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1 calamine protocoleProcedure REGULATED
ACETAMINOPHEN is the generic name of the medication that is commercially available under the following brand
names: Atasol, Tempra, Tylenol and other house brand names.
Under the Regulation respecting childcare centres and the Regulation respecting day care centres, acetaminophen
may be administered without medical authorization to a child received in a childcare centre, a home childcare setting
or a day care centre, provided it is administered in accordance with this Protocol and that a parent has given written
Parents are not required to consent to the application of this Protocol. However, if a parent does not sign theauthorization form, the medication may not be administered to the child unless the parent and a member of theCollège des médecins du Québec give written authorization.
Under no circumstances must the dosage exceed thedosage guidelines below or the dosage prescribed on Within the framework of this Protocol, acetaminophen may be administered solely to reduce fever. A tablet for adults must never be cut up and It may not be administered
administered to a child as it could alter the dosage: an • to children under two months of age;
inadequate dose would not provide the expected result, • to relieve pain;
while an overdose could pose serious risks to the child.
• during more than 48 consecutive hours (two
It is important to always check the concentration of days); or
acetaminophen and to follow the dosage instructions • to children who have received medication
on the container since new products of greater or lesser containing acetaminophen in the preceding four
strength may appear on the market. It is also recommended to use only one concentration if the In those four cases, the Protocol does not apply and brand name selected is available in more than one written authorizations from a physician and the parent are required to administer the medication.
Any administration of acetaminophen must be recorded Centres, persons recognized as home childcare in the register of medications prescribed by the providers and day care centres may have their own Regulation and the parent must be informed.
acetaminophen container, in which case the brand (See over)
name, the dosage form (drops, tablets, syrup) and theconcentration must be indicated on the authorizationform.
To avoid confusion, centres, persons recognized as This Protocol was prepared by the Ministère de home childcare providers and day care centres should l’Emploi, de la Solidarité sociale et de la Famille keep acetaminophen in only one of its 2 liquid forms: and approved by a working group composed of drops or syrup. If they receive children under 24 months representatives from the health and social of age, it is recommended that drops be used instead of services network and childcare services. The syrup. If they elect to use syrup for the other children, it information it contains reflects the state of is recommended to use only one concentration.
AUTHORIZATION FORM FOR THE ADMINISTRATION OF ACETAMINOPHEN
Parents are not required to consent to the application of this to administer to my child, in accordance with this Procedure, Protocol. However, if a parent does not sign the authorization acetaminophen sold under the following brand name: form, acetaminophen may not be administered to the childunless the parent and a member of the Collège des médecinsdu Québec give written authorization. A parent may limit theperiod of validity of the authorization by indicating the Brand name, form (drops, syrup or tablets) duration of the authorization in the space provided.
(name of the childcare centre, the person recognized as thehome childcare provider, the person who assists the provider or the person designated under the second paragraph ofsection 67 of the Regulation respecting childcare centres, ifany, or name of the day care centre) WHAT YOU SHOULD KNOW
The only sure way to measure fever is to take thechild’s temperature. A child’s temperature must be What is a normal temperature?
checked whenever the child’s general condition The normal temperature range will vary depending (persistent crying, loss of energy, change in general on the measurement method used, as illustrated in condition, loss of appetite, etc.) or physical symptoms (flushed cheeks, excessively warm skin,sweating) could be sign of fever. Measurement Normal
The following measures are recommended:• take the rectal temperature of children under temperature of children between two and five take the oral temperature of children over five always use disposable plastic tips as they are What is fever ?
more hygienic; otherwise, disinfect thethermometer properly between each use; Fever is defined as a body temperature that ishigher than normal. Normal temperature may vary if the child has just been physically active, wait somewhat depending on the child, the time of day, approximately 15 minutes as the child’s body the outdoor temperature and the level of activity.
temperature may be higher than normal if it is The cause of the fever is more important than the always comply with the time requirements for the thermometer being used since the time It is generally considered that there is fever if required may vary with the thermometer. A the rectal, oral or tympanic temperature is digital thermometer, which requires less time above 38.0°C or if the axillary temperature is above to take the temperature, is recommended.
