Guidelines
441 entriesNDoH Hospital-level paediatric STG
- Bleeding Oesophageal VaricesDescription General and supportive measures Medicine treatment Referral ICD-10 code: I85.0 DESCRIPTION Presentation with haematemesis (fresh blood) or melaena in a patient who has a spontaneous bleed from varices at the oesophageal-gastric junction. The patient may or may not have been known to have chronic liver disease and portal hypertension. This bleeding may be hard to control and be l→
- BronchiectasisDescription Diagnostic criteria General and supportive measures Medicine treatment Surgical treatment Role of chemoprophylaxis Referral ICD-10 code: J47 DESCRIPTION Irreversible dilatation of the subsegmental airways, inflammatory destruction of bronchial and peribronchial tissue, and accumulation of exudative material in dependent bronchi that occurs as a result of recurrent bacterial infe→
- BronchiolitisDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: J21.9 DESCRIPTION Bronchiolitis is an acute viral infection of the small airways of the lower respiratory tract affecting children between 4 months and 2 years of age. The most common pathogen is the respiratory syncytial virus. Recurrent episodes of wheeze associated with bronchiolitis→
- Bulimia NervosaBulimia Nervosa→
- BurnsDescription General and supportive measures Medicine treatment Referral ICD-10 code: T30.0 DESCRIPTION Burns lead to skin and soft tissue injury and may be caused by: heat, e.g. open flame, hot liquids, hot steam; chemical compounds; physical agents, e.g. electrical/lightning; radiation. GENERAL AND SUPPORTIVE MEASURES Emergency treatment Remove smouldering or hot clothing. Remo→
- COVID-19 in ChildrenDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: U07.1 *Notifiable condition. Also see: - National Department of Health – Guide to antigen testing for SARSCoV-2 in South Africa, revision. January 2023. 4 DESCRIPTION SARS-CoV-2 infections range from asymptomatic to severe. Case definition of COVID-19 (NICD/NDOH): A suspected COVID-19 ca→
- Calcium Abnormalities In ICUEffects of albumin and pH Alkalosis results in increased bound calcium – and decreased ionized calcium. In hypoalbuminaemia, total serum calcium measurement may be falsely low. Corrected calcium = measured calcium + (40 - albumin) x 0.025. Hypocalcaemia: See: Hypocalcaemia in children. In ICU, the focus is on low ionized calcium concentrations (< 1.0 mmol/L). Clinical effects of hypocalcaemia:→
- Cancer PainDescription Referral ICD-10 code: G89.3 DESCRIPTION Pain in children with cancer is common and can be divided into four categories: Pain as a result of the disease. Pain secondary to treatment of the disease (chemo and radiotherapy). Procedural pain (especially from bone marrow aspirations and LPs). Pain from other causes as experienced by children in general. Pain caused by malignancy may→
- CandidiasisDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: B37.2 DESCRIPTION Skin infection involving axillae, neck and perineum. Commonly occurs in immunocompromised individuals. Involvement of mouth and perineal regions suggests systemic disease. DIAGNOSTIC CRITERIA Clinical Red, raw-looking patches with satellite white→
- Candidiasis, OralICD-10 code: B37.0 See: Candidiasis, systemic and other . Click here for the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024 Chapter 2: Alimentary Tract, 2.1 Dental & Oral Disorders, 2.1.4 Candidiasis, Oral→
- Candidiasis, Systemic and OtherDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: B37 DESCRIPTION Superficial and/or disseminated (systemic) fungal infection caused by C. albicans , C. tropicalis and other candida species. Risk factors include: Prolonged, broad-spectrum antibiotic therapy. Compromised immune system, including patients infected with HIV or on ca→
- Carbon Monoxide PoisoningDescription General measures Medicine treatment ICD-10 code: Y17 DESCRIPTION Poisoning caused by accidental or intentional exposure to fires in poorly ventilated areas, combustion engines, faulty stoves and faulty heating systems. Patients present with: dizziness, headache, seizures and other CNS symptoms, nausea and vomiting, chest pain, tachycardia, high arterial carboxyhaemoglobin→
- Cardiac ArrhythmiasDescription Diagnostic criteria General and supportive measures Medicine Treatment Referral ICD-10 code: I49.9 DESCRIPTION A heart rate that is either abnormally slow or fast for age or irregular. Normal heart rate/minute for age: Newborn 100–160 < 1 year 110–160 1–2 years 100–150 2–5 years 95–140 5–12 years 80–120 > 12 years 60–100 DIAGNOSTIC CRITERIA Clinical Presenting features may→
