Patient Group Direction for the supply and/or administration of Paracetamol Oral Suspension 250mg/5ml (Paracetamol paediatric suspension) to children receiving treatment from NHS Borders services. This document authorises the supply and/or administration of Paracetamol oral suspension 250mg/5ml (Paracetamol paediatric suspension) by registered nurses to patients who meet the criteria for inclusion under the terms of the document The registered nurse seeking to supply and/or administer Paracetamol oral suspension 250mg/5ml (Paracetamol paediatric suspension) must ensure that all clients have been screened and meet the criteria before supply takes place The purpose of this Patient Group Direction is to help patients by providing them with more convenient access to pain relief in an efficient manner in the absence of medical cover. PGD previously approved: 01/11/2004 This direction was authorised on: March 2011 The direction will be reviewed by: March 2013 Clinician Responsible for Training and Review: Emergency Department Consultant PGD Reviewed by: Jacques Kerr, Beverly Meins, Clare Ketteridge, Gavin Gorman PGD for the supply/admin of Paracetamol Suspension 250mg/5ml 1
Patient Group Direction for administration of Paracetamol oral suspension 250mg/5ml (Paracetamol paediatric suspension) without a prescription for a named individual by registered nurses employed by NHS Borders. 1. This Patient Group Direction relates to the following specific preparation: Name of medicine, strength, formulation Legal status Storage Dose Route/method Frequency Total dose Quantity (Maximum/Minimum) Advice to Patients Relevant Warnings Follow up Arrangements Paracetamol Suspension 250mg/5ml (Paracetamol paediatric suspension) General Sales List (GSL) Store below 25 C and protect from light. 6-12 years 250-500mg 12-18 years 500mg Select dose depending on age, size of child and severity of pain. Oral Suspension Dose can be repeated at 4-6 hour intervals up to a maximum of 4 doses in 24 hours. Maximum: 4 doses in 24 hours (Maximum permitted supply 5000mg in 100ml) Advise patient s parent/guardian of treatment given Ensure awareness of the maximum dose/frequency Advise against the use of other products containing Paracetamol Advise to contact a doctor if the symptoms don t improve or get worse Anaphylaxis refer immediately for medical attention and treat as per NHS Borders anaphylaxis protocol/pgd. Adverse effects are rare see BNF for full details. Observe for effectiveness of pain relief. Seek medical advice if fails to respond to treatment or condition deteriorates. PGD for the supply/admin of Paracetamol Suspension 250mg/5ml 2
2. Clinical condition Clinical Condition to be treated Criteria for inclusion Criteria for exclusion Action if excluded or declines Interactions with other medicaments and other forms of interaction Referral Patients who require mild to moderate pain relief. Patients presenting with mild to moderate pain Children over the age of 6 years Medical and drug history taken, with no reason for exclusion Pyrexia Children under 6 years of age. (Refer to Paracetamol 120mg/5ml PGD) Patients with a known allergy to Paracetamol Patients who have taken any product containing Paracetamol in the previous four hours. Patients who cannot swallow Patients who have pain known to be unresponsive to Paracetamol. Patients with severe hepatic dysfunction. The patient must be referred to a doctor. The reason for referral should be documented. Few interactions. See current BNF for full list and details. Patients may be referred to a prescribing practitioner at any stage. Patients should be referred if the treatment proves to be ineffective in relieving the symptoms. 3. Records: As per department protocol a) The following records should be kept (either paper or computer based) The GP practice, clinic, hospital, and ward or department The patient name and CHI number The medicine name, dose, route, time of dose(s), and where appropriate, start date, number of doses and or period of time, for which the medicine is to be supplied or administered Drug batch number and expiry The signature and printed name of the approved healthcare professional that supplied or administered the medicine The patient group direction title and/or number If patient met the inclusion criteria and if the exclusion criteria was assessed Quantity supplied / received and current stock balance b) Preparation, audit trail, data collection and reconciliation- Stock balances should be reconcilable with receipts, administration, records and disposals on a patient by patient basis. PGD for the supply/admin of Paracetamol Suspension 250mg/5ml 3
c) Storage-Store below 25 C and protect from light. Standards must be consistent with the Summary of Product Characteristics. 4. Professional Responsibility All Health Professionals will ensure they have the relevant training and are competent in all aspects of medication use, including contraindications and the recognition and treatment of adverse effects. He/she will attend training updates as appropriate. For those involved in immunization, regular anaphylaxis updates are mandatory. Nurses will have due regard for the NMC Code of Professional Conduct, standards for conduct, performance and ethics (2008) and NMC Standards for Medicines Management (2007) 5. References British National Formulary (BNF) current edition http://bnf.org/bnf/index.htm British National Formulary (BNF) Children edition http://bnfc.org/bnfc/bnfc/current/ Borders Joint Formulary (BJF) http://intranet/new_intranet/microsites/index.asp?siteid=65&uid=1 Paracetamol SPC www.medicines.org.uk PGD for the supply/admin of Paracetamol Suspension 250mg/5ml 4
PGD for the supply/admin of Paracetamol Suspension 250mg/5ml 5