It is important as the triage nurse to
consider if paracetamol has already been
administered to the child by the parent
upon presentation to the emergency
department. Dosage as well as time or
times of administration during a 24-hour
period are important to reduce the risk
of toxicity in children. The safety margin
between a therapeutic and toxic dose
of paracetamol varies widely amongst
individuals and according to routes of
administration (Paul et al 2011).
Explicit variable doses of paracetamol
are reported throughout literature
without being able to make specific
recommendations. Paracetamol guidelines
(NPS 2012) in Australia recommend a
weight-based dose that is reiterated by
Glatstein and Scolnick (2008) as 15mg/
kg four hourly but not exceeding 80mg/
kg a day. Currently the dosages prescribed
are those specified by the medical officer,
as cannot be nurse initiated in the
current hospital environment. Therefore,
recommendations and dosages may change
depending on the doctors perception. It
is however, important for the triage
nurse to be aware of dosages, including
maximum dosages.
Risks of toxicity are variable throughout
literature. Most importantly, if the triage
nurse is concerned, paracetamol should
be withheld. Knowledge surrounding the
risk of toxicity including an increased risk in
the dehydrated child, and those with preexisting
conditions should be considered
(Dixon, Deehan, Dickson, Miller & Pegnam-
Mason 2006).
It is important as the triage nurse toconsider if paracetamol has already beenadministered to the child by the parentupon presentation to the emergencydepartment. Dosage as well as time ortimes of administration during a 24-hourperiod are important to reduce the riskof toxicity in children. The safety marginbetween a therapeutic and toxic doseof paracetamol varies widely amongstindividuals and according to routes ofadministration (Paul et al 2011).Explicit variable doses of paracetamolare reported throughout literaturewithout being able to make specificrecommendations. Paracetamol guidelines(NPS 2012) in Australia recommend aweight-based dose that is reiterated byGlatstein and Scolnick (2008) as 15mg/kg four hourly but not exceeding 80mg/kg a day. Currently the dosages prescribedare those specified by the medical officer,as cannot be nurse initiated in thecurrent hospital environment. Therefore,recommendations and dosages may changedepending on the doctors perception. Itis however, important for the triagenurse to be aware of dosages, includingmaximum dosages.Risks of toxicity are variable throughoutliterature. Most importantly, if the triagenurse is concerned, paracetamol shouldbe withheld. Knowledge surrounding therisk of toxicity including an increased risk inthe dehydrated child, and those with preexistingconditions should be considered(Dixon, Deehan, Dickson, Miller & Pegnam-Mason 2006).
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