Guidelines
441 entriesNDoH Hospital-level paediatric STG
- References - PoisoningChyka PA, Seger D, Krenzelok EP, Vale JA; American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. Position paper: single-dose activated charcoal. Clin Toxicol (Phila) 2005;43(2):61–87. Thanacoody R, Caravati EM, Troutman B, Hojer J, Benson B, Hoppu K et al. Position paper update: whole bowel irrigation for gastrointestinal decontamination of ov→
- References - Respiratory System1 World Health Organisation. Revised WHO classification and treatment of childhood pneumonia at health facilities. Evidence Summaries. WHO Library. 2014. https://apps.who.int/iris/bitstream/handle/10665/137319/9789241507813_eng.pdf;jsessionid=DC9 BAB4C398AE239AE3110330E619294?sequence=1 Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023→
- References - Rheumatology and VasculitidesBritish Society for Paediatric and Adolescent Rheumatology. Guidelines for Non-steroidal antiinflammatory drug (NSAIDs) use in Paediatric Rheumatology. 2005. Keser G, Direskeneli H, Aksu K. Management of Takayasu Arteritis: A Systematic Review. Rheumatology. 2014;53: 793-801. Petty RE, Laxer RM, Lindsley CB et al. Textbook of Pediatric Rheumatology 7th edition, 2016, Elsevier. Ozen S, Pistorio A,→
- References - Surgical ProphylaxisReferences Bratzler DW, et. al. Clinical Practice Guidelines for antimicrobial prophylaxis in surgery. Am J Health-Syst Pharm. 2013; 70:195-283. Steinberg JP, C et. al. Timing of antimicrobial prophylaxis and the risk of surgical site infection: results from the Trial to Reduce Antimicrobial Prophylaxis Errors. Ann Surg. 2009; 250:10-6. Soriano A, et. al. Timing of antibiotic prophylax→
- References - The Nervous SystemReferences→
- References - Tuberculosis - Paediatric STGTurkova A, Wills GH, Wobudeya E, Chabala C, Palmer A, Kinikar S. Shorter Treatment of Nonsevere Tuberculosis in African and Indian Children. NEJM. 2022, 386 (10): 911- 922. 2 National Department of Health. Management of Rifampicin-Resistant Tuberculosis. November 2019. https://www.health.gov.za/wp-content/uploads/2020/11/managementof-rifampicin-resistant-tb-booklet-1219-v6.pdf Standard Treatment→
- References for Pain Control1. South African Society of Anaesthesiologists (SASA) Paediatric Sedation Guidelines for Procedural Sedation and Analgesia. South Afr J Anaesth Analg. 2016, 22(1) (supplementary 5). https://painsa.org.za/wp-content/uploads/2020/03/Untitledattachment-00037.pdf Standard Treatment Guidelines and Essential Medicines List for South Africa Adult Hospital _Chapter 20: Pain Control;2023, 5th edition→
- Respiratory Distress in the NewbornDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: P22.9 DESCRIPTION Newborn experiencing difficulty with breathing. Causes of respiratory distress include: Pulmonary causes Extrapulmonary causes - respiratory distress syndrome (surfactant deficiency), - meconium aspiration, - pneumonia, - pneumothorax, - transient tachypnoea of newborn→
- Respiratory Panic - Paediatric Palliative CareDescription General and supportive care Medicine treatment DESCRIPTION Sudden onset of severe respiratory distress sometimes experienced with an end of life event such as pulmonary embolus, pneumothorax, pulmonary oedema, SVC syndrome, upper airway obstruction, and bleed into CNS tumour. GENERAL AND SUPPORTIVE CARE Remain calm and provide reassurance. Position in semi-fowlers position. Gentle suc→
- Resuscitation of the ChildA structured approach to the seriously ill or injured child can rapidly optimise their outcome. Estimation of weight in children is inaccurate and they should be weighed as soon as stabilised. The PAWPER tape allows for consideration of body habitus when estimating weight and can be used as an alternative to the formulae provided (in diagram below). The following is a diagrammatic overview→
- Resuscitation of the NewbornBe prepared! Be at the delivery! Check the equipment and emergency medicines! Ask 3 questions to evaluate the infant: Is there good tone? Is the infant breathing adequately and not just gasping? Is the heart rate above 100 beats per minute? If the answer to all three questions is ‘yes’, the newborn does not need resuscitation. If the answer to any of the three questions is ‘no’, the newborn needs→
- Retinopathy of PrematuritySee: Retinopathy of Prematurity (ROP). Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 19: Prematurity And Neonatal Conditions, 19.3 Prematurity/preterm Neonate, 19.3.3 Retinopathy Of Prematurity→
- Retinopathy of Prematurity (ROP)Description Time of screening Medicine treatment Referral ICD-10 code: H35.1 DESCRIPTION ROP is a potentially preventable cause of blindness. ROP is classified into five stages, ranging from mild (stage I) to severe (stage V): Stage I – Mildly abnormal blood vessel growth. Many children who develop stage I improve with no treatment and eventually develop normal vision. The disease res→
- Rheumatic Fever, AcuteDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: I01.9 * Notifiable condition. DESCRIPTION Rheumatic fever is an inflammatory condition that may follow a throat infection with group A streptococci. It is an important cause of acquired heart disease with significant morbidity and mortality rates, both in the acute phase of the dis→
