NORTHERN TERRITORY OF AUSTRALIA

Transcription

1 NORTHERN TERRITORY OF AUSTRALIA Government Gazette ISSN X No. S22 DARWIN 30 April 2014 NORTHERN TERRITORY DEFENCE HEALTH FACILITIES: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, STEVEN JAYE SKOV, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 24th April, Robertson Health Centre (ROBHC) Robertson Barracks Health Centre Building 121, Lighthorse Rd, Robertson Barracks Darwin Health Centre (DARHC) Darwin Health Centre, Building 204, RAAF Base Darwin Larrakeyah Health Centre, (LARHC) Larrakeyah Health Centre Building 4, Larrakeyah Barracks Tindal Health Centre (TDLHC) Tindal Health Centre, Building 320, off Stuart Highway, RAAF Base Tindal Robertson Barracks Medical Centre protocols (2007) 1/22 1:1,000 (1mg/mL) Flumazenil Glucagon HCL Glycerine Trinitrate Naloxone Paracetamol Paracetamol 500mg and Codeine 30mg GOVE DISTRICT HOSPITAL EMERGENCY DEPARTMENT: APPROVAL OF SCHEDULED SUBSTANCE TREATMENT PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH SCHEDULE 4 OR 8 SUBSTANCES (a) I, STEVEN JAYE SKOV, : (i) under section 254(1) of the Medicines, Poisons to for each hospital ward specified in Schedule A (ii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions:

2 Page 2 The Northern Territory Government Gazette No. S22, 30 April 2014 Dated 24th April, Emergency Department Gove District Hospital Matthew Flinders Way Nhulunbuy, NT 0880 CARPA Standard Treatment Manual 5th edition (2009) Minymaku Kutju Tjukurpa Women's Business Manual 4th edition (2008) Australian Immunization Handbook 10th Edition (2013) Childhood Vaccination Schedule 1 July 2013 Adult and Special Group Vaccination Schedule September 2013 Vaccination Schedule July 2013 Northern Territory Pneumococcal Vaccination and Revaccination Guideline September 2013 Albendazole Amethocaine Amoxycillin Amoxycillin/Clavulanic acid Aspirin Azithromycin Benztropine Benzylpenicillin Betamethasone Valerate Box Jelly Fish antivenom Cefaclor Ceftriaxone Cephalexin Chloramphenicol Ciprofloxacin Clindamycin Clotrimazole Dexamethasone/Framycetin/Gramicidin Dicloxacillin Doxycycline Flucloxacillin Folic acid Glucagon Glyceryl trinitrate Glyceryl trinitrate Spray Hydrocortisone 1% Ibuprofen Ipratropium Iron Iron/Folic Acid Isosorbide dinitrate Ketoconazole Levonorgestrel 750mcg Levonorgestrel 1.5mg Lignocaine 1% Lignocaine 2% Lignocaine with adrenaline (1:10,000) Lignocaine with adrenaline (1:100,000) Lignocaine/Prilocaine Loperamide Loratadine Metoclopramide Metronidazole Midazolam Naloxone Nitrofurantoin Oxybuprocaine Oxymetazoline Oxytocin Paracetamol Paracetamol 500mg/Codeine 30mg Penicillin Benzathine Penicillin G Procaine Phenoxymethylpenicillin (Penicillin V) Prednisolone Probenecid Prochlorperazine Promethazine Pyrantel embonate Roxithromycin Salbutamol Silver Sulphadiazine cream

3 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 3 Sulfamethoxazole/Trimethoprim Terbutaline Tinidazole Triamcinolone Compound cream Tuberculin PPD (Mantoux) Vaccine Diphtheria/Haemophilus Influenza B/HeapatitisB/ Pertussis/Poliomyelitis/Tetanus Vaccine Diphtheria/ Pertussis/Poliomyelitis/Tetanus 2/22 Vaccine Diphtheria/Pertussis/Tetanus Vaccine Diphtheria/Tetanus Vaccine Haemophilus (HIB) Vaccine Hepatitis A Vaccine Hepatitis B Vaccine Human Papillomavirus Vaccine Influenza Vaccine Meningococcal Conjugate C Vaccine MMR (Measles, Mumps, Rubella) Vaccine Pneumococcal Vaccine Rotavirus Vaccine Varicella Xylometazoline Zinc Sulphate Schedule 8 Substances Morphine NORTHERN TERRITORY MANDATORY TREATMENT PROGRAM: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, STEVEN JAYE SKOV, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 24th April, Darwin Alcohol Assessment and Treatment Service Darwin Hospital Campus, Nightcliff Nhulunbuy Alcohol and Other Drugs Rehabilitation Service 52 Bottlebrush Avenue, Nhulunbuy Alice Springs Alcohol Lot 03881, South Stuart Highway, Alice Springs CARPA Standard Treatment Manual 5th edition (2009) 3/22 Benztropine Midazolam Clotrimazole 1% Paracetamol Paracetamol 500mg/Codeine 30mg ROYAL FLYING DOCTOR SERVICE: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH SCHEDULE 4 OR 8 SUBSTANCES (a) I, STEVEN JAYE SKOV, : (i) under section 252 of the Medicines, Poisons

