Suggested action
No diazepam; repeat score in 2 hours.

When to use

  • Symptom-triggered assessment and benzodiazepine dosing in acute alcohol withdrawal.

Formula

Five items (tremor, sweating, hallucinations, orientation, agitation), each 0-2. Total 0-10. 0: reassess in 2 h; 1-3: diazepam 10 mg; 4-8: diazepam 20 mg; 9-10: diazepam 20 mg plus medical review.

Pearls and pitfalls

  • Do not score an intoxicated patient; use only once at least 8 hours have passed since the last drink.

References

  1. McPherson A, Benson G, Forrest EH. QJM. 2012;105(7):649-56.