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The Royal Children’s Hospital’s Paediatric Injectable Guidelines provide practitioners working in a busy paediatric setting with reliable, comprehensive and specific information about the safe preparation and administration of injectable medicines in children.

The Royal Children’s Hospital Melbourne (RCH) Paediatric Injectable Guidelines (PIG) was developed and compiled by the RCH’s clinical pharmacy team as a decision-making tool, aimed at providing standardised practices and care within our hospital. This grew into a publication that is now found in every drug room and available at every bedside at the RCH.

The demand for the use of the PIG outside of the RCH saw the resource first published and distributed for a wider audience in 2006 with the release of the 3rd edition, and subsequently the 4thand 5theditions in 2011 and 2016 respectively.

Due for release in early July, the new 2019 edition contains more than 100 clinical updates, monographs for more than  300 injectable drugs and many new drug monographs.  This new publication also includes:

  • Specific parenteral administration advice for paediatric patients.
  • Compatibility of medications with IV fluids – including compatibility with Plasma-Lyte 148.
  • Parenteral nutrition and fat emulsion compatibility and incompatibility.
  • Intravenous fluid additive calculations.
  • Infusion solution composition details.
  • Medication Safety features such as tall-man lettering and easy-to-read formatting.

To keep up with the demand of the broader healthcare environment and access to the PIG at a ward level, the online website was launched in November 2017. The last 12 months has seen access to the publication grow from a few health services to more than 200 hospitals across Australia and New Zealand. We now see an average of 6,000 users per month accessing the online PIG.

For users, the PIG is another much-needed resource that the Clinical Knowledge Network (CKN) in Queensland acquired on advice from clinicians involved in neonatal medicine and nursing, and paediatric pharmacy. Through the experience of the CKN network, the PIG is accessible to all Queensland Health services. Bruce Chio, an A/Pharmacist Consultant at the Queensland Children’s Hospital explains the benefits of utilising an Australian developed paediatric-specific resource within a hospital environment.

“Medication dosing and administration in children is very different compared to adults. Having reputable paediatric-specific resources readily available would help clinicians to have the right information at the right time, which ultimately improves patient outcomes.  It’s unique compared to other references. It’s developed within Australia so the information and medications are more applicable to our local practice and assist us in making clinical decisions that are best suited for our cohort of patients. With the information available in the PIG, clinicians can make rational decisions for medications to be administered. The PIG has helped bridge the gap, moving paediatrics away from being therapeutic orphans,” Mr Chio said.

The aim of the project was to develop the PIG as an online publication and provide a standardised care model across public health in Australia, improving safety and clinical outcomes.

The PIG is a self-funding project, with all resources generated by the sale of the books and online subscriptions going back into the clinical governance of the publication to improve content and quality.

The PIG is available as both a fully laminated, spiral bound flip-book, making it ideal for use in wet conditions such as drug preparation areas, and as an online subscription ranging from single-subscription personal use to unlimited state-level enterprise access.

Updates to online clinical content are conducted every six months, and a new printed update is available annually mid-year.

For further information visit


Clinical Knowledge Network – Case study – How a collaborative approach to information resource acquisition has improved paediatric care across Queensland.