4 Page 4 The Northern Territory Government Gazette No. S22, 30 April 2014 each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons or approved midwife (approved practitioner) to deal with the Schedule 4 or 8 substances specified in Schedule C in accordance with the Scheduled substance treatment protocol specified in Schedule B subject to the following conditions: with the Schedule 4 or 8 substances at the places specified in Schedule A or at places identified in each Scheduled substance treatment the Schedule 4 or 8 substances in the course of Scheduled substance treatment protocol, see section 5 Dated 24th April, Alice Springs Airport Santa Teresa Road Alice Springs Royal Flying Doctor Service OPS01 Clinical Protocols, Version 6, 2013 Royal Flying Doctor Service OPS09 Drug Reference Manual, Version 4, 2010 Amiodarone Atropine Ergometrine Maleate, Oxytocin Frusemide 4/22 Glyceryl Trinitrate Glucagon Haloperidol Hydrallazine Hydrocortisone Magnesium Sulphate Metoclopramide Midazolam Misoprostol Naloxone Olanzapine Salbutamol Syntocinon Schedule 8 Substances Morphine PRESCRIBED QUALIFICATIONS TO SUPPLY OR ADMINISTER OR POSSESS VACCINATIONS (a) I, STEVEN JAYE SKOV, : (i) under section 63(2) of the Medicines, Poisons and Therapeutic Goods Act, prescribe anyone of the qualifications in Schedule 1 and anyone of the qualifications in Schedule 2 as the qualifications required by an Aboriginal and Torres Strait Islander health practitioner, in the course of practising in the Aboriginal and Torres Strait Islander health practice profession, to: (A) supply or administer a Schedule 4 substance that is a vaccine to a person; and (B) possess that substance for those purposes; and (ii) under section 65(1A) of the Act, prescribe anyone of the qualifications in the Schedule 1 and anyone of the qualifications in Schedule 2 as the qualifications required by a nurse or midwife, in the course of practising in the nursing or midwifery profession as a nurse or midwife, to: (A) supply or administer a Schedule 4 substance that is a vaccine to a person; and (B) possess that substance for those purposes; and (iii) with reference to section 42(1)(b) of the Interpretation Act, prescribe the qualifications mentioned in subparagraphs (a)(i) and (a)(ii) of this instrument, subject to the conditions specified in Schedule 3. Schedule 4 substance, see section 7(2) Dated 24th April, 2014.

5 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 5 SCHEDULE 1 State/Territory Provider Qualification Australian Canberra Institute of Fundamentals of Immunisation Capital Territory Technology New South Wales The Australian College Immunisation Course for of Nursing Registered Nurses Northern Territory Centre for Disease About Giving Vaccines Course Control South Australia Department of Health South Australian Two Day and Aging (SA) Immunisation Education Workshop South Australia Department of Health Immunise the Basics and Aging (SA) South Australia Department of Health A Short Course on Immunology and Aging (SA) and Immunisation for Nurses Queensland Australian Catholic Certificate of Immunisation University Course of The Program for Nurse Immunisers Queensland Central Queensland Advanced Nursing Practice: Health Service District Immunisation Course Education and Research Unit Queensland Cunningham Centre - Immunisation Program - Toowoomba and Cairns Registered Nurse Health (Drugs and Poisons) Regulation 1996 Queensland University of Southern ANP5004 Immunisation Queensland Nursing Queensland Yangulla Centre Rural Advanced Nursing Practice: Health Training Unit Immunisation Course Tasmania University of Tasmania Immunisation Education for Registered Nurses Victoria La Trobe University Nurse Immuniser Program Western Australia WA Health Immunisation Certification SCHEDULE 2 1 Basic Life Support Certificate or Apply First Aid Certificate SCHEDULE 3 1 The practitioner's qualifications specified in Schedule 2 must be current and the practitioner must provide documentary evidence of the qualifications. 2 The practitioner must provide documentary evidence of the qualification specified in Schedule 1 from the provider including the date on which the qualification was obtained. 3 A practitioner who completed a qualification specified in Schedule 1 from an interstate provider is only authorised under subparagraphs (a)(i) and (a)(ii) of this instrument if: (a) the qualification was obtained within the last 5 years or the practitioner has completed, within the last 5 years, an up-skill course for the practitioner's Schedule 1 qualification as approved by the provider from which the practitioner completed the qualification; and (b) the practitioner completes the About Giving Vaccines Up-skill Course provided by the Centre for Disease Control in the Northern Territory within 6 months from the date the practitioner starts practising in the Territory; or (c) if the qualification was obtained more than 5 years ago, the practitioner must complete the About Giving Vaccines course provided by the Centre for Disease Control in the Northern Territory specified in Schedule 1 within 6 months from the date the practitioner starts practising in the Territory. 4 The practitioner must continue to complete regular up-skill courses. If the period since the date the practitioner completed the qualification specified in Schedule 1 or the date the practitioner completed the most recent up-skill course is more than 3 years but less than 5 years, then the practitioner must complete either the About Giving Vaccines Up-skill Course provided by the Centre for Disease Control in the Northern Territory, or an up-skill course for the practitioner's Schedule 1 qualification as approved by the provider or a full course from Schedule 1. 5 If 5 years or more have elapsed since the practitioner completed the most recent up-skill course or

