Guidelines

465 entries

NDOH Standard Treatment Guidelines and clinical protocols

Antepartum HaemorrhageThe 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→
Anti-Cancer TreatmentsGeneral principles and management of cancer pain in adultsOther→
Anti-Infectives for Systemic UseFusidic acid Linezolid Ketoconazole Itraconazole Caspofungin/micafungin/anidulafungin Voriconazole (VCZ) Ribavirin Sofosbuvir-velpatasvir Intravenous Immunoglobulin (IVIG) Palivizumab ATC Code J01XC01 Medicine Fusidic acid Indication Treatment of staphylococcal infections, mainly involving bone and joints: - Methicillin-sensitive organisms, as alternative to cloxacillin or flucloxacOther→
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 antiparkinsoPEML (Paeds)→
Anticoagulant (Warfarin and Rodenticide Superwarfarin) PoisoningDescription General measures Medicine treatment T45.5 + (X44.99/X64.99/Y14.99) * Notifiable condition – rodenticide superwarfarin poisoning Poisoning from all pesticides (i.e. agricultural stock remedies) is a notifiable medical condition. Please visit https://nicd.ac.za/nmc-overview/notification -process for further information. DESCRIPTION Poisoning due to ingestion of warfarin and superwarfariEML (Adult)→
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 accidentPEML (Paeds)→
AnticoagulationThe 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→
Antifibrinolytic MedicationDescription Medicine Treatment Description Tranexamic acid is an antifibrinolytic agent that acts by inhibiting the activation of plasminogen, an enzyme responsible for fibrinolysis. Tranexamic acid may be considered in the following settings: Adjunctive medication in the prevention and treatment of bleeding. Where viscoelastic testing shows evidence of hyperfibrinolysis. Medicine Treatment SeverEML (Adult)→
Antimalarials (Age 2 months up to 5 years)IMCI - Child (Age 2 months up to 5 years)IMCI→
Antimicrobial MedicinesStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
Antimicrobial Prescribing GuidesAntimicrobial Prescribing GuidesOther→
Antimicrobial Prophylaxis for Surgical ProceduresAltemeier classification of surgical wounds Procedures that need antibiotic prophylaxis Choice of prophylactic antibiotics Timing of prophylactic antibiotics Duration of prophylactic antibiotic therapy Altemeier classification of surgical wounds 256 Class 1: Clean SSI risk < 1% Sterile area of body. Skin intact before surgical incision. Surgery does not involve opening of gastrointestinal, resOther→
Antimicrobial StewardshipAntimicrobial stewardship refers to a systematic approach to optimising the appropriate use of an antibiotic to improve patient outcome(s) and limit emergence of resistant pathogens, whilst ensuring patient safety. It is one arm of the national and international response to the increasing public health crisis of antibiotic resistance. A critical component is adequate infection control. AntibioticEML (Adult)→
Antineoplastic and Immunomodulating AgentsPlatinum coordination compounds, Taxanes, Doxorubicin Cyclophosphamide Chlorambucil Melphalan Ifosfamide Busulfan Temozolomide Bacille Calmette-Guerin (BCG) Dacarbazine Methotrexate Pemetrexed Mercaptopurine Thioguanine Fludarabine Cytarabine Topical 5 Fluorouracil Capecitabine Capecitabine plus Gemcitabine Fluorouracil Vinblastine Vincristine Vinorelbine Vinorelbine (IV) Vinorelbine (oral) DocetOther→
Antipruritics, including Antihistamines, Anaesthetics, etc.Dithranol Clobetasol 0.05% Isotretinoin Acitretin Imiquimod topical 5% ATC Code D05AC01 Medicine Dithranol Indication Psoriasis NEMLC Recommendation Not Approved Review Indicators - Availability of registered product - Evidence of efficacy Date Ratified 23 June 2022 ATC Code D07AD Medicine Very potent topical corticosteroid – Group IV: e.g. Clobetasol 0.05% Examples: CreaOther→
Antiretroviral Agents PoisoningDescription General measures Treatment T37.5 + (X44.99/X64.99/Y14.99) 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 acidotiEML (Adult)→
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 acidotiPEML (Paeds)→
Antiretroviral Drug Dosing Chart for Children 2012Antiretroviral Drug Dosing Chart for Children 2012Other→
