Give Paracetamol, observe for 6 hours then review

Rory is transferred to the ward and you give instructions to the ward staff to do regular observations and let you know if he deteriorates.

Meanwhile you review two other patients in the ED. The first is a two year old girl with diarrhea and features of dehydration. You start some nasogastric rehydration and also plan to review her later. The second is a six week old with breathing difficulties and coryza. You arrange a chest radiograph and send some blood tests.

You are called after 2 hours by the ward. Rory has become unrousable – his observations are stable, but he is not responding to painful stimuli. His father has now arrived and wants to take Rory home.

You are now called to review the two year old and the 6 weeker.

What is the most appropriate plan?