Guidelines

23 entries

NDoH Hospital-level paediatric STG

Magnesium Abnormalities In ICU40–60% of ICU patients have hypomagnesaemia. Hypomagnesaemia: Clinical effects of hypomagnesaemia: Electrolyte abnormalities: Hypokalaemia Hypocalcaemia Hypophosphataemia Arrhythmias: Prolonged QT interval. Polymorphic VT – Torsade de pointes. Neurologic: Altered mentation, generalized seizures, tremors, hyper-reflexia, weakness. Click on image to enlarge Magnesium supplementation: IV: Ampoules o→
MalariaDescription Diagnostic criteria ICD-10 code: B54 * Notifiable disease. DESCRIPTION Malaria is transmitted by the bite of an infected female Anopheles mosquito. The incubation period varies with the species of the parasite, Plasmodium falciparum being shortest, usually 7–21 days, and P. malariae the longest. The incubation period may be prolonged by use of malaria prophylaxis or certain anti→
Malaria ProphylaxisMalaria chemoprophylaxis should be used in moderate-risk malaria-endemic areas in South Africa from September to May, both together with preventive measures against mosquito bites. Risk maps are provided in the National Guidelines for the Prevention of Malaria (2018). It is recommended that persons intending to travel to malaria-endemic areas outside of South Africa take the relevant chemoprophyl→
Malnutrition, Severe AcuteDescription Diagnostic Criteria ICD-10 code: E40–E43 Z-scores For practical purposes a 'z-score' is the number of standard deviations (SD) below or above the mean. 2 SD or 2 z-scores above the mean (+2) equates fairly closely to the 97 th percentile and 2 SD or 2 z-scores below the mean (–2) equates fairly closely to the 3 rd percentile. 3 SD or 3 z-scores above or below the mean would→
Malodorous Fungating Wounds/ Tumours - Paediatric Palliative CareDescription General and supportive measures Medicine treatment DESCRIPTION Non-healing fungating tumours that are often secondarily infected and smelly causing social ostracization and distress to child and family. Examples include exophytic retinoblastoma, infected bedsores, rhabdomyosarcoma, osteosarcoma or Kaposi’s sarcoma. GENERAL AND SUPPORTIVE MEASURES Supportive counselling. Set realistic→
Management of Anaesthetic and Post-Anaesthetic ComplicationsDescription Medicine treatment DESCRIPTION Various events may occur during and after anaesthesia, which require management. MEDICINE TREATMENT Laryngospasm Maintain a good seal and attempt bag-mask ventilation, maintaining continuous positive pressure. Deepen the level of anaesthesia with a volatile anaesthetic agent (if laryngospasm is partial) – may overcome laryngospasm without the need for su→
Management of PainManagement of pain→
Massive Haemorrhage With Massive Transfusion of BloodDefinition Diagnostic Criteria Medicine Treatment Referral DEFINITION Massive blood loss in children is recognised when a child requires a blood transfusion to replace 50% of total blood volume in 3–4 hours (40 mL/kg) or > 100% of total blood volume in 24 hours or receives replacement of 10% of total blood volume/minute. The rapid recognition is important to maintain tissue oxygenation by rest→
MeaslesDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: B05 *Notifiable condition DESCRIPTION The following case definition is an epidemiological and not a diagnostic tool: Fever and maculopapular rash with any one of the following: cough, coryza/runny nose, conjunctivitis. Suspect measles in any child fulfilling the case definition. An acute→
Meningitis Bacterial, NeonatalDescription Diagnostic criteria Special Investigations General and supportive measures Medicine treatment Referral ICD-10 code: G01 DESCRIPTION A bacterial infection of the meninges in the first month of life. Consider meningitis in any neonate being evaluated for sepsis or infection, as most organisms implicated in neonatal sepsis also cause neonatal meningitis. The most common causative o→
