Guidelines
44 entriesNDoH Hospital-level paediatric STG
- Abscess, RetropharyngealDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: J39.0 DESCRIPTION An infective process of the retropharyngeal space either due to: abscess formation in a retropharyngeal lymph node (lymphadenitis), rarely, extension of infection from surrounding tissues, or rarely, local injury. Always consider cold abscess of TB as a possible cause.→
- AcneDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: L70 DESCRIPTION An inflammatory condition of hair follicles leading to comedone formation; inflammatory papules and/or nodules that can cause scarring and post inflammation hyper-pigmentation, on healing. DIAGNOSTIC CRITERIA Black-heads or white-heads (comedones). GENERAL AND SUPPO→
- Acute Bacterial TracheitisAcute bacterial tracheitis→
- Acute Disseminated Encephalomyelitis (ADEM)Acute Disseminated Encephalomyelitis (ADEM)→
- Acute Kidney Injury (Renal Failure, Acute)Description Diagnostic criteria General and supportive measures Medicine treatment Other complications Referral ICD-10 code: N17.9 DESCRIPTION Acute kidney injury (AKI) is a syndrome characterised by a rapid decline in glomerular filtration rate and retention of fluid and nitrogenous waste products. It often presents as a continuum of volume responsiveness 'pre-renal AKI' up to a point→
- Acute Lower Respiratory Tract Infections in Young ChildrenThe term acute lower respiratory tract infection is used here to embrace acute viral bronchiolitis as well as acute viral and bacterial pneumonia. Antibiotics are indicated in the empiric treatment of pneumonia and are not usually indicated for the treatment of bronchiolitis. If it is not possible to confidently diagnose acute viral bronchiolitis clinically or if there are concerns about bacteria→
- Acute MastoiditisAcute mastoiditis *New*→
- Acute PainDescription Medicine treatment ICD-10 code: R52.0 DESCRIPTION Acute pain is pain of short duration that usually resolves as injured tissues heal. Note: - Do not hesitate to start with opioid analgesia in cases of severe pain. - Always reassess the degree of response and adjust management accordingly. MEDICINE TREATMENT The correct use (dose, scheduling, duration) of the correct analgesic wi→
- Adolescence and Child RightsAdolescence is a period of significant physical, emotional, and cognitive change. The development of independence from family and the pressure to conform to peers can impose challenges in the management of chronic disease. However, adolescents with chronic illnesses require more support from family and caregivers. Adolescence spans the period of pubertal development, which manifests with physical→
- Adolescent Chronic Disease: Transition Of CareDescription General and supportive measures Medicine treatment Referral ICD-10 code: Z00.3 DESCRIPTION Transition of care in adolescence is described as the purposeful, planned movement of a person with chronic medical conditions from a child-centred to an adult-orientated healthcare service. Specialised programmes for transition improve adherence and outcomes. Careful assessment of→
- Adrenal Hyperplasia, CongenitalDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 Code: E25.0 DESCRIPTION Autosomal recessive enzymatic defects of the cortisol biosynthetic pathways in the adrenal gland. The presentation depends on the severity and type of the enzyme defect. DIAGNOSTIC CRITERIA Clinical Neonates with disorder of sex development (ambiguous genitalia). Adrenal→
- Adrenal Insufficiency, AcuteDescription Diagnostic criteria Medicine treatment Referral ICD-10 Code: E27.4 DESCRIPTION Acute failure of adrenal function, suspected when a patient presents with hypotension, hypoglycaemia, hyponatraemia, hyperkalaemia and metabolic acidosis. Patients on chronic steroid therapy are at risk for adrenal insufficiency if treatment is abruptly stopped. Increase steroid dose during times of s→
- Alcohol WithdrawalAlcohol Withdrawal→
- Alcohol Withdrawal DeliriumAlcohol Withdrawal Delirium→
- Allergies To PenicillinsDescription General and Supportive Measures Medicine Treatment Referral ICD-10 code: Z88.0 DESCRIPTION Patients may present with immediate (e.g. anaphylaxis, bronchospasm, angioedema) or delayed reactions (most commonly maculopapular rash without systemic involvement; rarely SJS/TEN or other systemic reactions). GENERAL AND SUPPORTIVE MEASURES Stop penicillin. MEDIC→
- Allergies To SulphonamidesDescription General and Supportive Measures Medicine Treatment Referral ICD-10 code: Z88.2 DESCRIPTION The commonest sulphonamide allergies are related to co-trimoxazole, especially when used in HIV-infected patients for P. jirovecii treatment and/or prophylaxis. Patients may present with: a morbilliform or maculopapular rash only, usually within a few days of starting treatment (most commo→
