Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Miscellaneous issuesincreasing the flow rate will not increase the delivered oxygenconcentration. The non-rebreathe masks can be used to delivergreater than 60% oxygen with flow rates of 10 – 15 L min -1 .Should you require a patient to have supplemental oxygenadministered, you must prescribe it on the drug chart. Oxygen maynot be administered if not prescribed. You should prescribe theappropriate oxygen percentage. Alternatively, prescribe nasalcannulas with a flow rate (usually 2 L min -1 ).Paracetamol loading dosesParacetamol is an effective perioperative analgesic agent. Wherepracticable oral administration is preferred – the intravenouspreparation is many times more expensive and the total costpressure of using intravenous paracetamol is high. Ward nurses willgive oral premedicants if you prescribe them, especially if you tell thenurses that you have prescribed premedicants.The following statement was agreed at the anaesthesia departmentmeeting in January 2009 and at the trust’s Drugs and TherapeuticsCommittee in December 2009:“Paracetamol is an effective and safe analgesic widely used inperioperative care. Where indicated for prophylaxis or treatment ofsurgical pain, prescriptions for oral administration can consist of aloading dose (where the patient is not consuming regularparacetamol) followed by regular dosing or treatment as required bythe patient. An appropriate oral loading dose is a single dose of30 mg kg -1 or less, usually to a maximum dose of 2 g. This will lead tothe following dose recommendations:Patient 70 kg or over. 2 g Leading to 5 g in the first 24 hours.Patient under 70 kgbut over 50 kg.1.5 g Leading to 4.5 g in the first 24hours.“As with all prescriptions, the responsibility for adapting it to unusualcircumstances lies with the prescriber.”220 Anaesthetists Handbook January 2010