Symptomatic Relief Policy (SRP) in CAMHS (<18 years) Inpatients on Huntlyburn Ward ONLY

Objectives

To enable nursing staff to administer selected ‘when required’ medications to patients admitted as inpatients under CAMHS.

The policy is in place to ensure that nursing (and midwifery) staff (given the provisos in No 3 below) can supply appropriate ‘when required’ medications in the interests of patient comfort. The eight medications included in the CSRP are detailed in the table.

Procedure

A prescriber should prescribe the medications included in the policy by entering on the Medicine Chart ‘CAMHS Symptomatic Relief Policy’ in the As Required Section. The entry should be signed and dated in the normal manner. Or on the mental health medicine charts the prescriber is required to sign the “symptomatic relief policy” box on the as required section of medicines, annotate ‘CAMHS’ on the entry, date it and add any appropriate exclusions.

The prescriber may exclude any of the items which in their judgement would not be appropriate, e.g. “CAMHS Symptomatic Relief Policy except for Paracetamol tablets”.

The nurse or midwife must record administration on the administration part of the Medicine Chart by entering the letter of the medicine and the amount given.

The dose(s) administered must not exceed the maximum stated on the CSRP. If further treatment is required a prescriber must be contacted.

Use of the CSRP must be reviewed weekly by the prescriber and/or clinical pharmacist and appropriate adjustment to the Medicine Chart made.

This policy excludes patients who have a purple “end of life” care drug chart, as they have in place a comprehensive “When Required” medication section and any patients 18 years or older.

Table of Medications Permitted Under Policy and Associated Codes for Kardexes

Code	Drug	Indication	Dose	Max Dose allowed	Contraindications
A	Paracetamol	Pain	By MOUTH Child 6–7 years 240–250 mg, every 4–6 hours; maximum 4 doses per day. Child 8–9 years 360–375 mg, every 4–6 hours; maximum 4 doses per day. Child 10–11 years 480–500 mg, every 4–6 hours; maximum 4 doses per day. Child 12–15 years 480–750 mg, every 4–6 hours; maximum 4 doses per day. Child 16–17 years 0.5–1 g, every 4–6 hours; maximum 4 doses per day. Available as 120mg/5ml and 250mg/5ml liquids. Tablets, as 500mg, are also available if tolerated, and soluble or effervescent tablets can be ordered from Pharmacy	Maximum 4 doses per day	Patients already receiving the maximum dose of paracetamol Patients on co-codamol, co-dydramol or any combination product which includes paracetamol allergy to paracetamol recent overdose of paracetamol concerns about liver function
B	Senna	Constipation	by mouth using tablets Child 6-17 years 7.5mg - 15mg once daily, to be adjusted according to response By mouth using syrup Child 4–17 years 3.75–15mg once daily, to be adjusted according to response. Tablets are available as 7.5mg strength and liquid is available as 7.5mg/5ml strength.	15mg in 24 hours	Intestinal obstruction Recent gastro-intestinal surgery Acute or chronic gastro-intestinal condition Medical review if patient has been on anti diarrhoeal medication (also these should be stopped) Not to be used in pregnancy
F	Peptac	Dyspepsia	Up to 10ml may be given at any one time	4 doses (40ml) in 24 hours
G	Liquid Paraffin 50% White Soft Paraffin 50%	Emollient	Apply as required	No Maximum	Allergy to constituents
J	Cetirizine	Hayfever	Child 6-11 years 5mg twice daily Child 12-17 years 10mg once daily Available as either 10mg tablets or 1ml/ml liquid	1 dose in 24 hours	Not to be used in pregnancy Not to be used in breastfeeding Drowsiness Severe liver impairment Lactose intolerance

Roles and Responsibilities

Role Responsibility

Prescriber Annotate Kardex as per policy

Nursing Staff Administer with Kardex as per policy & document codes on Kardex

Next review date: 31/05/2027

Author(s): Richardson-Read S.

Version: 1.0

Co-Author(s): Boeing L .

Approved By: ADTC

Reviewer name(s): Barron M.

Symptomatic Relief Policy (SRP) in CAMHS (<18 years) Inpatients on Huntlyburn Ward ONLY

Objectives

Procedure

Table of Medications Permitted Under Policy and Associated Codes for Kardexes

Roles and Responsibilities

Editorial Information