- Rhinitis, Allergic/Allergic RhinosinusitisRhinitis, allergic/allergic rhinosinositis→
- Rhinosinusitis, Acute Bacterial (ABRS)Description Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: J01 DESCRIPTION Inflammation or infection of one or more of the sinuses that occurs most often after a viral infection or with allergic rhinitis. DIAGNOSTIC CRITERIA Child with an acute upper respiratory tract infection presenting with: persistent illness (nasal discharge, facial pain/pressure, or dayt→
- RicketsDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: E55.0 DESCRIPTION Failure to calcify osteoid tissue in a growing child, usually due to deficiency of vitamin D, its active metabolites, calcium, phosphorus or other rare causes. This leads to bone deformity. Occurs in ex-premature babies during infancy and in children with developmental→
- Salicylate PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T39.0 DESCRIPTION Salicylate poisoning may result from oral and/or topical exposure. Salicylate products vary widely in concentration, e.g. oil of wintergreen is 100% methylsalicylate. As little as 4 mL of oil of wintergreen may be fatal in a child. DIAGNOSTIC CRITERIA Clinical Ingestion→
- Schistosomiasis (Bilharzia)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: B65.0/B65.1 DESCRIPTION Disease manifestations caused by infestation by species of the genus Schistosoma. Infestations with S. haematobium and S. mansoni are endemic in certain areas of South Africa. Nematodes reside in the venous plexus draining the bladder wall (haematobium) or intesti→
- SchizophreniaSchizophrenia→
- Scorpion StingsDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T63.2 DESCRIPTION Some scorpion species can cause serious systemic toxicity. Thick-tailed scorpions with small pincers are extremely toxic, resulting in both local and systemic features. Thin-tailed scorpions with large pincers are much less toxic and usually cause local symptoms only. D→
- Sedation of an Acutely Disturbed Child or AdolescentSedation of an Acutely Disturbed Child or Adolescents→
- Seizures, NeonatalDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: P90 DESCRIPTION Neonatal seizures are usually secondary to a serum biochemical disorder or an underlying brain disturbance/injury/malformation. Seizures may be subtle due to the relatively underdeveloped cortex. Seizures persist when limbs are flexed (as opposed to jitteriness). The most→
- SepsisDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A41.9 For neonatal sepsis, see: Septicaemia of the newborn . DESCRIPTION Severe sepsis is an uncontrolled inflammatory response as a result of suspected or proven infection. DIAGNOSTIC CRITERIA Clinical A systemic inflammatory response with at least two of the following four criteria, on→
- Septicaemia of the NewbornDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: P36.9 DESCRIPTION Bacterial or fungal invasion of blood before or after birth, which may spread to involve other organs/systems, e.g. meninges (meningitis), lungs (pneumonia), bone (osteomyelitis), and kidneys (pyelonephritis). DIAGNOSTIC CRITERIA Clinical The baby usually presents with→
- Severe Tuberculosis DiseaseIndications Includes more serious pulmonary TB, such as smear-positive TB, cavitatory pulmonary TB, bronchopneumonic TB, extensive (multiple lobes involved) pulmonary TB disease, and tuberculous empyema. Includes all HIV/TB co-infected cases. Includes extrapulmonary TB, e.g. spinal, osteo-articular or abdominal TB. However: Exclude TB meningitis and miliary TB. Dosing: Weigh at each visit and adj→
- ShockDescription Diagnostic criteria General and supportive measures Medical treatment ICD-10 Code: R57.9 DESCRIPTION An acute syndrome that reflects the inability of the pulmonary and circulatory system to provide adequate perfusion, oxygen and nutrients to meet physiological and metabolic demands. Compensation is achieved by increased pulse rate, and peripheral vascular constrictio→
- Sinusitis, ComplicatedSinusitis, complicated→
- Skin and Mucosal Disorders in HIVSkin and mucosal disorders are more severe in immune suppressed (HIV-infected) patients and may be worsened by IRIS. HIV may present initially with skin or mucosal lesions, or these lesions may develop during the course of the illness. Lesions respond to antiretroviral therapy together with treatment for the specific skin and/or mucosal disorder. Skin eruptions or rashes are relatively common in→
- Snake Venom in the EyeDescription General measures Referral ICD-10 code: S05.9 + (X20.99) DESCRIPTION Direct or indirect snake venom exposure to the eye, particularly from various species of spitting cobras and rinkhals, can cause chemical injury with varying clinical presentations ranging from periocular swelling and mild conjunctival and corneal inflammation to frank corneal ulceration and perforation with eve→
- SnakebiteDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T63.0 DESCRIPTION The effects of snakebites may be cytotoxic, neurotoxic and/or haemotoxic. The overall effect is determined by the predominant toxin in the snake venom. In the majority of cases, the species of snake is unknown. The patients can be divided into: no evidence of bite, no e→