- Amitraz PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T60.9 *Notifiable condition. DESCRIPTION Amitraz is pesticide used in tick-dips for animals and as an insecticide in crop sprays. Liquid formulations often contain solvents that may cause additional clinical effects. Significant skin contact may lead to systemic effects. Note : Where th→
- Amoebiasis (Entamoeba Histolytica)Description Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: A06.9 DESCRIPTION Amoebic colitis is caused by the parasite Entamoeba histolytica . It can cause localised intestinal disease or disseminated disease. Amoebiasis is now relatively uncommon in South Africa, but immunodeficiency is a risk factor. DIAGNOSTIC CRITERIA Clinical Diarrhoea with mucus, b→
- Anaemia of Chronic Disorders (Infection or Disease)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D63 DESCRIPTION Anaemia caused by chronic infection or disease. This may be due to interference with nutrient supply or suppression of haemopoiesis. Iron may be trapped in the reticuloendothelial system resulting in relative iron deficiency. Symptomatic anaemia may manifest with tachypno→
- Anaemia, AplasticDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D61.0 DESCRIPTION Pancytopenia caused by bone marrow failure with a hypocellular bone marrow without infiltration or fibrosis. May be acquired or inherited. Inherited bone marrow failure syndromes include Fanconi anaemia, which has specific associated phenotypic features and chromosomal→
- Anaemia, HaemolyticDescription Diagnostic criteria General and supportive measures Medicine treatment Surgical treatment Referral ICD-10 code: D55–59 DESCRIPTION Anaemia caused by excessive destruction of red blood cells. Destruction may be due to: Corpuscular defects: abnormalities of the cell membrane (e.g. hereditary spherocytosis), enzyme abnormalities (e.g. G6PD deficiency), or abnormal haemoglobin (e.g.→
- Anaemia, Iron DeficiencyDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D50.9 DESCRIPTION Iron deficiency is the most common cause of anaemia. The commonest causes of iron deficiency anaemia are poor nutritional intake, excessive milk ingestion and blood loss due to parasites (whipworm and hookworm). Lower limits of normal haemoglobin: Age Hb (g/dL) Birth 13→
- Anaemia, MegaloblasticDescription Diagnostic Criteria General and supportive measures Medicine treatment Referral ICD-10 code: D53.1 DESCRIPTION Anaemia caused by a deficiency of folate and/or vitamin B 12 . DIAGNOSTIC CRITERIA Clinical Pallor and fatigue. History of chronic diarrhoea. Investigations Megaloblastic anaemia: elevated MCV (mean corpuscular volume) and MCH (mean corpuscular haemoglobin). Macro-ovalo→
- Anaemia, Sickle CellDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D57 DESCRIPTION Haemolytic anaemia due to homozygous inheritance of sickle cell mutation. Patients may experience complications: Painful vaso-occlusive crises Haemolytic crises (usually secondary to infection) Aplastic crises Thrombotic crises, e.g. acute chest syndrome, priapism or stro→
- AnalgosedationDescription Diagnostic criteria General and supportive measures Medicine treatment DESCRIPTION With respect to the comfort of critically ill children, the first priority is ensuring adequate analgesia, best assessed by validated pain assessment scales such as the revised FLACC (R-FLACC), Wong-Baker Faces, Numeric Pain Rating etc. However, sedation is routinely required to minimise anxiety and fac→
- Anaphylaxis/Anaphylactic ReactionsDescription Diagnostic criteria General and supportive measures Medicines treatment Preventative measures and home based treatment Referral ICD 10 code: T78.2 DESCRIPTION An acute, potentially life-threatening hypersensitivity reaction starting within seconds to minutes after administration of, or exposure to, a substance to which the individual is sensitised. Clinical manifestations inclu→
- Annexure 1: Amoxicillin/Clavulanic Acid Weight Band Dosing TableAmoxicillin/Clavulanic Acid (14:1 Ratio) 600mg/42.9mg/5 ml Amoxicillin/clavulanic acid, oral, 45 mg/kg/dose of amoxicillin component, 12 hourly. Click on the image to enlarge. Erratum for updates (08 April 2026): Click here to access pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _Annexure 1: Amoxicillin/Clavulanic Acid Weight Ban→
- Anorexia NervosaAnorexia Nervosa→
- Anticholinergic PoisoningDescription Diagnostic Criteria General and supportive measures Medicine treatment Referral ICD-10 code: T44.3 DESCRIPTION Various plant species and pharmaceutical preparations can cause anti-cholinergic toxicity. Plants: Datura stramonium , e.g. ‘stinkblaar' and 'malpitte'. Medicines: atropine, diphenoxylate with atropine and diphenhydramine. Other classes of medicines include antiparkinso→
