Decision Making Process Basis of discussion / decision-making? (Tick as appropriate) [X] Wishes of child/young person with capacity Wishes of parent(s) for child on interests” basis “best Best interests basis (as in Mental Capacity Act 2005) Other (please state) Comment Specific Treatment Plans (Prompt: allergies recorded on Front Cover) Weight Management of seizures Date of Weight (Please select one option only) (Kg) Manage using APLS guidelines Requires a personalised seizure plan below Personalised Seizure plan: (drug name, dose and route) please add patient weight used to calculate drug doses First Line after mins Second Line after further mins Third Line after further mins Yes No Call 999 for emergency transfer to hospital? If yes, at what stage Description of usual seizure pattern/ types Other instructions for seizures Management of infection This section is for community use and may involve instructions to transfer to hospital. Contact specialist team and microbiology Please record if likely to be neutropaenic or have an immune deficiency
Decision Making Process Basis of discussion / decision-making? (Tick as appropriate) [X] Wishes of child/young person with capacity Wishes of parent(s) for child on “best interests” basis Best interests basis (as in Mental Capacity Act 2005) Other (please state) Comment Specific Treatment Plans (Prompt: allergies recorded on Front Cover) Management of seizures (Please select one option only) Date of Weight Weight (Kg) Manage using APLS guidelines Requires a personalised seizure plan below Personalised Seizure plan: (drug name, dose and route) please add patient weight used to calculate drug doses First Line after mins Second Line after further mins Third Line after further mins Call 999 for emergency transfer to hospital? Yes No If yes, at what stage Description of usual seizure pattern/ types Other instructions for seizures Management of infection This section is for community use and may involve instructions to transfer to hospital. Contact specialist team and microbiology Please record if likely to be neutropaenic or have an immune deficiency
CYPACP-CHSW-Reg-Charity-v1.1-no-macro.docx