- Special Considerations in HIV Infected Children & ThrombocytopeniaSpecial Considerations In HIV-Infected Children Thrombocytopenia Description Diagnostic criteria General and supportive measures Medicine treatment Referral SPECIAL CONSIDERATIONS IN HIV-INFECTED CHILDREN In addition to the usual causes of blood disorders in childhood, HIV-infected children are at increased risk of developing anaemia, thrombocytopenia and neutropenia secondary to drugs (esp→
- Spider BitesICD-10 code: T63.3 The vast majority of spiders are not harmful to humans. Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 18: Poisoning, 18.2 Envenomation, 18.2.5 Spider Bites Click here for Spider Bites, Neurotoxic (Button/Widow Spiders) Click here for Spider Bites, Necrotic Arachnidism→
- Spider Bites, Necrotic ArachnidismDescription Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: T63.3 DESCRIPTION Violin/recluse (Loxosceles) spiders and sac (Cheiracanthium) spiders can produce local necrotic skin lesions that are mediated by enzymes. DIAGNOSTIC CRITERIA Bites are initially painless. Skin lesions can vary from mildly erythematous lesions to severe local reaction, i.e. blis→
- Spider Bites, Neurotoxic (Button/Widow Spiders)Description Diagnostic criteria General and supportive measures Medicine treatment DESCRIPTION The term latrodectism is used to describe the systemic symptoms and signs following envenomation by the bite of the Latrodectus species (button or widow spiders). Most cases are caused by the bite of a black button spider; brown button spider bites are usually milder and characterized by local sym→
- Spinal Cord Compression - Paediatric Palliative CareDescription General and supportive measures Medicine treatment Referral DESCRIPTION Loss of neurological function in limbs (usually lower) caused by spinal compression from tumour or other disease process. Should be managed as an emergency in an attempt to delay complete loss of function for as long as possible. Caused in children by intramedullary or intradural metastases or extradural compressi→
- Staphylococcal Scalded Skin SyndromeDescription General and supportive measures Medicine treatment Referral ICD-10 Code: L00 DESCRIPTION Blistering skin condition that presents like scalded skin. GENERAL AND SUPPORTIVE MEASURES Appropriate wound care. MEDICINE TREATMENT Cloxacillin, IV, 50 mg/kg/dose 6 hourly for 5 days. Neonates: Week 1–2 of age: administer 12 hour→
- Staphylococcal SepticaemiaDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A41.2 DESCRIPTION Staphylococci cause disease by direct invasion of tissues with liberation of toxins. Septicaemia may occur when haematogenous dissemination occurs from a focus of infection. DIAGNOSTIC CRITERIA Clinical Features of septicaemia should raise an index of suspicion o→
- Status EpilepticusStatus Epilepticus (Convulsive)→
- Stevens-Johnson Syndrome (SJS)/ Toxic Epidermal Necrosis (TEN)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10: L51.1 / L51.2 DESCRIPTION Life-threatening, acute hypersensitivity reaction with systemic upset, epidermal necrosis, and mucous membrane involvement. TEN and SJS are different ends of the same spectrum: in TEN, epidermal necrosis involves > 30% of body surface area, while in SJS the i→
- Stimulant/Methaqualone (Mandrax)/Cannabis WithdrawalStimulant/Methaqualone (Mandrax)/Cannabis Withdrawl→
- StrabismusDescription Diagnostic criteria Referral ICD-10 code: H50.9 DESCRIPTION Strabismus (squint) is a misalignment of the two eyes. A non-paralytic squint (concomitant strabismus): will not have restrictions of ocular movements in any of the eye positions. A paralytic squint (incomitant strabismus): will have a restriction in one or more of the six cardinal eye positions. Consider cranial→
- Substance Use DisorderSubstance use Disorder→
- Substance WithdrawalSubstance Withdrawal→
- Substance-Induced Mood DisorderSubstanced-Induced Mood Disorder→
- Substanced-Induced Psychotic DisorderSubstanced-Induced Psychotic Disorder→
- Sulfonylurea PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T38.3 DESCRIPTION Sulfonylureas may cause severe and protracted hypoglycaemia. The half-life of the sulfonylureas varies: Glibenclamide: T 1/2 = 10 hours Gliclazide: T 1/2 = 10-12 hours Glimepiride: T 1/2 = 5-8 hours DIAGN→
- Surgical ProphylaxisDescription Principles of surgical prophylaxis Antibiotic prophylaxis Beta-lactam allergies DESCRIPTION Surgical prophylaxis is the pre- or intra-operative administration of antibiotics to patients to reduce the risk of postoperative wound infection. Specific epidemiological considerations may alter the choice of agents. PRINCIPLES OF SURGICAL PROPHYLAXIS The need for prophylactic antibiotic→
- Sydenham ChoreaSydenham Chorea→
- Sympathomimetic Agent PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 codes: T43.6/F14 DESCRIPTION Pseudoephedrine in decongestants, methylphenidate and illicit drugs such as cocaine and amphetamines ('Tik') are sympathomimetic agents. These agents are frequently abused as recreational drugs. DIAGNOSTIC CRITERIA Clinical hypertension, tachycardia, tachypno→