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 thebcurrent 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).