- Cardiorespiratory ArrestDescription General and supportive measures Medicine treatment Referral ICD-10 code: I46.9 Click on the image to enlarge DESCRIPTION Cardiorespiratory arrest in children usually follows a period of circulatory or respiratory insufficiency and less commonly is precipitated by a sudden cardiac event. It is, therefore, important to pre-empt cardiorespiratory arrest in→
- Cellulitis And ErysipelasDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: L03.9/A46 DESCRIPTION Infection of the skin and subcutaneous tissue usually caused by streptococci, staphylococci or H. influenzae . In cellulitis, the border of the lesion is indistinct. Erysipelas The affected area is: well demarcated with clear borders, very tender and wa→
- Cerebral Oedema in Diabetic Ketoacidosis (DKA)Description Diagnostic criteria General and supportive measures Medicine treatment ICD-10 Code: G93.6 DESCRIPTION A condition of brain swelling during the course of treatment for DKA. Cerebral oedema usually occurs 4–12 hours after the initiation of treatment, but may be present at the time of diagnosis. It often follows an initial period of clinical and biochemical improvement. Cerebral oedema c→
- Cerebral Palsy (CP)Cerebral Palsy (CP)→
- Cerebrovascular Disease/ StrokeCerebrovascular Disease/Stroke→
- Chemical Burn to the EyeDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T26.9 DESCRIPTION Damage to one or both eyes caused by contact with irritating chemical substances, either alkali or acid. Presentation: pain, inability to open the eye(s), blurred vision, and excessive tearing. DIAGNOSTIC CRITERIA To assess the extent of epithelial loss, after irrigatin→
- Childhood PsychosisChildhood Psychosis→
- Children With Prosthetic Heart ValvesDescription Medicine treatment ICD-10 code: Z95.2 DESCRIPTION Valve replacement may be required for severe valvular disease when valve repair is not feasible or advisable. The valves may be mechanical valves or bioprosthetic valves or preserved human tissue valves. In children, bioprosthetic valves tend to degenerate, calcify and have structural deterioration more frequently and more rapidl→
- CholeraDefinition Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A00.9 * Notifiable condition. DEFINITION An acute diarrhoeal disease caused by V. cholerae . DIAGNOSTIC CRITERIA Clinical Sudden onset of severe, watery diarrhoea, i.e. ‘rice water’ diarrhoea. Low-grade or no fever. Persistent vomiting not associated with nausea. Rapid fluid and electroly→
- Chronic Bullous Disease Of ChildhoodICD-10 code: L12.2 DESCRIPTION Tense blisters that lead to ulceration involving the groin, face and trunk. DIAGNOSTIC CRITERIA Skin biopsy with immunofluorescence. GENERAL AND SUPPORTIVE MEASURES Appropriate wound care. REFERRAL All cases. Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 5: Dermatology, &nbs→
- Chronic CholestasisDescription General and supportive measures Medicine treatment DESCRIPTION Impairment of bile formation and/or bile flow which may present with pruritis and/or jaundice. It is classified as intrahepatic (e.g. chronic hepatitis, paucity of bile ducts) or extrahepatic (e.g. biliary atresia). GENERAL AND SUPPORTIVE MEASURES Diet supplemented with medium-chain triglycerides. MEDICINE TREATMENT For pr→
- Chronic Cough - Paediatric Palliative CareDescription General and supportive measures Medicine treatment ICD-10 code: R05 DESCRIPTION Involuntary cough lasting more than 3 weeks caused by chronic stimulation of cough receptors impairing sleep, communication and feeding. GENERAL AND SUPPORTIVE MEASURES Determine and treat the underlying cause where possible. Exclude undiagnosed GORD and bronchospasm. If caused by ACE inhibitor, cons→
- Chronic Kidney Disease (Renal Failure, Chronic)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: N18.9 DESCRIPTION Chronic kidney disease (CKD) is defined as: "evidence of structural or functional kidney abnormalities (abnormal urinalysis, imaging studies or histology) that persist for at least 3 months, with or without a decreased glomerular filtration rate (GFR), as defined by a G→
- CirrhosisDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: K74.6 DESCRIPTION The end result of irreversible damage to the liver tissue, causing a widespread, diffuse process of fibrosis with regenerating nodule formation. The fibrosis and abnormal portosystemic vascular connections that result cause ongoing damage. The progression rate is variab→
- Common Medications Used in Psychiatry and Their Side EffectsCommon Medications Used in Psychaitry and Their Side Effects→
- Congenital GlaucomaDescription Diagnostic criteria Referral ICD-10 code: Q15.0 DESCRIPTION Congenital glaucoma is caused by abnormal development of the draining angle of the eye. DIAGNOSTIC CRITERIA Symptoms: Tearing Photophobia Blepharospasm Signs: Enlarged eye (buphthalmos or ‘cow eye’ appearance). Corneal haziness (due to corneal oedema or scarring). Optic disc cupping. Raised intraocular pressure. REFERRA→
- Congenital Heart Disease (CHD)ICD-10 code: Q24.9 DESCRIPTION Structural abnormalities of the heart or great vessels present at birth. They fall into 4 pathophysiological groups: Acyanotic left to right shunts – ventricular septal defect (VSD), patent duct arteriosus (PDA), atrial septal defect (ASD), atrioventricular septal defect (AVSD). Acyanotic obstructive lesions – pulmonary stenosis, aortic stenosis, coarctation o→
- Congenital Heart Disease With Left to Right ShuntDescription Diagnostic criteria General and supportive measures Medicine treatment Referral DESCRIPTION Structural abnormalities of the heart and great vessels that are usually associated with left to right shunting – most commonly: ventricular septal defect, atrial septal defect, patent ductus arteriosus and atrioventricular septal defect. DIAGNOSTIC CRITERIA Each condition has specific clinical→
- ConjunctivitisICD-10 code: H10.1 See Primary Healthcare Level Standard Treatment Guidelines and Essential Medicines List, Chapter 18: Eye Conditions, sections: Conjunctivitis Conjunctivitis, Allergic Conjunctivitis, Bacterial (excluding conjunctivitis of the newborn) Conjunctivitis of the Newborn Conjunctivitis, Viral (Pink-eye) Click here for the pdf . Standard Treatment Guidelines and Essential Medicines Lis→
- Constipation - Paediatric Palliative CareDescription General and supportive measures Medicine treatment ICD-10 code: K59.0 DESCRIPTION The infrequent passage of hard stools. See: Constipation/ Faecal Loading . In palliative care, the most frequent causes are drug related (especially opioids), pain, immobility and neurological impairment (e.g. cerebral palsy). GENERAL AND SUPPORTIVE MEASURES Review medications causing constipation.→
- Constipation / Faecal LoadingDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: K59.0 DESCRIPTION Constipation: The infrequent passage of hard stools. This is often due to behavioural retention following previous painful episodes of defaecation (functional constipation), but may also be due to organic causes (metabolic, endocrine, neurogenic, lower bowel abnor→
- Contraception, Teenage Pregnancy And Teratogenicity RisksDescription General and supportive measures Medicine treatment Referral ICD- 10 Code: Z30.9 DESCRIPTION Adolescents are at risk for both sexually transmitted diseases and unintended pregnancy. Healthcare workers need to be supportive of adolescents regardless of whether they are abstinent or sexually active. The foetus may be at risk for teratogenic effects of chronic medications taken by a pregn→
- Convulsions, Not Febrile ConvulsionsSee section: Seizures. Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 1: Emergencies and Trauma, 1.1 Paediatric Emergencies, 1.1.6 Convulsions, Not Febrile Convulsions→
- Cutaneous HaemangiomasDescription Diagnostic criteria General and supportive measures Referral ICD-10 code: D18.0 DESCRIPTION Benign tumours of the vascular endothelium that may be classified as either congenital or infantile. They are characterised by abnormal proliferation of endothelial cells and abnormal blood vessel architecture. Congenital haemangiomas: Fully grown at birth, and are either rapidly in→
- Cutaneous Larva Migrans/Ancylostoma Braziliense (Dog Hookworm)Description Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: B76.9/B76.0 DESCRIPTION Infestation of the skin by dog hookworm larvae. Maturation of the larvae cannot occur resulting in a self-limiting infection. DIAGNOSTIC CRITERIA Presents as an itchy ‘serpiginous’ skin lesion. GENERAL AND SUPPORTIVE MEASURES Regular deworming of dogs. Wearing→
