Calling all peds/ER nurses RE: Tylenol dosage

[6spdftwtm]

In your experiences...

What is acceptable practice for a one-time dosage of acetaminophen?

What is acceptable practice for q4hr administration?

Have you ever seen a child that received a one-time hepatotoxic dose (

What about hepatotoxic doses received over multiple doses in a 1-2 day timeframe?

Late,

Trav

[platon20]

Yes, a fever of 100.4 or higher in a 1 month old is certainly a big deal. They will get admitted to the hospital for at least 48 hours. They will get a blood culture, urine culture, maybe a CXR/FA6 if they have respiratory symptoms, a lumbar puncture, and at least 48 hours of antibiotics.

However, that has nothing to do with tylenol. We recently had a 6 week old admitted to the hospital with fever of 103. He got all the stuff I talked about but he didnt get a single dose of tylenol during the entire hospital stay because he wasnt irritable, his fever wasnt dangerously high, and he was eating fine.

Tylenol is greatly overused in pediatrics. I'd estimate that of all the kids in the hospital who were admitted for fevers, less than 10-20% actually needed tylenol to help recover.

[NeoPediRN]

15mg/kg. I have never given a hepatotoxic dose of Tylenol, nor would I.

[hiddencatRN, BSN, RN]

Fevers are uncomfortable. Treating most fevers is about making the patient more comfortable. I'm OK with comfort measures prior to a child being so uncomfortable that they stop drinking.

[platon20]

Of course you guys also need to realize that tylenol is not without risk. Lots of research has come out lately showing that tylenol (which is the only antipyretic you can use in kids under 6 months old) is linked to increased risk of asthma.

[PediMommy]

I've always dosed Tylenol at 15mg/kg q 4.

I find it funny that a 1 month old baby with 102 fever isn't concerning. Whether or not the baby is eating normally doesn't really come into play. They would get a full sepsis work up from any pedi doc/doc I've ever worked with. Also, while fever is good it also cause pt have discomforts other that irritability. Just because a child isn't irritable doesn't mean they're not in pain. They maybe to uncomfortable to act out what we consider being irritable or just handle pain differently.