Meningitis, Acute BacterialDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: G00 * Notifiable condition. (N. meningitidis and H. influenzae) This guideline applies to children > 60 days old. For the management of neonates, See: Meningitis bacterial, neonatal . DESCRIPTION Bacterial meningitis most commonly results from haematogenous dissemination of micr→
Meningitis, CryptococcalDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: G02.1 DESCRIPTION An uncommon childhood meningitis that may occur in older HIV-infected children with severe CD4 T-cell depletion. Pulmonary and skin involvement can occur. DIAGNOSTIC CRITERIA Clinical Acute or chronic headache in an older HIV-infected child. Meningism need not be presen→
Meningitis, Tuberculous (TBM) In ChildrenDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A17.0 *Notifiable condition. DESCRIPTION Tuberculous meningitis is an infection of the meninges caused by M. tuberculosis. Early diagnosis and treatment improves the prognosis. Differentiation from acute bacterial meningitis may be difficult. If in any doubt, treat for both conditions. C→
Meningo-Encephalitis/Encephalitis, Acute ViralDescription General and supportive measures Medicine treatment Referral ICD-10 code: A86 DESCRIPTION A number of viruses cause infection of the brain and meninges. Herpes simplex is the most important because it is treatable. A high mortality and morbidity is associated with untreated herpes meningo-encephalitis. Complications include: increased intracranial pressure, permanent neurological→
MeningococcaemiaICD-10 code: A39.2/A39.4 DESCRIPTION Palpable bleeding into skin caused by N. meningitides and is associated with rapid spread. This is a medical emergency and can be fatal. See: Infective/Infectious Diseases: Sepsis Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 5: Dermatology, 5.4. Purpura,&nb→
Miliary TB In ChildrenDescription Medicine Treatment ICD-10 code: A19.9 DESCRIPTION Miliary tuberculosis is a potentially fatal form of TB disease due to the spread of the organism in the bloodstream to the lungs, brain and other organs. Patients with miliary TB are assumed to have CNS involvement and are treated accordingly. MEDICINE TREATMENT Children < 8 years: The 75/50 RH and 75/50/150 RHZ formulations a→
Mucosal Bleeds - Paediatric Palliative CareDescription General and supportive care Medicine treatment DESCRIPTION Massive bleeds at the end of life, although rare, can occur in several conditions and include: Haematemesis (e.g. bleeding varices, fulminant liver failure). Epistaxis (in haematological malignancies). Haemoptysis (rare in children). Tumour related erosion of blood vessels (less common in children). GENERAL AND SUPPORTIVE CARE→
Multisystem Inflammatory Syndrome in ChildrenDescription Diagnostic criteria Treatment Referral ICD-10 code: U10.9 *Notifiable condition. DESCRIPTION A rare but serious inflammatory syndrome has been linked to COVID-19. Also known as Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 infection (PIMS-TS) or Kawasaki-like syndrome. The syndrome occurs after resolution of acute COVID-19 or following→
MumpsICD-10 code: B26 See: Primary Health Care Standard Treatment Guidelines and Essential Medicines List, Infections and Related Conditions, Mumps 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, 8.14 Mumps→
Myasthenia GravisMyasthenia Gravis→
Myasthenic Crisis (MC)Myasthenic Crisis (MC)→
Mycobacterium Avium Complex (MAC) InfectionDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A31.0 DESCRIPTION Atypical mycobacterium, causing disease in extremely immunocompromised patients. MAC infection in HIV-infected children usually presents with disseminated disease, often enlarged intra-abdominal lymph nodes and pancytopenia. Pulmonary, GIT or skin disease is less common→
MyocarditisDescription Diagnostic criteria General and supportive measures Medicine treatment of viral myocarditis Referral ICD-10 code: I40 DESCRIPTION Myocarditis is an inflammatory disease of the cardiac muscle. The majority of paediatric myocarditis cases are caused by viral infection. Viral myocarditis should be suspected whenever a child presents with arrhythmia, heart failure or cardiogenic sho→