6 Page 6 The Northern Territory Government Gazette No. S22, 30 April 2014 qualification the practitioner must successfully re-complete a full course qualification specified in Schedule 1. 5/22 ALICE SPRINGS HOSPITAL ADULT WARDS: APPROVAL OF SCHEDULED SUBSTANCE TREATMENT PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, STEVEN JAYE SKOV, : (i) under section 254(1) of the Medicines, Poisons to for each hospital ward specified in Schedule A (ii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 24th April, Adults Wards Medical East, Medical West, Surgical, Renal and Rehabilitation Wards Alice Springs Hospital Gap Rd, Alice Springs NT 0870 Salbutamol inhaled: Schedule substance treatment protocol Dated 7 April 2014 Glyceryl trinitrate (Anginine): Schedule substance treatment protocol Dated 7 April /22 Salbutamol inhaler Glyceryl trinitrate ALICE SPRINGS HOSPITAL - INTENSIVE CARE UNIT: APPROVAL OF SCHEDULED SUBSTANCE TREATMENT PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, STEVEN JAYE SKOV, : (i) under section 254(1) of the Medicines, Poisons to for each hospital ward specified in Schedule A (ii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 24th April, Intensive Care Unit Alice Springs Hospital Gap Rd, Alice Springs NT 0870 : Schedule substance treatment protocol adult Dated 7 April 2014 Atropine: Schedule substance treatment protocol adult Dated 7 April 2014 Magnesium sulphate: Schedule substance treatment

7 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 7 7/22 protocol adult Dated 7 April 2014 Potassium chloride: Schedule substance treatment protocol adult Dated 7 April 2014 Potassium dihydrogen phosphate: Schedule substance treatment protocol adult Dated 7 April 201, Sodium dihydrogen phosphate: Schedule substance treatment protocol adult Dated 7 April :10,000 (1mg/10mL) Atropine Magnesium sulphate Potassium chloride Potassium dihydrogen phosphate Sodium dihydrogen phosphate CENTRE FOR DISEASE CONTROL: PROTOCOLS AND APPROVAL FOR ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH PRACTITIONERS TO DEAL WITH (a) I, STEVEN JAYE SKOV, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(b) of the Medicines, Poisons each Aboriginal and Torres Strait Islander health practitioner to be an approved ATSI health practitioner to deal with the Schedule 4 substances specified in Schedule C in accordance with the Scheduled substance treatment protocol specified in Schedule B subject to the following conditions: (A) the approved ATSI health practitioner must only deal with the Schedule 4 substances at the places specified in Schedule A or at places identified in each Scheduled Schedule B; (B) the approved ATSI health practitioner must only deal with the Schedule 4 substances in the course of the approved practitioner's duties. Dated 24th April, Darwin Ground floor, Block 4, Royal Darwin Hospital Campus, Rocklands Drive Tiwi,Darwin Alice Springs Alice Springs Hospital Campus, 1 Gap Road Alice Springs Katherine O'Keefe House, Katherine Hospital Campus, Gorge Road, Katherine Gove Cnr Matthew Flinders Way and Chesterfield Circuit, Nhulunbuy Tennant Creek Cnr Schmidt and Windley Street, Tennant Creek Australian Immunization Handbook 10th Edition (2013) Childhood Vaccination Schedule 1 July 2013 Adult and Special Group Vaccination Schedule September 2013 Vaccination Schedule July 2013 Northern Territory Pneumococcal Vaccination and Revaccination Guideline September 2013 Tuberculin PPD (Mantoux) Vaccine BCG Vaccine Diphtheria/Tetanus/Pertussis/Polio Vaccine Diphtheria/Tetanus/Pertussis/Hepatitis B/Polio Vaccine Diphtheria/Tetanus/Polio Vaccine Diphtheria/Tetanus Vaccine Hepatitis A Vaccine Hepatitis B Vaccine Haemophilus (Hib) Vaccine Influenza Vaccine Meningococcal Vaccine MMR (Measles, Mumps, Rubella) Vaccine Pneumococcal Vaccine Rotavirus Vaccine Human Papillomavirus Vaccine Varicella Vaccine Poliomyelitis 8/22

8 Page 8 The Northern Territory Government Gazette No. S22, 30 April 2014 CENTRE FOR DISEASE CONTROL: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, STEVEN JAYE SKOV, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Scheduled substance treatment protocol, see section 5 Dated 24th April, Darwin Ground floor, Block 4, Royal Darwin Hospital Campus, Rocklands Drive Tiwi, Darwin Alice Springs Alice Springs Hospital Campus, 1 Gap Road Alice Springs Katherine O'Keefe House, Katherine Hospital Campus, Gorge Road, Katherine Gove Cnr Matthew Flinders Way and Chesterfield Circuit, Nhulunbuy Tennant Creek Cnr Schmidt and Windley Street, Tennant Creek Australian Immunization Handbook 10th Edition (2013) Childhood Vaccination Schedule 1 July 2013 Adult and Special Group Vaccination Schedule September 2013 Vaccination Schedule July 2013 Northern Territory Pneumococcal Vaccination and Revaccination Guideline September 2013 Tuberculin PPD (Mantoux) Vaccine BCG Vaccine Diphtheria/Tetanus/Pertussis/Polio Vaccine Diphtheria/Tetanus/Pertussis/HepatitisB/Polio Vaccine Diphtheria/Tetanus/Polio Vaccine Diphtheria/Tetanus Vaccine Hepatitis A Vaccine Hepatitis B Vaccine Haemophilus (Hib) Vaccine Influenza Vaccine Meningococcal Vaccine MMR (Measles, Mumps, Rubella) Vaccine Pneumococcal Vaccine Rotavirus Vaccine Human Papillomavirus Vaccine Varicella Vaccine Poliomyelitis 9/22 NORTHERN TERRITORY CORRECTIONAL SERVICES: PROTOCOLS AND APPROVAL FOR ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH PRACTITIONERS TO DEAL WITH SCHEDULE 4 OR 8 SUBSTANCES (a) I, STEVEN JAYE SKOV, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to

