Restricted: OHS Guidlines for the Use of IV Acetaminphen

Orderable by Provider (post-operative setting only)

• IV acetaminophen will be restricted to use in the post-operative setting only
  • Colorectal surgery patients may receive 3 doses post-operatively due to the propensity for prolonged NPO status and unavailable rectal route of administration; however, the order will auto-discontinue after 24 hours
  • Pediatric congenital heart patients may receive 4 doses post-operatively due to the propensity for prolonged NPO status; however, the order will auto-discontinue after 24 hours
  • All other surgery patients (non-colorectal, non-congenital heart) may receive 1 dose post-operatively
• No PRN orders
• IV acetaminophen will only be available to order within order-sets; it will not be available on any facility or preference list
• Repeat doses will be rejected by pharmacy and the provider will be notified
• In accordance with OHS.PHARM.047 IV to Oral Conversion, pharmacists may automatically change orders for IV acetaminophen to oral for patients meeting criteria listed in the policy

Orderable by Pharmacist

• If a patient meets the following criteria, the provider may contact the pharmacy and the pharmacist may enter a verbal order for up to a 24-hour supply of IV acetaminophen:
  • Patient is ≤ 5kg and NPO
• If a patient meets the following criteria, the provider may contact the pharmacy and the pharmacist may enter a verbal order for a one-time dose of IV acetaminophen:
  • Patient needs an antipyretic or pharmacologic treatment for mild pain, AND
  • Patient is NPO, AND
  • Patient has at least one of the following contraindications for rectal administration:
    
    • Suspected paralytic ileus or colonic obstruction
    • Evidence of gastrointestinal bleeding
    • Recent rectal or anal surgery
    • Trauma or abnormalities involving the perineal or perianal areas
    • Neutropenia

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