How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 175

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HEADACHE, FULLNESS IN HEAD
Ask "Does your head feel different? Does it feel like there is a band around your head?"
Do not rate for dizziness or lightheadedness. Otherwise, rate severity.
0 not present
1 very mild
2 mild
3 moderate
4 moderately severe
5 severe
6 very severe
7 extremely severe
AGITATION
Observation.
0 normal activity
1 somewhat more than normal activity
2
3
4 moderately fidgety and restless
5
6
7 paces back and forth during most of the interview, or constantly thrashes about
ORIENTATION AND CLOUDING OF SENSORIUM
Ask: "What day is this? Where are you? Who am I?"
0 oriented and can do serial additions
1 cannot do serial additions or is uncertain about date
2 disoriented for date by no more than 2 calendar days
3 disoriented for date by more than 2 calendar days
4 disoriented for place/or person

Total CIWA-Ar Score ______

Rater's Initials ______

Maximum Possibl R66