Following extensive consultation and review, the Nurse and Midwife Initiated Medication PPG has been updated to align processes at all Western Health sites. The updated PPG can be found on Prompt.
All Nurses and Midwives who administer medications are required to familiarise themselves with these changes. Changes to the Medication Administration record in EMR will go – live on Monday 21st November.
| Indication | Medication | Recommended Dose | Comment |
| Indigestion/Reflux | Aluminium Hydroxide Compound mixture (Gastrogel®) | Adult: 10 – 20mL | If possible, separate administration from other medication by 2hrs. |
| Peppermint water | Adult: 10 – 20mL | ||
| Constipation | Docusate with senna 50/8mg (Coloxyl with Senna®) tablets | Adult: 1 – 2 tablets | |
| Docusate (Coloxyl®) tablets | Adult: 120mg tablet
Child >3 years: 50mg tablet |
||
| Glycerol suppositories | Adult: 1 suppository | ||
| Microlax® enemas | Adult: 1 enema | NOT to be given via an abdominal stoma (e.g. colostomy). | |
| Nulax® | Adult: 1 – 2 teaspoons | ||
| Fybogel®
or Metamucil® |
Adult: 1 sachet
Adult: 2 teaspoons |
Mix in 250mL water
Mix in 250mL water
|
|
| Lactulose Liquid | Adult:15-30ml orally | ||
| Angina | Glyceryl Trinitrate tablets (Anginine®)
Glyceryl Trinitrate spray (Nitrolingual®) |
Adult: Maximum of 2 tablets in 10 minutes
Adult: 1 spray under tongue. May repeat once if no relief within 5 minutes |
Only in patients with cardiac history who have taken sublingual glyceryl trinitrate tablets (Anginine®) before.
BP above 100 systolic. Notify doctor after administration for further orders.
Only in patients with cardiac history who have taken Anginine® or Nitrolingual Spray before. BP above 100 systolic. Notify doctor after administration for further orders. |
| Pain | Paracetamol | Adult: 500mg-1000mg
Child: 15mg/kg |
Before administration:
· Ensure patient has no history of liver dysfunction. · Ensure maximum dose over 24 hours will not be exceeded. Maximums: o Adult: 4g / 24 hours; o Child: 60mg / kg / 24 hours (up to 4g).
If pain is unrelieved notify the medical officer, and document in the Progress Notes. |
| Insertion of indwelling catheter or indwelling catheter pain. For Urology Nurses insertion of catheters for the administration of intravesical chemo and BCG therapy |
Lignocaine Gel | Instil for 3-5 minutes prior to catheterisation | |
| Insertion of Intravenous cannula | Emla | ||
| Urinary Alkaliniser | Sodium citrotartrate (Ural ®, Citravescent ®, Uricalm ®) | 1 Sachet orally | |
| Oral rehydration (Mild to moderate dehydration) | Hydralyte Ice Blocks | 1 ice block | |
| First Aid Asthma | Salbutamol 100mcg-metered dose inhaler plus spacer | Using spacer: one puff four breaths, then repeat until 4 puffs have been given. Maximum of 4 puffs every 4 minutes until medical attention is available. | |
| Hypoglycaemia | Glucose | Neonate: Glucose 40%.
1 dose (oral, gel) Buccal: 0.5mL/kg of glucose gel (=200 mg/kg of glucose)
|
True Blood Glucose <4.0 mmol/L
|
| FOR USE IN THE EMERGENCY DEPARTMENT ONLY
by nursing staff who are deemed competent against the Emergency Department Pain Package |
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| Pain | Ibuprofen | Adult: 400mg
Child: 10mg/kg |
DO NOT GIVE IF UNDER 3 MONTHS OF AGE.
Prior to administration, confirm none of the following are present (discuss with doctor if present): 1. Previous ibuprofen dose in the preceding 8 hours. 2. Dehydration. 3. Abdominal pain. 4. Hypersensitivity to ibuprofen or other NSAIDS, including aspirin. 5. History of peptic ulcers or gastrointestinal haemorrhage. 6. Renal, cardiac, or bleeding diseases. 7. Hypertension, asthma or epilepsy. 8. Taking warfarin, NOACs or steroids (includingprednisolone). 9. Pregnancy (category C, use alternative). |
| FOR USE IN BIRTHING AT JOAN KIRNER WOMENS AND CHILDREN”S ONLYby Midwife who is deemed competent against the Perineal Repair Learning Package. | |||
| Pain | Lidocaine (Lignocaine) 1% | Adult: 20ml (3mg/kg)
|
Used for infiltration prior to perineal repair. A maximum of 3mg per kg of body weight (approximately 20mL for a 70kg healthy woman) may be administered over a one hour period. |
| Pain | Water for injection | Adult: 0.1-0.5ml intradermal | Intradermal sterile water injections can be offered when women experience severe lower back pain in labour. |