Antiretroviral TherapyPlease 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 Adult Hospital Level Chapter 10: HIV_and_AIDS_with_supporting_NEMLC_Report_Reviews_2025-9-VersioEML (Adult)→
Antiretroviral Therapy, Adults and Adolescents (10-19 years old)Please 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 Health Care - PHC Chapter 11: Human Immunodeficiency Virus and Acquired Immune DeficiencPrimary Care→
Antiseptics and DisinfectantsDescription Disinfecting Surfaces Intact Skin Wounds and Mucous Membranes Articles and Instruments DESCRIPTION Disinfectants are used to kill micro-organisms on working surfaces and instruments, but cannot be relied on to destroy all micro-organisms. Antiseptics are used for reducing bacterial load on skin and mucous membranes. Disinfecting surfaces Guidelines for the use of disinfectants CleansiPrimary Care→
AnxietyAn approach to symptom management to guide decision-making in the management of patients with life-threatening illnessOther→
AnxietyNeuropsychiatric ConditionsPrimary Care→
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 anxietPEML (Paeds)→
Anxiety And Obsessive-Compulsive DisordersDescription General measures Medicine treatment Referral ICD-10 code: F40.0-2/F40.8-9/F41.0-3/F41.8-9/F42.0-9 + (F10.0-F19.9/R45.0-8/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8) Description Anxiety is an emotional response to a perceived or anticipated stress. It is diagnosed as a disorder when it is excessive or persistent and impacts daily functioning. Anxiety disorders often present with medically uneEML (Adult)→
Anxiety DisordersAnxiety DisordersPEML (Paeds)→
Anxiety DisordersDescription General measures Medicine treatment Referral ICD-10 code: F40.0-2/F40.8-9/F41.0-3/F41.8-9/F42.0-2 + (F10.0-F19.9/R42/R45.0-8/Z65.0-5/Z65.8-9/Z81.0-4/ Z81.8) Description Anxiety is an emotional response to an apparent stress. It is diagnosed as a disorder when it is excessive or persistent and impacts daily functioning. Anxiety disorders are associated with an increase in cigarette smoPrimary Care→
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 –PEML (Paeds)→
Aphthous Ulcers in HIV InfectionPlease 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 Health Care - PHC Chapter 11: Human Immunodeficiency Virus and Acquired Immune DeficiencPrimary Care→
Aphthous ulcersICD-10 code: K12.0 Description Medicine Treatment Referral DESCRIPTION Painful ulcers in the mouth, except the gums, hard palate and dorsum of the tongue. Minor ulcers (< 1 cm diameter) usually heal within 10 days. Major ulcers (> 1 cm diameter) are very painful, often very deep and persist. Major ulcers usually indicate advanced HIV infection. MEDICINE TREATMENT Minor aphthous ulcers: ChilPrimary Care→
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 tPEML (Paeds)→
AppendicesAppendix 1 - Phototherapy Appendix 2 - Exchange Transfusion Appendix 3 - Newborn Resuscitation Algorithm Appendix 1 - Phototherapy Click on the image to enlarge Click here for the pdf version of the image Appendix 2 - Exchange Transfusion Click on the image to enlarge Click on here fo the pdf version of the image Appendix 3 - Newborn Resuscitation Algorithm Click on the image to enlarge Click herOther→
AppendicitisDescription General Measures Medicine Treatment Referral ICD-10 code: K35.0-3/K35.8-9/K37 DESCRIPTION This is characterised by inflammation of the appendix, and usually requires urgent surgical intervention. Clinical features include: Sudden peri-umbilical pain often migrating to the right iliac fossa. Nausea and vomiting. Loss of appetite. Fever. Constipation or occasionally diarrhoea. Bloated aPrimary Care→
Appendix 10: Cover Letter to Parent/ CaregiverClick here for Appendix 10: Cover letter to parent/caregiver SASA Paediatric Guidelines for the Safe use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Children: 2021–2026Other→
Appendix 10: Cover Letter to Patient/ Parent/ GuardianClick here for Appendix 10: Cover letter to patient/parent/guardian South African Society of Anaesthesiologists (SASA) Guidelines for the Safe Use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Adults: 2020–2025Other→
