Guidelines
465 entriesNDOH Standard Treatment Guidelines and clinical protocols
- Acute MeningitisOverview Definition and Pathophysiology Clinical Presentation Differential Diagnosis Diagnostic Tests Management Medications Complications Patient Education References and Guidelines Notes for HCPs Clinical Highlights Recommended reads Field Triage Clinical Setting Condition Type Infectious Diseases Emergency ICU Acute Overview Condition Name: Acute Meningitis. ICD-10 Codes: - G00 = BacteriaOther→
- Acute MeningitisThis guideline aims to assist healthcare workers with antibiotic prescribing for common clinical syndromes in adult patients in South Africa, utilizing Local and International guidelines, key publications, and expert opinion.Other→
- Acute MeningitisMeningitisPrimary Care→
- Acute Neuropathic PainGeneral considerations Central neuropathic pain Peripheral neuropathic pain General management of acute neuropathic pain Pharmacological management of acute neuropathic pain Algorithm for the pharmacological management of acute neuropathic pain Acute herpetic neuralgia General considerations Owing to its severity and persistence (considered as chronic pain), neuropathic pain has a high morbidityOther→
- Acute Otitis ExternaAcute Otitis ExternaOther→
- Acute Otitis Media (Adults)Infection Acute otitis media (Adults) Brief outline/clinical setting Bulging tympanum and temperature >38 Antibiotics are recommended in recurrent episodes, neonates, immunocompromised, structural abnormalities, fever >38 or pain for >48 hours, day care attendees/ siblings thereof Aetiologies/organisms Viral (50%) , Strep Pneumoniae, Haemophilus Influenza, Moraxella catarrhalis Optimal aOther→
- 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 wiPEML (Paeds)→
- Acute PainPlease click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Primary_Healthcare_Chapter_20_Pain_with_supporting_NEMLC_Report_2025-9_Review_Version_1.0_(26_FePrimary Care→
- Acute Pain ManagementSee: Guidelines for the management of acute pain in specific scenarios 2022 Click here for the full pdf South African Society of Anaesthesiologists (SASA) Practice Guidelines_2022Other→
- Acute Pain Management in Elderly PatientsFactors affecting pain control in the elderly Measurement of pain Analgesic techniques in the elderly As a greater proportion of the population falls into the ‘elderly’ category (aged ≥ 65 years), more and more elderly patients are presenting for treatment of acute pain. Medical conditions which often lead to acute pain are more likely in older adults. These conditions include the followinOther→
- Acute PancreatitisSurgical Emergencies - Acute PancreatitisOther→
- Acute Post Strep GlomerulonephritisAcute Post Strep GlomerulonephritisOther→
- Acute Renal FailureAcute Renal FailureOther→
- Acute Respiratory Distress SyndromeOverview Definition and Pathophysiology Clinical Presentation Differential Diagnosis Diagnostic Tests Management Medications Complications Patient Education References and Guidelines Notes for HCPs Clinical Highlights Recommended Reads Field Triage Clinical Setting Condition Type Pulmonology Emergency ICU Acute Overview Condition Name: Acute Respiratory Distress Syndrome (ARDS) ICD-10 Code = J80Other→
- Acute Rheumatic FeverAcute Rheumatic FeverOther→
- Acute Severe AsthmaPaediatrics - Acute Severe AsthmaOther→
- Acute Severe HypertensionAcute Severe HypertensionOther→
- Acute Third Nerve PalsyAcute Third Nerve PalsyOther→
- Acute Upper Respiratory Tract InfectionThis guideline aims to assist healthcare workers with antibiotic prescribing for common clinical syndromes in adult patients in South Africa, utilizing Local and International guidelines, key publications, and expert opinion.Other→
- Acute Viral Laryngotracheobronchitis (Croup)Paediatrics - Acute Viral Laryngotracheobronchitis (Croup)Other→
- Acute and Transient Psychotic DisordersDescription General Measures Medicine Treatment Referral ICD-10 code: F23.0-F23.9/F24/F28/F29 + (F10.0-F19.9/R45.0-8/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8) Description Sudden onset of ≥ 1 psychotic symptoms (usually delusions, hallucinations, or disorganised thinking) which resolves spontaneously, usually within 1 month, with a full return to premorbid social or occupational functioning. StressfulPrimary Care→
