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Patient Group Direction
for the administration of
Chlorphenamine
By Paramedics and Technicians
In the Management of Anaphylaxis and Symptomatic Allergic Reaction.
Elite Medical & Ambulance Services Ltd
Date Issued 28-02-
Issued By David Staplehurst
PGD Reference PGD-CPH-
Review Date 02-03-
Next Review Date 02-03-
This Patient Group Direction (PGD) must only be used by those who are named or authorised to do so by their organisation (Elite Medical & Ambulance Services Ltd) and allowed to practice under it. The most recent, signed and in date copy must be used.
Upon issue of this version of the PGD, all previous versions must be removed from use. No Supply or Administration may be made under the terms of this PGD after the expiry date stated. Change History:
Version Number Change Details Date
0.1 New PGD 28.02.
0.2 Reviewed 28 - 01 - 2019
Any person able to recognise anaphylactic reaction is permitted to administer intramuscular adrenaline injection for the purpose of saving life, whether they are a healthcare professional or not. There is no need to be signed up to this PGD to treat patients in an emergency.
Training and Competence:
Requirements of registered paramedics and IHCD Technicians working under this PGD
Qualifications, Professional Registration and Compliance
HCPC registration for Paramedic’s IHCD certification for Technician’s Current employment with Elite Medical & Ambulance Services Ltd
Initial Training
All staff must have undertaken appropriate based training, they must be competent in the diagnosis and treatment plans for the conditions listed in this PGD and must be competent to recognise and manage adverse effects as a result of drugs given via this PGD, this includes but isn’t limited too loss of airway reflexes, respiratory arrest etc.
The NICE competency framework: For health professionals using Patient Group Directions should be used by health care professionals planning to work under this PGD to identify any gaps in their knowledge. The gaps should be addressed before the healthcare professional is authorised to work under this PGD.
Competency Assessment
Those entitled to use this PGD should be aware of the legislation surrounding there usage, the user should know their responsibilities for the PGD and the company’s own policies.
All relevant staff are responsible to declare their own competence in use of this PGD, ensuring they themselves have the relevant knowledge and skills to remain compliant in the use of this PGD. Support for staff is available through the Clinical and Medical Directors.
Current endorsement from the Medical Director to specifically use the PGD, a copy of which will be held on the one drive and a file copy in the main office.
On Going Training and Competency
The clinical member of staff must meet all of the education requirements stated in this PGD, they must also have read the medicines management policy and be compliant in medicines management.
On going regular CPD training, and work with in the limitations of their own practice and scope.
The clinician is also responsible for there own awareness to changes in drug recommendations and doses, and they must also keep up to date on any adverse incidents or reportable concerns with medicines.
Clinical Condition:
Clinical Condition Anaphylaxis and symptomatic allergic reaction falling short of anaphylaxis but causing distress such as severe itching.
Inclusion Criteria
Severe anaphylaxis (should follow initial treatment with IM adrenaline).
Symptomatic allergic reaction falling short of anaphylaxis but causing the patient distress such as severe itching.
Exclusion Criteria
- Known hypersensitivity
- Children under 1 year old
Cautions (including relevant actions to be taken)
- Hypotension
- Epilepsy
- Glaucoma
Details of Medicine:
Name and Strength of Medicine Chlorphenamine
Legal Category POM
Route / Method of administration
Intramuscular Injection (IM), Intravenous (IV) or Intraosseous (IO) use is for specialists ONLY (IV Preferred).
Dose / Frequency Single dose of 10 milligrams (mg)
Quantity to be administered and / or supplied
The IM dose should be drawn up in a 1ml syringe, clearly labeled and administered slowly over one minute. The appropriate dose administered and the surplus capped with a syringe cap.
Resuscitation equipment must be available
Full patient monitoring including SPo2, BP, pulse and ECG, must be carried out and where possible ETCO2 recorded.
Maximum / minimum treatment period
Only a single dose to administered by any route. Initiate CPR at any stage if appropriate
Administration details
The drug should be counter checked and date / strength / dosage confirmed. The IM site should ideally be the Deltoid or Dorsogluteal muscles The IV / IO site should be prepared following Aseptic Non Touch Technique (ANTT), secured and check is patent before administration.
Adverse effects
Possible side effects: Sedation, Dry Mouth, Headache, Blurred Vision, Psychomotor Impairment, Gastrointestinal Disturbance, Transient Hypotension. Rarely - Convulsions.
Elderly are more likely to suffer side effects.
Patient’s who receive Chlorphenamine should be advised to avoid driving or undertaking any other complex psychomotor skills due to the possible side effects detailed above.
Records to be kept
- Record of valid informed consent was given by the patient or that best interest was followed in cases with inability to comply
- Patient Name, Address, DOB, GP details
- Diagnosis / Working diagnosis
- Dose Given, Route Administered
- Batch Number and Expiry Date
- Time drugs administered
- Patient advice given
- Adverse reaction advice given
- Signature and name of clinician who administered drug
- Error reporting via the internal compliance system
- Incident number if appropriate All records should be clear, legible and contemporaneous
Appendice:
- https://bnf.nice.org.uk/drug/chlorphenamine-maleate.html [Accessed Feb 2018]
- https://www.jrcalc.org.uk/guidelines/ [Accessed Feb 2018]
PGD’s DO NOT REMOVE THE INHERIT ACCOUNTABILITY AND RESPONSIBILITY FOR THE PROFESSIONAL’S ACTIONS
IT IS THE RESPONSIBILITY FOR EACH PROFESSIONAL TO PRACTICE WITHIN THEIR
OWN COMPETENCE AND CAPABILITY AND IN ACCORDANCE WITH THEIR CODE OF
PROFESSIONAL PRACTICE.
I have read and understood this Patient Group Direction and agree to administer this medicine in accordance with this document.
Name of Health Care Professional Signature
Name of Authorising Clinician Date