9 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 9 (iii) under section 250(1)(b) of the Medicines, Poisons each Aboriginal and Torres Strait Islander health practitioner to be an approved ATSI health practitioner to deal with the Schedule 4 or 8 substances specified in Schedule C in accordance with the Scheduled substance treatment protocol specified in Schedule B subject to the following conditions: (A) the approved ATSI health practitioner must only deal with the Schedule 4 or 8 substances at the places specified in Schedule A or at places identified in each Scheduled Schedule B; (B) the approved ATSI health practitioner must only deal with the Schedule 4 or 8 substances in the course of the approved practitioner's duties. Dated 24th April, Darwin Correctional Centre Tivendale Road, Berrimah Alice Springs Correctional Centre Stuart Highway, Alice Springs Don Dale Juvenile Detention Centre Tivendale Road, Berrimah Alice Springs Juvenile Holding Centre (Aranda) 9 Kemp St, Alice Springs Alice Springs Juvenile Detention Centre Stuart Highway, Alice Springs Barkly Work Camp Peko Road, Tennant Creek CARPA Standard Treatment Manual 5th edition (2009) Australian Immunization Handbook Edition 10th Edition (2013) Northern Territory Adult and Special Groups Vaccination Schedule September 2013 NT pneumococcal vaccination and revaccination guideline September 2013 Albendazole Amethocaine Amoxycillin Amoxycillin/Clavulanic acid Aspirin Azithromycin Benzathine Penicillin Benztropine Benzylpenicillin Ceftriaxone Cephalexin Chloramphenicol Ciprofloxacin Clindamycin Clotrimazole Dexamethasone/Framycetin/Gramicidin Dicloxacillin Doxycycline Flucloxacillin Glucagon Glyceryl trinitrate Glyceryl trinitrate spray Hydrocortisone 1% Ibuprofen Ipratropium Ketoconazole Lignocaine 1% Lignocaine with adrenaline (1:100,000) Lignocaine/Prilocaine Loperamide Loratadine Metoclopramide Metronidazole Midazolam Naloxone Nitrofurantoin Oxybuprocaine Paracetamol Paracetamol 500mg/Codeine 30mg Phenoxymethylpenicillin (Penicillin V) Prednisolone Probenecid Procaine Penicillin (Penicillin G) Prochlorperazine Promethazine Pyrantel embonate Roxithromycin Salbutamol Sulfamethoxazole/Trimethoprim

10 Page 10 The Northern Territory Government Gazette No. S22, 30 April /22 Tinidazole Trimethoprim Tuberculin PPD (Mantoux) Vaccine Diphtheria/Pertussis/Tetanus Vaccine Diphtheria/Tetanus Vaccine Hepatitis B Vaccine Human Papillomavirus Vaccine Influenza Vaccine Pneumococcal Schedule 8 Substances Morphine NORTHERN TERRITORY CORRECTIONAL SERVICES: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH SCHEDULE 4 OR 8 SUBSTANCES (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons and Therapeutic Goods Act, and with reference to section 42 of the Interpretation Act, declare each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons or approved midwife (approved practitioner) to deal with the Schedule 4 or 8 substances specified in Schedule C in accordance with the Scheduled substance treatment protocol specified in Schedule B subject to the following conditions: with the Schedule 4 or 8 substances at the places specified in Schedule A or at places identified in each Scheduled substance treatment the Schedule 4 or 8 substances in the course of Dated 24th April, Darwin Correctional Centre Tivendale Road, Berrimah Alice Springs Correctional Centre Stuart Highway, Alice Springs Don Dale Juvenile Detention Centre Tivendale Road, Berrimah Alice Springs Juvenile Holding Centre (Aranda) 9 Kemp St, Alice Springs Alice Springs Juvenile Detention Centre Stuart Highway, Alice Springs Barkly Work Camp Peko Road, Tennant Creek CARPA Standard Treatment Manual 5th edition (2009) Australian Immunization Handbook Edition 10th Edition (2013) Northern Territory Adult and Special Groups Vaccination Schedule September 2013 NT pneumococcal vaccination and revaccination guideline September 2013 Albendazole Amethocaine Amoxycillin Amoxycillin/Clavulanic acid Aspirin Azithromycin Azithromycin Benzathine Penicillin Benztropine Benzylpenicillin Ceftriaxone Cephalexin Chloramphenicol Ciprofloxacin Clindamycin Clotrimazole Dexamethasone/Framycetin/Gramicidin Dicloxacillin Doxycycline Flucloxacillin Glucagon Glyceryl trinitrate Glyceryl trinitrate spray Hydrocortisone 1% Ibuprofen Ipratropium Ketoconazole Lignocaine 1% Lignocaine with adrenaline (1:100,000)