- Cyanotic Congential Heart Disease With Hypoxaemia Attack/Spells (Hypercyanotic Spells)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: Q24.9 DESCRIPTION Acute worsening of central cyanosis in patients with a tetralogy of Fallot and certain other cyanotic heart diseases with pulmonary stenosis and a ventricular septal defect. DIAGNOSTIC CRITERIA Clinical Rapid worsening of central cyanosis, tachypnoea/dyspnoea, anxiety a→
- Cyanotic Heart Disease in the NewbornDescription Diagnostic Criteria General and Supportive Measures Medicine Treatment Surgical Treatment Referral ICD-10 code: Q24.9 DESCRIPTION Blue or grey discolouration of the skin and tongue in room air, with an oxygen saturation of less than 85% in the presence of a cardiac lesion (complex lesions such as common arterial trunk may be associated with saturations greater than 90%). Note: S→
- Cystic FibrosisDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: E84.9 DESCRIPTION An autosomal recessive disorder of exocrine glands, mainly affecting the gut, pancreas and lungs. DIAGNOSTIC CRITERIA Clinical Recurrent infections of the respiratory tract with later bronchiectasis, respiratory failure and cor pulmonale. Bulky, greasy and foul-smelling→
- Cytomegalovirus (CMV) InfectionDescription Diagnostic criteria Medicine treatment Referral ICD-10 code: B25.9 DESCRIPTION CMV is an extremely common childhood infection, with almost all children infected by 5 years of age. The majority of childhood infections are asymptomatic or present with a mononucleosis-like syndrome NOT requiring anti-viral treatment. CMV can cause clinically significant disease following congenital→
- Cytomegalovirus (CMV) RetinitisDescription Diagnostic criteria Medicine treatment Referral ICD-10 code: B25.8 DESCRIPTION Characteristic appearance: opacification of the retina with areas of haemorrhage, exudate and necrosis. Occurs in immunocompromised patients and could be an important cause of visual impairment in HIV-infected patients. DIAGNOSTIC CRITERIA Confirm retinitis with ophthalmological assessment. Confirm CM→
- Delayed Hypersensitivity ReactionsDescription General and supportive measures Medicine treatment Referral See Erythema multiforme See Stevens-Johnson syndrome (SJS)/Toxic epidermal necrosis (TEN) See Drug reactions DESCRIPTION Broad spectrum of clinical manifestations involving different organs, including liver, kidneys and skin. Cutaneous reactions are most prevalent and range from maculopapular or morbilliform→
- Depression - Paediatric Palliative CareDescription General and supportive treatment Medicine and treatment ICD-10 code: F32-34 DESCRIPTION Low mood in children and adolescents who become aware of their impending death is often congruent and appropriate and does not always warrant treatment. However, around 10 to 30% of chronically ill children are depressed. DSM 5 criteria instruct clinicians to exclude “symptoms that are c→
- Depression in Childhood and AdolescenceDepression in Children and Adolescence→
- Diabetes InsipidusDescription Diagnostic Criteria Medicine Treatment Referral ICD-10 Code: E23.2 / N25.1 DESCRIPTION Suspect diabetes insipidus in any child with polydipsia and polyuria. Infants may present with failure to thrive. Central diabetes insipidus is due to deficiency of antidiuretic hormone. Nephrogenic diabetes insipidus occurs if the kidney is unable to respond to antidiuretic hormone. DIAGNOSTIC CRIT→
- Diabetes MellitusDESCRIPTION A syndrome of abnormal carbohydrate metabolism, associated with a relative or absolute impairment of insulin secretion with varying degrees of peripheral resistance to the action of insulin. Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 7: Endocrine, 7.5 Diabetes Mellitus Click here for 7.5.1→
- Diabetes Mellitus in AdolescentsDescription General and supportive measures Medicine treatment ICD-10 Code: E10 DESCRIPTION Adolescence is the period between 10 to 19 years of age. The adolescent and the transition should be managed with special planning, i.e.: the admission policy of the hospital, observing the wishes of the adolescent, emotional and physical maturity considerations, and the presence of any co-existing medical→
- Diabetes Mellitus, Insulin Dependent: Acute ComplicationsStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 7: Endocrine, 7.5 Diabetes Mellitus, 7.5.2 Diabetes Mellitus, Insulin Dependent: Acute Complications Click here for 7.5.2.1 Cerebral Oedema In Diabetic Ketoacidosis (DKA) Click here for 7.5.2.2 Diabetic Ketoacidosis Click here for 7.5.2.3 Hypoglycaemia In Diabe→