WHAT YOU SHOULD DO
inform the parent of the child’s condition; If you notice the start of an increase in body
administer acetaminophen according to the temperature (a rectal, oral or tympanic
temperature between 37.5°C and 38.0°C or an instructions on the medication container, in axillary temperature between 37°C and 37.5°C), accordance with the rules in this Procedure; and if the child’s general condition is good and one hour after administering acetaminophen, there are no specific medical precautions that need take the child’s temperature again; if the temperature is still high, ask the parent to come and pick up the child. If the parentcannot be reached, call the persons designated have the child drink (water, fruit juice or milk) by the parent as emergency contacts and if they cannot be reached, take the child to a keep an eye on the child and take the his/her medical service, to the local community service temperature again after 60 minutes, or sooner centre or to a hospital emergency department.
if his/her condition seems to be worsening; inform the parent of the child’s condition.
When you administer acetaminophen,
If a child under two months of age has a fever (a
always use simple words, appropriate to the rectal temperature above 38.0°C or an axillary child’s age, to explain to the child the relationship between his/her condition, themedication being taken and the expected apply the measures listed above for an increase in body temperature (dress comfortably, havethe child drink and keep an eye on him/her); notify the parent immediately; ask the parent to come and pick up the child and, in the check the concentration, dosage instructions meantime, apply the measures listed above; and expiry date on the medication container; if the parent cannot come to pick up the child, pour the medication (drops or syrup) into a call the persons designated by the parent as administer it to the child; never put a medicine reached, take the child to a medical service, to dropper directly into a child’s mouth, unless it the local community service centre (CLSC) or to is a disposable dropper. The spoon must be administer acetaminophen without a written medical authorization for the child.
if administering a tablet, put it in a medicine cup then have the child take it. If the child If a child two months of age or older has a fever
wants to, he/she may drink a little water after (a rectal, oral or tympanic temperature above 38.0°C or an axillary temperature above 37.5°C), apply the measures listed above for an increase in body temperature (dress comfortably, havethe child drink and keep an eye on the (See over)
ACÉTAMINOPHEN : DOSAGE
The dosage unit may be repeated every four hours.
Do not exceed six doses in a 24-hour period.
The dosages shown in the chart above are based on a maximum dose of 10 to 15 mg/kg/.
This Protocol may be applied as indicated even if a child has been given ibuprofen at home before arriving at the childcare establishment, regardless of the time elapsed. There is nocontra-indication to or danger in givingacetaminophen to a child who received IBUPROPHEN:
ibuprofen earlier since the two medications donot work in the same way.
A warning is needed since a clear distinction OTHER MEDICATIONS:
The availability of an increasing number of Although both medications have antipyretic combination medications containing acetami- (fever-reducing) properties, they must not be nophen and another pharmaceutical product on confused because they belong to different the market calls for greater care in applying this classes of medications and work differently.
Ibuprofen must not, under any circumstances, be substituted for acetaminophen for thefollowing reasons: Good communication between parents and the person authorized to administer the medication ibuprofen is a non-steroidal anti inflam- medication the child received in the four hours before arriving at the childcare establishment so the dosage and frequency of administration that the Protocol may be applied safely, for the it has been established that all NSAIDs may If an educator or a person recognized as a home affect respiratory functions; that is why childcare provider notices fever in a child within four hours of the child’s arrival and has been other medication earlier, she may contact a between salicylates and ibuprofen (allergic pharmacist to obtain the necessary information concerning the medication and apply theProcedure accordingly.
When applying this Protocol, care must be taken to never confuse ibuprofen and acetaminophenor substitute one for the other.
Table of Contents Letter of Introduction ………………………………………………Page 2 Daily Schedules ……………………………………………………Page 3 Infants, Creepers, Toddlers Clothing and Personal Belongings .……………………………….Page 5 Arrival and Departure Procedures Transportation Procedures Emergencies and Hazardous Weather Health and M