11 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 11 11/22 Lignocaine/Prilocaine Loperamide Loratadine Metoclopramide Metronidazole Midazolam Naloxone Nitrofurantoin Oxybuprocaine Paracetamol Paracetamol 500mg/Codeine 30mg Phenoxymethylpenicillin (Penicillin V) Prednisolone Probenecid Procaine Penicillin (Penicillin G) Prochlorperazine Promethazine Pyrantel embonate Roxithromycin Salbutamol Sulfamethoxazole/Trimethoprim Tinidazole Trimethoprim Tuberculin PPD (Mantoux) Vaccine Diphtheria/Pertussis/Tetanus Vaccine Diphtheria/Tetanus Vaccine Hepatitis B Vaccine Human Papillomavirus Vaccine Influenza Vaccine Pneumococcal Schedule 8 Substances Morphine ALICE SPRINGS HOSPITAL DAY CARE UNIT: APPROVAL OF SCHEDULED SUBSTANCE TREATMENT PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 254(1) of the Medicines, Poisons to for each hospital department specified in Schedule A (Scheduled substance treatment protocol) and (ii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: (A) the approved practitioner must only deal with the at the places specified in Schedule A or at places identified in each Scheduled Schedule B; Dated 28th April, 2014 Alice Springs Hospital Day Stay Unit Gap Rd, Alice Springs NT 0870 Promethazine for management of hypersensitivity reactions Scheduled substance treatment protocol Dated 17 April 2014 IV Hydrocortisone for management of hypersensitivity reactions Scheduled substance treatment protocols Dated April /22 Promethazine Hydrocortisone ALAN WALKER CANCER CARE CENTRE: DECLARATION OF PLACE, APPROVAL OF PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons and Therapeutic Goods Act, and with reference to section 42 of the Interpretation Act, declare each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons

12 Page 12 The Northern Territory Government Gazette No. S22, 30 April 2014 Schedule B subject to the following conditions: with the at the places Dated 28th April, Alan Walker Cancer Care Centre Royal Darwin Hospital Rocklands Drive, Tiwi NT 0810 Promethazine for management of hypersensitivity reactions Scheduled substance treatment protocol Dated 17 April 2014 IV Hydrocortisone for management of hypersensitivity reactions Scheduled substance treatment protocols Dated April /22 Promethazine Hydrocortisone 2012 COMMENCEMENT NOTICE I, Sally Gordon Thomas, Administrator of the Northern Territory of Australia, under section 2 of the 2012 (No. 13 of 2012), fix 1 May 2014 as the day on which that Act commences. Dated 28th April, S. G. Thomas Administrator 14/22 NORTHERN TERRITORY SCHOOL HEALTH SERVICES: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (Scheduled substance treatment protocol) and (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 28th April, Casuarina Senior College 61 Parer Drive, Moil Darwin Middle School Atkins Drive, The Gardens Dripstone Middle School 10 Delamere Street, Tiwi Nightcliff Middle School 90 Aralia Street, Rapid Creek Sanderson Middle School 60 Matthews Road, Malak Henbury Special School 4 Henbury Avenue, Wanguri

13 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 13 Nemarluk School 30 Styles Street Alawa Rosebery Middle School Corner Forrest Parade and Belyuen Road, Rosebery Taminmin College 70 Challoner Circuit, Humpty Doo Katherine High School Grevillea Road, Katherine East Nhulunbuy High School 51 Matthew Flinders Way, Nhulunbuy Barkly College Tennant Creek High School Campus 38 Stuart Street, Tennant Creek Centralian Middle School Gillen Campus 56 Milner Road, Alice Springs Centralian Senior College 10 Grevillea Drive, Alice Springs Acacia Hill School 80 Spearwood Road, Alice Springs Australian Immunization Handbook 10th Edition (2013) 15/22 Childhood Vaccination Schedule 1 July 2013 Vaccination Schedule July 2013 Northern Territory Pneumococcal Vaccination and Revaccination Guideline September : Human papillomavirus Tuberculin PPD (Mantoux) Vaccine Diptheria/Tetanus/Pertussis Vaccine Pneumococcal Vaccine Influenza Vaccine Varicella NORTHERN TERRITORY POLICE STATIONS AND WATCH HOUSES: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) (ii) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and under section 254(1) of the Medicines, Poisons to (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 28th April, Police Station and Watch House - Darwin Mitchell Street, Mitchell Centre, Darwin Police Station and Watch House - Katherine 55 Acacia Drive, Katherine East Police Station and Watch House - Alice Springs 6 Parsons Street, Alice Springs CARPA Standard Treatment Manual 5th edition (2009) Aspirin Diazepam Glyceryl Trinitrate Glucagon Ibuprofen Lignocaine with adrenaline Loperamide Metoclopramide Midazolam Nicotine replacement therapy Olanzapine Paracetamol Paracetamol 500mgs and codeine 30mgs Salbutamol Thiamine 16/22

