Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A)
The Withdrawal Assessment Tool WAT-A2A
An assessment Instrument for monitoring iatrogenic withdrawal symptoms in children receiving an alpha-2 agonist
The Withdrawal Assessment Tool WAT-A2A was codeveloped by Martha A.Q. Curley, R.N., Ph.D. and Jean C. Solodiuk, R.N., Ph.D. (Department of Anesthesiology, Critical Care and Pain Medicine; ([email protected])
An assessment Instrument for monitoring iatrogenic withdrawal symptoms in children receiving an alpha-2 agonist
The Withdrawal Assessment Tool WAT-A2A was codeveloped by Martha A.Q. Curley, R.N., Ph.D. and Jean C. Solodiuk, R.N., Ph.D. (Department of Anesthesiology, Critical Care and Pain Medicine; ([email protected])
Copyright and Permission to use the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A)
Copyright for the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) is held by its co-creators: Copyright 2023 Jean C. Solodiuk and Martha A. Q. Curley, All Rights Reserved.
You are free to reproduce and use the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A), without modification, for research or clinical practice. The Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) may be reproduced on forms with hospital or clinical unit letterhead or logos, or used in hospital based electronic recordsystems.
Please cite: Solodiuk JC, Donado C, Wickerham L, Goodyear L, Hayes J, Mortell RE, Greco CD, Curley MAQ. Development and Preliminary Testing of the Withdrawal Assessment Tool-Alpha 2 Agonist: An Assessment Instrument for Monitoring Iatrogenic Withdrawal Symptoms in Children Receiving an Alpha-2 Agonist. Pediatr Crit Care Med. 2024 Dec 3. doi: 10.1097/PCC.0000000000003645. Epub ahead of print. PMID: 39625342.
Copyright Attribution should be included as follows: Copyright 2023 Jean C. Solodiuk and Martha A. Q. Curley, All Rights Reserved.
You may not remove or alter the copyright language embedded in the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A). The Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) may not be used for commercial purposes or monetized without the express written permission from the copyright holders. If you would like to republish the tool in any form external to your organization, you will have to obtain permission from the copyright holders. Permission requests should be made in writing to the copyright holders ([email protected] and [email protected]).
Requests to translate the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) into another language should be made in writing to the copyright holders. Forward and back translations must be certified for accuracy. Translations must include the following language: “Adapted with permission from the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A), Copyright 2023 Jean C. Solodiuk and Martha A.Q. Curley, all rights reserved.”
Any translations must be made freely available for research or clinical practice. Translations may not be used for commercial purposes or monetized without the written permission from the copyright holders.
You are free to reproduce and use the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A), without modification, for research or clinical practice. The Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) may be reproduced on forms with hospital or clinical unit letterhead or logos, or used in hospital based electronic recordsystems.
Please cite: Solodiuk JC, Donado C, Wickerham L, Goodyear L, Hayes J, Mortell RE, Greco CD, Curley MAQ. Development and Preliminary Testing of the Withdrawal Assessment Tool-Alpha 2 Agonist: An Assessment Instrument for Monitoring Iatrogenic Withdrawal Symptoms in Children Receiving an Alpha-2 Agonist. Pediatr Crit Care Med. 2024 Dec 3. doi: 10.1097/PCC.0000000000003645. Epub ahead of print. PMID: 39625342.
Copyright Attribution should be included as follows: Copyright 2023 Jean C. Solodiuk and Martha A. Q. Curley, All Rights Reserved.
You may not remove or alter the copyright language embedded in the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A). The Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) may not be used for commercial purposes or monetized without the express written permission from the copyright holders. If you would like to republish the tool in any form external to your organization, you will have to obtain permission from the copyright holders. Permission requests should be made in writing to the copyright holders ([email protected] and [email protected]).
Requests to translate the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) into another language should be made in writing to the copyright holders. Forward and back translations must be certified for accuracy. Translations must include the following language: “Adapted with permission from the Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A), Copyright 2023 Jean C. Solodiuk and Martha A.Q. Curley, all rights reserved.”
Any translations must be made freely available for research or clinical practice. Translations may not be used for commercial purposes or monetized without the written permission from the copyright holders.
Withdrawal Assessment Tool - Alpha-2 Agonist (WAT-A2A) Instructions
- Start WAT-A2A scoring from the first day of weaning in patients who have received dexmedetomidine and/or clonidine dosing, including transdermal patch for >5 days. The WAT-A2A should be completed at least once every 12 hours (e.g., at 08:00 and 20:00 ± 2 hours). Continue twice daily scoring until 24 hours after last dose of dexmedetomidine or 72 hours after the last dose of clonidine.
Before the start of A2A weaning, document the patient’s baseline HR and DBP using the most recent 5 days of data from the patient’s health record.
- This is the most commonly occurring value for HR and DBP. Eliminate periods of pain, agitation, or events that alter vital signs. Note the +20% and +50% range values (Baseline value x 1.2 = +20%; Baseline value x 1.5 = +50%).
- Current HR: Score 0 if heart rate is at or near baseline. Score 1 if HR increased by 20% but less than 50%. Score 2 if HR is increased by more than 50%.
- Current DBP: Score 0 if diastolic BP is at or near baseline. Score 1 if diastolic BP increased by 20% but less than 50%. Score 2 if diastolic BP is increased by more than 50%.
- State behavior: Score 0 if patient asleep, awake or calm or SBS = 0, Score 1 if patient awake and distressed or SBS ≥ +1.
- Tremor: Score 0 if the patient exhibits no or only occasional tremors. Score 1 if patient exhibits persistent tremors.
- Sum the four items for the total WAT-A2A score (0-6). Note numeric trends over time.
Downloadable WAT-A2A
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