- Adapted WHO Clinical StagingIMCI - Anti-retroviral therapy (ART)IMCI→
- Addendum 1: Charlson Comorbidity IndexThe Charlson Index was developed in 1987 and is based on 1-year mortality data from internal medicine patients admitted to a single New York Hospital. It was initially validated in a cohort of breast cancer patients. The index encompasses 19 medical conditions weighted 1–6 with total scores ranging from 0–37. In the development phase of the index, mortality for each disease was converted to a relOther→
- Addendum 2: Karnofsky Performance ScaleThe Karnofsky Performance Scale allows patients to be classified according to their functional impairment. This can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients. The lower the Karnofsky score, the worse the survival for most serious illnesses. KARNOFSKY PERFORMANCE STATUS SCALE DEFINITIONS RATING (%) CRITERIA Able to carry on normal acOther→
- Addendum 3: IPOS-RenalClick on the image to enlarge. Click on the image to enlarge. Click here for the pdf . Wearne, N., Krause, R., Davidson, B., and Brennan, F., 2020. Renal palliative and supportive care in South Africa – A consensus statement. African Journal of Nephrology , 23(1), pp.86-107. Other→
- Addendum 4: Useful Online ResourcesSA Hypertension Guidelines https://www.hypertension.org.za/guidelines Kidney Disease: Improving Global Outcomes CKD evaluation and management https://kdigo.org/guidelines/ckd-evaluation-and-management/ CKD and anaemia https://kdigo.org/guidelines/anemia-in-ckd/ Blood pressure and CKD https://kdigo.org/guidelines/blood-pressure-in-ckd/ Assessment Tools Edmonton Symptom Assessment System Revised ReOther→
- Additional InformationAdditional InformationOther→
- Additional InformationAdditional InformationEML (Adult)→
- AdministrationTransfusing an unidentified patient Monitoring for adverse events or reactions during transfusions Transferring blood with a patient Consensus Grade 19.1 The use of blood and blood products should be directed by established protocols. Yes B 19.2 The use of blood and blood products should be subjected to gatekeeping controls. Yes C Administering the wrong blood type in error (with the riskOther→
- Administration of Uterotonics after Caesarean Section(CHBAH, CMJAH, RMMCH) WITS, Feb 2017. For review: Feb 2018Other→
- Admission of a Woman in LabourThe guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.Other→
- 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 physicalPEML (Paeds)→
- 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 ofPEML (Paeds)→
- 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). AdrenalPEML (Paeds)→
- Adrenal InsufficiencyIntroduction Relative Adrenal Insufficiency Addisonian crisis Introduction See: Adrenal insufficiency (Addison Disease) . Relative Adrenal Insufficiency ICD-10 code: E27.4/E27.9 Description This is a transient, disproportionate reduction of glucocorticoids in relation to the severity of stress. Note that absolute cortisol levels may be normal. The prevalence of relative adrenal insufficiencEML (Adult)→
- Adrenal Insufficiency (Addison Disease)Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- 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 sPEML (Paeds)→
- Adult Sedation and Analgesia: DefinitionsSedation endpoints Continuum of PSA Non-dissociative sedation Dissociative sedation Sedation techniques Failed sedation Prolonged sedation Sedation is a drug-induced depression of consciousness, with a continuum varying from minimal sedation/anxiolysis, moderate sedation and analgesia, dissociative sedation, to deep sedation, and finally general anaesthesia as outlined below (Table 1). Table 1: TOther→
- Adult Sedation and Analgesia: Documentation Required for Procedural Sedation and AnalgesiaBefore sedation During sedation During recovery Other Accurate documentation of all sedation processes is an important tool in the hands of the sedation practitioner. Documentation is crucial to protect the sedation practitioner in case of legal challenges. If it was not written down, it never happened. Before sedation Documentation is aimed at gathering information from the patient, as well as gOther→