14 Page 14 The Northern Territory Government Gazette No. S22, 30 April 2014 CARE FLIGHT: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH SCHEDULE 4 OR 8 SUBSTANCES (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons and Therapeutic Goods Act, and with reference to section 42 of the Interpretation Act, declare each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons or approved midwife (approved practitioner) to deal with the Schedule 4 or 8 substances specified in Schedule C in accordance with the Scheduled substance treatment protocol specified in Schedule B subject to the following conditions: with the Schedule 4 or 8 substances at the places specified in Schedule A or at places identified in each Scheduled substance treatment the Schedule 4 or 8 substances in the course of Dated 28th April, Top End Medical Retrieval Service Gove Airport Melville Bay Rd, Nhulunbuy NT 0881 Top End Medical Retrieval Service 12 Lancaster Road Darwin International Airport Eaton, NT 0812 Top End Medical Retrieval Service Katherine Tindal Civilian Airport Stuart Highway Katherine, NT 0850 Careflight Medication Guidelines Ref: MS Date Effective 01/05/2013 Declared Places Outreach Services Schedule Substance Treatment Protocol 24 April 2014 Aciclovir Adenosine Amiodarone Atropine Benztropine Benzyl penicillin Ceftriaxone Clopidogrel Dopamine Enoxaparin Ergometrine Frusemide Gentamicin Glucagon Glyceryl Trinitrate Haloperidol Hydralazine Hydrocortisone Insulin Lignocaine Magnesium Sulphate Meropenem Metaraminol Metoprolol Metronidazole Midazolam Misoprostol N acetyl cysteine Naloxone Nifedipine Noradrenaline Octreotide Omeprazole Ondansetron Oxytocin Pancuronium Phenobarbitone Phenytoin Potassium chloride Promethazine Propofol Prostaglandin E1 Rocuronium Salbutamol

15 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 15 17/22 Sodium bicarbonate Surfactant Suxamethonium Tenecteplase Thiopentone Tranexamic acid Tropisetron Vitamin K Schedule 8 Substances Fentanyl Ketamine Morphine NT RENAL SERVICES: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1 )(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 28th April, Katherine Dialysis unit Gorge road Katherine NT 0851 Nightcliff Renal Unit 192 Dick Ward Drive Nightcliff 0810 Palmerston Dialysis Unit Farrar Health Precinct 1 Gurd Street Palmerston 0830 Peritoneal Dialysis Centre Casuarina Health Services Centre G6, 9 Scaturchio Street Casuarina NT 0810 Tiwi Dialysis Unit 693 Pauti Drive Wurrumiyanga (Nguiu) Bathurst Island 0822 Renal Dialysis Unit 10 Flynn Drive Alice Springs Miwatj Aboriginal Corporation C/-Yirrkala Health Clinic Yirrkala, NT 0880 Nephrocare 33 Gap Rd Alice Springs WDWPT Aboriginal Corporation Purple house 69 Flynn Drive Alice Springs Hermannsburg Lot 106 Hermannsburg Road Ntaria, NT 0872 Lajamanu Lot 452, Lajamanu St. Lajamanu, NT 0852 Yuendumu: Lot 648, Park St Yuendumu, NT 0872 Kintore Lot 118, Kintore Rd, Walungurru, NT 0872 Protocol: 1:1,000 (1mg/mL) injection for anaphylaxis NT Renal Services-Schedule Substance Treatment Protocol: Sublingual Glyceryl Trinitrate (GTN) for chest pain Protocol: Intra-peritoneal Ceftazidime for peritonitis Protocol: Intra-peritoneal Cephazolin for peritonitis Protocol: Intra-peritoneal Heparin for peritonitis Protocol: Lignocaine 1% Injection for local anaesthesia

16 Page 16 The Northern Territory Government Gazette No. S22, 30 April 2014 Protocol: Oral Nystatin for prevention of fungal peritonitis Protocol: Glucose (Dextrose) 50% Injection for severe hypoglycaemia 18/22 Glycerine trinitrate Ceftazidime Cephazolin Heparin sodium Lignocaine Nystatin HOSPITAL RENAL SERVICES: APPROVAL OF SCHEDULED SUBSTANCE TREATMENT PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 254(1) of the Medicines, Poisons to for each hospital department specified in Schedule A (ii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions Dated 28th April, Ward 7A Royal Darwin Hospital Rocklands Drive, Tiwi NT 0810 Kidney Dialysis Unit Alice Springs Hospital Gap Rd Alice Springs Renal Dialysis Unit Tennant Creek Tennant Creek Hospital Schmidt Street Tennant Creek NT Renal Services - Schedule Substance Treatment Protocol: 1:1,000 (1mg/mL) injection for anaphylaxis NT Renal Services-Schedule Substance Treatment Protocol: Sublingual Glyceryl Trinitrate (GTN) for chest pain Protocol: Intra-peritoneal Ceftazidime for peritonitis Protocol: Intra-peritoneal Cephazolin for peritonitis Protocol: Intra-peritoneal Heparin for peritonitis Protocol: Lignocaine 1% Injection for local anaesthesia Protocol: Oral Nystatin for prevention of fungal peritonitis Protocol: Glucose (Dextrose) 50% Injection for severe hypoglycaemia 19/22 Glycerine trinitrate Ceftazidime Cephazolin Heparin sodium Lignocaine Nystatin CENTRE FOR DISEASE CONTROL: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons and Therapeutic Goods Act, and with reference to section 42 of the Interpretation Act, declare each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and

