Patients Who Have Taken 4 Or More Doses (4 Grams Or 8 X 500Mg Tablets for Adults Or 4

Issued by Midlands Health Network Ltd as a template to guide the development of practice policies and procedures. Document owners are responsible for modifying to meet their particular circumstances. Standing order template guide Issued: 00/00/0000 Review date: 00/00/0000

Medicine Standing Order Title

 Paracetamol 500mg tablet

Rationale

 To improve access for patients to appropriate medication for treatment of mild to moderate pain and/or pyrexia by setting out the criteria under which approved nurses are able to supply this medication

Organisation/clinic

 To enable approved registered nurses employed by this organisation to supply or administer paracetamol 500mg tablets to patients 12 years and over for the treatment of mild to moderate pain and/or pyrexia. (NB refer to paracetamol suspension standing order for treatment of children)

Medicine/s

 Paracetamol 500mg tablet

Dosage instructions for each medicine

 Check patient weight if patient is a child  Administer 1 or 2 x 500mg tablets as a single dose immediately with or without food swallowed with a glass of water (calculate child dose based on child weight of 15mg/kg or max 60mg/kg/day for children of normal/average build)  If patient is a child and child is obese, anorectic or malnourished use bmi-paracetamol dose calculator via this link http://www.bpac.org.nz/resources/other/bmi_calc/bmiCalc.html  Patient may be instructed to repeat dose (after leaving practice) every 4 to 6 hours (max 4 doses for children or 4 g/8 x 500mg tablets in 24 hours for adults) if required

Route of administration

 Oral

Indication/circumstances for activating the standing order

 Patient presentation to practice or during consultation with mild to moderate pain or pyrexia  The use of antipyretic agents should be considered in patients with fever who appear distressed or unwell  Antipyretic agents should not routinely be used with the sole aim of reducing body temperature in patients with fever who are otherwise well

Precautions and exclusions that apply to this standing order

 Always seek GP advice if concerned about serious disease (e.g. meningitis)  Children aged under 12 years  Patients with known alcohol dependency  Severe liver disease  Hypersensitivity to paracetamol (allergy or previous adverse event)  Patients who have taken paracetamol-containing products within the previous 4 hours  Patients who have taken 4 or more doses (4 grams or 8 x 500mg tablets for adults or 4 doses for children) of paracetamol within the previous 24 hours (see MIMS index under paracetamol for a list of other products containing paracetamol). If risk of overdose is suspected contact the National Poisons Centre at http://www.poisons.co.nz/index.php or 0800 764 766

Persons authorised to administer the standing order

 Registered Nurses (as named below)

Competency/training requirements for the person(s) authorised to administer

 All nurses must be familiar with the content of this standing order before administering paracetamol 500mg tablets

Countersigning and audit The organisational standing order policy and procedure must be signed by management, the issuer and every person operating understanding standing orders Signed by issuer/s Name Signature Title medical practitioner or dentist Date

Signed by Management Name & Title Date

Persons operating under this standing order Name & Title Signature Date

For all standing orders, refer to the Ministry of Health Standing Order Guidelines (2002) (currently under review) http://www.moh.govt.nz/notebook/nbbooks.nsf/0/20E3161A3ABC937BCC257836006EB4EA/ $file/standing-order.pdf