Appendix 11: Pre-Procedural ChecklistClick here for Appendix 11: Pre-procedural checklist South African Society of Anaesthesiologists (SASA) Guidelines for the Safe Use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Adults: 2020–2025Other→
Appendix 11: Pre-Procedural ChecklistClick here for Appendix 11: Pre-procedural checklist SASA Paediatric Guidelines for the Safe use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Children: 2021–2026Other→
Appendix 12: Post-Sedation Monitoring Chart and Discharge Criteria QuestionnaireClick here for Appendix 12: Post-sedation monitoring chart and discharge criteria questionnaire South African Society of Anaesthesiologists (SASA) Guidelines for the Safe Use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Adults: 2020–2025Other→
Appendix 12: Post-Sedation Monitoring Flow ChartClick here for Appendix 12: Postsedation monitoring flow chart SASA Paediatric Guidelines for the Safe use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Children: 2021–2026Other→
Appendix 13: Discharge Scoring SystemClick here for Appendix 13: Discharge scoring systems SASA Paediatric Guidelines for the Safe use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Children: 2021–2026Other→
Appendix 13: Discharge Scoring SystemsClick here for Appendix 13: Discharge scoring systems South African Society of Anaesthesiologists (SASA) Guidelines for the Safe Use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Adults: 2020–2025Other→
Appendix 1: Basic Equipment and Drugs for Procedural Sedation and Analgesia in AdultsClick here for Appendix 1: Basic equipment and drugs for procedural sedation and analgesia in adults South African Society of Anaesthesiologists (SASA) Guidelines for the Safe Use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Adults: 2020–2025Other→
Appendix 1: Basic Equipment and Drugs for Procedural Sedation and Analgesia in ChildrenClick here for Appendix 1: Basic equipment and drugs for procedural sedation and analgesia in children SASA Paediatric Guidelines for the Safe use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Children: 2021–2026Other→
Appendix 1: Brief Pain InventoryThis guideline is endorsed by the following professional groups: Cape Pelvic Pain Society, PainSA, South African Rheumatism and Arthritis Association, and South African Society of Anaesthesiologists.Other→
Appendix 23.I: Management of VentilationInitiation of Ventilation Titration of Ventilation Weaning of Ventilation Initiation of Ventilation Once a patient has been intubated and is appropriately sedated, the ventilator is set as follows: Select the level of support: Assist-Control: Pressure Control or Volume Control The ventilator delivers the same breath during every inspiration, whether initiated by the ventilator or by the patient.EML (Adult)→
Appendix 23.II: Family Meeting FormClick on the image to enlarge Click here for the appendix pdf Click here for the circular Standard Treatment Guidelines and Essential Medicines List for South Africa Adult Hospital _Chapter 23: Adult Critical Care_NEMLC Medicine Recommendations Review Cycle_ 2020_2023EML (Adult)→
Appendix 2: Opioid Risk ToolThis guideline is endorsed by the following professional groups: Cape Pelvic Pain Society, PainSA, South African Rheumatism and Arthritis Association, and South African Society of Anaesthesiologists.Other→
Appendix 2: Practice Appraisal ProtocolClick here for Appendix 2: Practice appraisal protocol South African Society of Anaesthesiologists (SASA) Guidelines for the Safe Use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Adults: 2020–2025Other→
Appendix 2: Practice Appraisal Protocol for Paediatric SedationClick here for Appendix 2: Practice appraisal protocol for paediatric sedation SASA Paediatric Guidelines for the Safe use of Procedural Sedation and Analgesia for Diagnostic and Therapeutic Procedures in Children: 2021–2026Other→
Appendix 3: Sample Opioid AgreementThis guideline is endorsed by the following professional groups: Cape Pelvic Pain Society, PainSA, South African Rheumatism and Arthritis Association, and South African Society of Anaesthesiologists.Other→