17 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 17 to (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 29th April, Darwin Ground floor, Block 4, Royal Darwin Hospital Campus, Rocklands Drive Tiwi, Darwin Alice Springs Alice Springs Hospital Campus, 1 Gap Road Alice Springs Katherine O'Keefe House, Katherine Hospital Campus, Gorge Road, Katherine Gove Cnr Matthew Flinders Way and Chesterfield Circuit, Nhulunbuy Tennant Creek Cnr Schmidt and Windley Street, Tennant Creek Department of Health, Centre for Disease Control, Schedule Substance Treatment Protocol Version 1; 23 April 2014 Declared Places Outreach Services Schedule Substance Treatment Protocol 28 April /22 Amoxycillin with probenecid Azithromycin Benzathine penicillin Benzyl benzoate Calmurid cream Ceftriaxone with lignocaine 1% Ciprofloxacin Crotamiton Erythromycin Oseltamivir Permethrin Procaine penicillin Rifampicin Roxithromycin Salbutamol Trimethoprim with suxamethoxazole Tubersol CENTRE FOR DISEASE CONTROL: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons and Therapeutic Goods Act, and with reference to section 42 of the Interpretation Act, declare each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions:

18 Page 18 The Northern Territory Government Gazette No. S22, 30 April 2014 Scheduled substance treatment protocol, see section 5 Dated 29th April Clinic 34 Darwin Ground Floor Health House 87 Mitchell Street Darwin Darwin Ground floor, Block 4, Royal Darwin Hospital Campus, Rocklands Drive Tiwi, Darwin Alice Springs Alice Springs Hospital Campus, 1 Gap Road Alice Springs Katherine O'Keefe House, Katherine Hospital Campus, Gorge Road, Katherine Gove Cnr Matthew Flinders Way and Chesterfield Circuit, Nhulunbuy Tennant Creek Cnr Schmidt and Windley Street, Tennant Creek Sexual Health and Blood Bome Virus Unit Scheduled Substance Treatment protocol, Version 1, 23 April 2014 Declared Places Outreach Services Schedule Substance Treatment Protocol 28 April /22 Amoxycillin with Proben acid Azithromycin Benzathine Penicillin Ceftriaxone with Lignocaine Cephalexin Ciprofloxacin Clotrimazole Doxycycline Hydrocortisone Metron idazole Levonorgestrel Paracetamol Podophyllotoxin Trimethoprim Valaciclovir ROYAL DARWIN HOSPITAL EMERGENCY DEPARTMENT: APPROVAL OF SCHEDULED SUBSTANCE TREATMENT PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH SCHEDULE 4 OR 8 SUBSTANCES (a) I, Steven Jaye Skov, : (i) under section 254(1) of the Medicines, Poisons to for each hospital department specified in Schedule A (ii) under section 250(1)(a) of the Medicines, Poisons or approved midwife (approved practitioner) to deal with the Schedule 4 or 8 substances specified in Schedule C in accordance with the Scheduled substance treatment protocol specified in Schedule B subject to the following conditions: with the Schedule 4 or 8 substances at the places specified in Schedule A or at places identified in each Scheduled substance treatment the Schedule 4 or 8 substances in the course of Dated 29th April, Emergency Department Royal Darwin Hospital Rocklands Drive, Tiwi NT 0810 Royal Darwin Hospital Emergency Department Scheduled Substance Treatment Protocols signed 24 April 2014 Amethocaine Aspirin Ibuprofen Nitrous oxide 50% Oxygen 50%

19 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 19 22/22 Levonorgestrel 750mcg Ondansetron Paracetamol Paracetamol 500mg/Codeine 30mg Salbutamol Schedule 8 Substances Morphine URBAN COMMUNITY HEALTH CLINICS: PROTOCOLS AND APPROVAL FOR ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH PRACTITIONERS TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(b) of the Medicines, Poisons each Aboriginal and Torres Strait Islander health practitioner to be an approved ATSI health practitioner to deal with the Schedule 4 substances specified in Schedule C in accordance with the Scheduled substance treatment protocol specified in Schedule B subject to the following conditions: (A) the approved ATSI health practitioner must only deal with the Schedule 4 substances at the places specified in Schedule A or at places identified in each Scheduled Schedule B; (B) the approved ATSI health practitioner must only deal with the Schedule 4 substances in the course of the approved practitioner's duties. Dated 30th April, Casuarina Community Care Centre Casuarina Plaza Building, Corner of Trower Road and Vanderlin Drive Karama Child and Family Health Clinic Karama Shopping Centre, Kalymnos Drive, Karama Nylander Street Child Health Clinic Nylander Street, Parap Palmerston Community Care Centre Palmerston Health Precinct, corner Temple Terrace and Roystonea Avenue, Farrar Katherine Community Health Centre Government Centre, First Street, Katherine Nhulunbuy Health Centre Endeavour Square, Chesterfield Circuit, Nhulunbuy Tennant Creek Community Health Centre 172 Paterson Street, Matt Glynn Building, Tennant Creek Alice Springs Community Health Centre Flynn Drive, Alice Springs CARPA Standard Treatment Manual 5th edition (2009) as amended at June 2013 Minymaku Kutju Tjukurpa Women's Business Manual 4th edition (2008) as amended at January 2012 Australian Immunization Handbook Edition 10th Edition (2013) Adult and Special Groups Vaccination Schedule September 2013 Childhood Vaccination Schedule 1 July 2013 Northern Territory Pneumococcal Vaccination and Revaccination Guideline September 2013 Vaccination Schedule July 2013 Declared Places Outreach Services Schedule Substance Treatment Protocol 28 April 2014 Department of Health, Centre for Disease Control, Schedule Substance Treatment Protocol Version 1; 23 April 2014 Sexual Health and Blood Borne Virus Unit Scheduled Substance Treatment protocol, Version 1, 23 April : 1000 Amoxycillin Azithromycin Benzathine Benzylpenicillin 900mg Benzyl Benzoate Application BP Ceftriaxone Crotamiton 10% Clotrimazole 1% cream Doxycycline Dimeticone 4% Hydrocortisone 1 % Lignocaine 1% Lignocaine Prilocaine 5% cream