- Anticoagulant PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: T45.5 *Notifiable condition (if poisoning due to agricultural or stock remedy, e.g. rodenticide). DESCRIPTION Poisoning due to warfarin and ‘super-warfarins’ (long-acting warfarin) (products such as pellets, granules, wedges, blocks and powder marketed as rodent pesticides). These may be accident→
- Antiretroviral Agents PoisoningDescription General measures Treatment ICD-10 code: T37.5 DESCRIPTION Limited data is available regarding overdose of these medicines. Toxicological effects are generally extensions of adverse effects. GENERAL MEASURES Monitor FBC, serum electrolytes, renal and liver function. Monitor serum lipase in patients with abdominal pain. Lactic acid and serum pH should be monitored in acidoti→
- Anxiety - Paediatric Palliative CareDescription General and supportive treatment Medicine treatment ICD-10 code: F41.9 DESCRIPTION Anxiety is common in children with life-threatening and life-limiting illnesses and often exacerbates other symptoms (e.g. dyspnoea and insomnia). Anxiety in this population may be: Transitory – often triggered by certain situations or procedures. Formal generalized anxiety disorder. ‘Death anxiet→
- Anxiety DisordersAnxiety Disorders→
- Aphthous UlcersDescription General and supportive measures Medicine treatment Referral ICD-10 code: K12.0 DESCRIPTION Painful ulcers in the oropharynx. Minor ulcers (< 1 cm diameter) usually heal within 2 weeks. Major ulcers (> 1 cm diameter) are very painful, often very deep and persist. GENERAL AND SUPPORTIVE MEASURES Maintain adequate nutrition and hydration by encouraging fluid and food intake –→
- Apnoea, NeonatalDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: P28.3 DESCRIPTION A neonate presenting with episodes of cessation of breathing. Apnoea episodes in a previously asymptomatic well neonate may be the first indication of a serious underlying disease. Apnoea episodes in an already unwell neonate indicate deterioration in the condition of t→
- Approach to a Child with a Haematological ProblemCommon blood products – dosing, volumes and storage Red cell products: Storage: 1–6 °C (refrigerator). Administration: Use blood administration sets. Paediatric red cell concentrate (25–150 mL). Paediatric red cell concentrate, leucodepleted (75 mL). Packed cells (volume in mL) = 4 x weight x desired increase in haemoglobin. Whole blood, leucodepleted (485 mL): used in exchange transfusion; volum→
- Arthritis Juvenile IdiopathicICD-10 code: M08.0 See: Rheumatology and Vasculitides : Juvenile Idiopathic Arthritis (JIA) . Click here for the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024 Chapter 8: Infective/Infectious Diseases, 8.30 Arthritis, Juvenile Idiopathic→
- Arthritis, Septic (Pyogenic)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: M00.9 DESCRIPTION Septic arthritis may occur as a result of haematogenous seeding of the synovium during transient periods of bacteraemia. Septic or pyogenic arthritis is often part of a generalised septicaemia which may involve more than one joint and is caused by pyogenic micro-organis→
- Ascites, Due to Portal HypertensionGeneral and supportive measures Medicine treatment Referral ICD-10 code: R18 GENERAL AND SUPPORTIVE MEASURES Restrict sodium intake, 1-2 mmol/kg/24 hours. Restrict fluids if serum sodium < 130 mmol/L. MEDICINE TREATMENT Spironolactone, oral, 1–3 mg/kg as a single daily dose. Can increase dosage slowly to 4-6 mg/kg/day. Continue for as long as needed to control ascites. Monitor serum pota→
- Asthma Attack, AcuteDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: J46 DESCRIPTION Acute exacerbation of wheezing that is unresponsive to bronchodilator therapy that is usually effective in a child who had been previously diagnosed with asthma. DIAGNOSTIC CRITERIA Clinical signs include: intense wheezing, decreased air entry, hyperinflation, dyspnoea, t→
- Asthma, ChronicDescription Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: J45 DESCRIPTION Asthma is a chronic inflammatory airways disease in which many cells and cellular elements play a role. Susceptible individuals present with recurrent episodes of early morning wheezing, breathlessness, chest tightness and cough. There is widespread variable airflow obstruction th→
- Attention Deficit Hyperactivity Disorder (ADHD)Attention Deficit Hyperactivity Disorder (ADHD)→
- Autism Spectrum Disorder (ASD)Autism Spectrum Disorder (ASD)→
- Avoidant/Restrictive Food Intake DisorderAvoidant/Restrictive Food Intake Disorder→