- Adult Sedation and Analgesia: Drugs Used in Procedural Sedation & AnalgesiaTo access the PDF version of the guidelines on drugs used in procedural sedation and analgesia as outlined in the "Guidelines for the safe use of procedural sedation and analgesia for diagnostic and therapeutic procedures in adults: 2020–2025," please click on the link provided below: Drugs used in procedural sedation and analgesia South African Society of Anaesthesiologists (SASA) Guidelines forOther→
- Adult Sedation and Analgesia: Foreword and AcknowledgementsForeword Acknowledgements Foreword to the 2020–2025 edition of the SASA Guidelines for the safe use of procedural sedation and analgesia for diagnostic and therapeutic procedures in adultsForeword to the 2020–2025 edition of the SASA Guidelines for the safe use of procedural sedation and analgesia for diagnostic and therapeutic procedures in adults Writing guidelines on procedural sedation and anOther→
- Adult Sedation and Analgesia: IntroductionSedation as a means to facilitate challenging or painful procedures, or as a safe, cost-effective and time-saving alternative to general anaesthesia, is a popular addition to modern medical care. These guidelines are compiled to ensure safe Procedural Sedation Analgesia (PSA) for adult patients. They are intended for use by all medical practitioners and their teams, who participate in sedation foOther→
- Adult Sedation and Analgesia: PersonnelThe sedation practitioner (SP) Observer and ancillary personnel Personnel requirements for each sedation endpoint Personnel requirements for sedation for adults with special needs Whenever a sedation is performed, there should be no less than two people present, i.e. the operator, performing the procedure, and an appropriately trained observer. If the operator also provides the sedation for the pOther→
- Adult Sedation and Analgesia: Preparation for SedationEnvironment and clinical setting Valid informed consent to sedation and analgesia for medical/dental procedures (Appendix 3) Patient assessment Guidelines for fasting Environment and clinical setting Sedation practitioners must understand the limitations of working in the relative isolation of the out-of-hospital setting. The premises and supporting facilities where sedation is performed, must meOther→
- Adult Sedation and Analgesia: ReferencesPractice Guidelines for Moderate Procedural Sedation and Analgesia 2018. A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. AnestOther→
- Adult Sedation and Analgesia: Safe Sedation PracticePrinciples of safe sedation practice Pearls and pitfalls of safe sedation practice Sedation techniques need to be adjusted in the following groups Recovery It is beyond the scope of these Guidelines to review any specific sedation techniques in detail. These should be addressed by supervised clinical training. A variety of sedation techniques are available, and practitioners may offer a comOther→
- Adult Sedation and Analgesia: Standards of MonitoringThe principles of monitoring are described by the Academy of Medical Royal Colleges in Safe Sedation Practice for Healthcare Procedures . 5 All the members of the sedation team must have a detailed knowledge of the monitoring equipment and interpretation of the information provided by the monitors. Both clinical monitoring and electronic monitoring must be used. The sedation technique used,Other→
- Adult VaccinationRabies vaccination Note: As COVID vaccination recommendations are being updated regularly as new evidence emerges, please consult the latest National Department of Health vaccine policy recommendations. Vaccine Indications Comments Influenza vaccine Z25.1 - Pregnant women. - Elderly patients >65 years. - HIV-infected patients. - Patients with chronic pulmonary or cardiac conditiEML (Adult)→
- Adult, Adolescent and Older Child ContactsTPT should be offered to TPT should be deferred or not offered if the individual Management of TPT in adult, adolescent, and older child (weighing more than 25 kilograms) contacts This group of potential TPT patients were previously called “household contacts”. Significant TB exposure can however occur both within and outside the household. Therefore, the term “household contact” is confusing andOther→
- Advanced Cardiac Arrest Algorithm - Adult & PaediatricAdvanced Cardiac Arrest AlgorithmOther→