20 Page 20 The Northern Territory Government Gazette No. S22, 30 April 2014 Lignocaine2% CATH Gel Syringe Metronidazole Permethrin 5% Probenecid Salbutamol Tinidazole Tuberculin PPD Vaccine Diphtheria, Tetanus Vaccine Diphtheria, Pertussis, Tetanus Vaccine Diphtheria, Pertussis, Tetanus, Poliomyelitis Vaccine Diphtheria, Pertussis, Tetanus, Hepatitis B, Poliomyelitis, Haemophilus Influenzae type B Vaccine Haemophilus Influenzae type B Vaccine Haemophilus Influenzae B/Meningococcal C Conjugate 23/22 Vaccine Hepatitis A Vaccine Hepatitis B Vaccine Hepatitis A, Hepatitis B Vaccine Human Papillomavirus Vaccine Influenza Vaccine Measles, Mumps, Rubella(MMRII) Vaccine Measles, Mumps, Rubella (MMRII) Vaccine Measles, Mumps, Rubella, Varicella Vaccine Meningococcal C Vaccine Pneumococcal Vaccine Poliomyelitis Vaccine Rabies Vaccine Rotavirus Vaccine Varicella URBAN COMMUNITY HEALTH CLINICS: PROTOCOLS AND APPROVAL FOR NURSES AND MIDWIVES TO DEAL WITH (a) I, Steven Jaye Skov, : (i) under section 252 of the Medicines, Poisons each health centre or clinic specified in Schedule A to be a place to which Part 2.6 of the Act applies; and to (iii) under section 250(1)(a) of the Medicines, Poisons Schedule B subject to the following conditions: Dated 30th April, Casuarina Community Care Centre Casuarina Plaza Building, Corner of Trower Road and Vanderlin Drive Karama Child and Family Health Clinic Karama Shopping Centre, Kalymnos Drive, Karama Nylander Street Child Health Clinic Nylander Street, Parap Palmerston Community Care Centre Palmerston Health Precinct, corner Temple Terrace and Roystonea Avenue, Farrar Katherine Community Health Centre Government Centre, First Street, Katherine Nhulunbuy Health Centre Endeavour Square, Chesterfield Circuit, Nhulunbuy Tennant Creek Community Health Centre 172 Paterson Street, Matt Glynn Building, Tennant Creek Alice Springs Community Health Centre Flynn Drive, Alice Springs CARPA Standard Treatment Manual 5th edition (2009) as amended at June 2013 Minymaku Kutju Tjukurpa Women's Business Manual 4th edition (2008) as amended at January 2012 Australian Immunization Handbook Edition 10th Edition (2013) Adult and Special Groups Vaccination Schedule September 2013 Childhood Vaccination Schedule 1 July 2013 Northern Territory Pneumococcal Vaccination and Revaccination Guideline September 2013 Vaccination Schedule July 2013

21 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 21 Declared Places Outreach Services Schedule Substance Treatment Protocol 28 April 2014 Department of Health, Centre for Disease Control, Schedule Substance Treatment Protocol Version 1; 23 April 2014 Sexual Health and Blood Borne Virus Unit Scheduled Substance Treatment protocol, Version 1, 23 April : 1000 Amoxycillin Azithromycin Benzathine Benzylpenicillin 900mg Benzyl Benzoate Application BP Ceftriaxone Crotamiton 10% Clotrimazole 1% cream Doxycycline Dimeticone 4% Hydrocortisone 1% Lignocaine 1% Lignocaine Prilocaine 5% cream Lignocaine2% CATH Gel Syringe Metronidazole Permethrin 5% Probenecid Salbutamol Tinidazole Tuberculin PPD Vaccine Diphtheria, Tetanus Vaccine Diphtheria, Pertussis, Tetanus Vaccine Diphtheria, Pertussis, Tetanus, Poliomyelitis Vaccine Diphtheria, Pertussis, Tetanus, Hepatitis B, Poliomyelitis, Haemophilus Influenzae type B Vaccine Haemophilus Influenzae type B Vaccine Haemophilus Influenzae B/Meningococcal C Conjugate Vaccine Hepatitis A Vaccine Hepatitis B Vaccine Hepatitis A, Hepatitis B Vaccine Human Papillomavirus Vaccine Influenza Vaccine Measles, Mumps, Rubella (MMRII) Vaccine Measles, Mumps, Rubella (MMRII) Vaccine Measles, Mumps, Rubella, Varicella Vaccine Meningococcal C Vaccine Pneumococcal Vaccine Poliomyelitis Vaccine Rabies Vaccine Rotavirus Vaccine Varicella 24/22

22 Page 22 The Northern Territory Government Gazette No. S22, 30 April 2014

23 The Northern Territory Government Gazette No. S22, 30 April 2014 Page 23

24 Page 24 The Northern Territory Government Gazette No. S22, 30 April 2014 Government Printer of the Northern Territory