cliot (version 1.0.0)

wat1_pediatric_score: Withdrawal Assessment Tool - 1 (WAT-1) for Pediatric Withdrawal

Description

Calculates the WAT-1 score to assess withdrawal symptoms in pediatric patients (typically in the PICU) who are being weaned from opioids or benzodiazepines. The scale includes an assessment of records (past 12 hours), a 2-minute pre-stimulus observation, and a stimulus-recovery assessment.

Usage

wat1_pediatric_score(loose_stools, vomiting_retching, temperature_gt_37_8,
                     tremor, sweating, uncoordinated_movements, yawning_sneezing,
                     startle_to_touch, muscle_tone, time_to_calm, agitation_state)

Value

A list containing:

WAT1_Score

The calculated total score (Range 0-11 or 0-12 depending on agitation weight implementation, typically 0-11).

Interpretation

Clinical interpretation (Score >= 3 indicates significant withdrawal).

Arguments

loose_stools

Numeric (0 or 1). Any loose/watery stools in the last 12 hours? (1 = Yes).

vomiting_retching

Numeric (0 or 1). Any vomiting or retching in the last 12 hours? (1 = Yes).

temperature_gt_37_8

Numeric (0 or 1). Temperature > 37.8 C in the last 12 hours? (1 = Yes).

tremor

Numeric (0 or 1). Moderate to severe tremor observed during the 2-minute pre-stimulus observation? (1 = Yes).

sweating

Numeric (0 or 1). Any sweating observed during the 2-minute pre-stimulus observation? (1 = Yes).

uncoordinated_movements

Numeric (0 or 1). Uncoordinated or repetitive movements observed during the 2-minute pre-stimulus observation? (1 = Yes).

yawning_sneezing

Numeric (0 or 1). Yawning or sneezing (>1 time) observed during the 2-minute pre-stimulus observation? (1 = Yes).

startle_to_touch

Numeric (0 or 1). Moderate to severe startle response to tactile stimulus? (1 = Yes).

muscle_tone

Numeric (0 or 1). Increased muscle tone during stimulus? (1 = Yes).

time_to_calm

Numeric (0 or 1). Time to calm down after stimulus > 2-5 minutes? (1 = Yes).

agitation_state

Numeric (0 or 1). Patient state during the 2-minute observation. (0 = Calm/Asleep/Awake and distressed <2 mins, 1 = Awake and distressed >= 2 mins). Note: Scoring guides may vary slightly on "State" definition but generally, sustained distress adds 1 point.

References

Franck LS, Harris SK, Soetenga DJ, Amling JK, Curley MA. The Withdrawal Assessment Tool-1 (WAT-1): an assessment instrument for monitoring opioid and benzodiazepine withdrawal in pediatric patients. Pediatr Crit Care Med. 2008;9(6):573-580. doi:10.1097/PCC.0b013e31818c84bd

Examples

# Example 1: Significant Withdrawal
# Fever, Tremor, Sweating, Agitated
wat1_pediatric_score(0, 0, 1, 1, 1, 0, 0, 0, 0, 0, 1)

# Example 2: No Withdrawal
# No symptoms
wat1_pediatric_score(0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0)