Guidelines
194 entriesNDOH Standard Treatment Guidelines and clinical protocols
- Diarrhoea, AcuteDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A09.0 DESCRIPTION Diarrhoea is a serious common childhood illness evidenced by the passing of frequent profuse loose watery stools. Vomiting may or may not be present. Diarrhoeal disease is often caused by viral infection but may be due to bacterial infection, dietary or other causes. DePEML (Paeds)→
- Diarrhoea, Acute Non-InflammatoryDescription General Measures Medicine Treatment ICD-10 code: A04.1 DESCRIPTION Diarrhoea without macroscopic blood or mucus, or neutrophils on microscopy. Common causes include viruses and enterotoxigenic strains of E. coli. Note: Neutropenic patients may have inflammatory diarrhoea in the absence of neutrophils. GENERAL MEASURES Rehydration is the cornerstone of management. This should be done wEML (Adult)→
- Diarrhoea, Acute in ChildrenDescription General Measures Medicine Treatment Referral CAUTION There is no place for anti-diarrhoeal preparations in the treatment of acute diarrhoea in children or in dysentery. ICD-10 code: A09.0/A09.9 DESCRIPTION A sudden onset of increased frequency of stools that are looser than normal, with or without vomiting. Commonly caused by a virus but may be caused by bacteria or parasites. The cauPrimary Care→
- Diarrhoea, Acute, Without Blood, in AdultsDescription Medicine Treatment Referral ICD-10 code: A09.0/A09.9/K52.2/K52.8/K52.9 DESCRIPTION Acute diarrhoea is usually self-limiting and is managed by fluid replacement. MEDICINE TREATMENT Treat dehydration vigorously: Oral rehydration solution (ORS). OR Homemade sugar and salt solution (SSS). Homemade sugar and salt solution (SSS) ½ level medicine measure of table salt plus 8 level mediPrimary Care→
- Diarrhoea, Chronic Other Than Post InfectiousDescription Diagnostic criteria Referral ICD-10 code: K52.9 DESCRIPTION Chronic diarrhoea: diarrhoea for longer than two weeks. Chronic diarrhoea results in significant morbidity and mortality associated with poor nutrition. Chronic diarrhoea is most frequently due to: Temporary loss of disaccharidase activity in the intestinal microvillous brush border, e.g. lactase loss; or luPEML (Paeds)→
- Diarrhoea, Chronic, in AdultsDescription General Measures Medicine Treatment Referral ICD-10 code: A07.1/A09.0/A09.9/K52.2/K52.8/K52.9 DESCRIPTION Defined as diarrhoea lasting > 4 weeks. LoE:IVb 12 GENERAL MEASURES Encourage HIV testing: Most cases are likely to be HIV related. Send a stool sample for microscopy for ova, cysts and parasites. Do not request culture and sensitivity of the stool sample. Giardiasis isPrimary Care→
- Diarrhoea, HIV-AssociatedDescription Medicine Treatment Referral B20.8 + (A07.2-3) DESCRIPTION Diarrhoea that persists for > 2 weeks. Often associated with wasting. Diarrhoea persisting for 4 weeks is a WHO stage 3 condition (if there is weight loss or fever it is stage 4). Send stool sample to look for ova, cysts and parasites in all cases. Note: A negative stool specimen does not exclude Cryptosporidium . If CryptosPrimary Care→
- Diarrhoea, Persistent in ChildrenDescription General Measures Medicine Treatment Referral ICD-10 code: A09.0/A09.9/K52.2/K52.8/K52.9 DESCRIPTION Diarrhoea for 7–14 days. GENERAL MEASURES Assess for possible HIV infection and manage appropriately (See: Antiretroviral therapy, Adults ). Prevent dehydration using homemade sugar and salt solution. Counsel mother regarding feeding. If breastfeeding, give more frequent, longer feeds.Primary Care→
- Diazepam (Age 2 up to 5 years)IMCI - Child (Age 2 months up to 5 years)IMCI→
- Differential DiagnosisThis booklet is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.Other→
- Differential Diagnosis of a Pelvic MassThis booklet is intended as a practical guide to patient care for registrars, medical officers, interns and medical students attached to the gynaecology units at the University of the Witwatersrand Academic Hospitals. Anyone can use it.Other→
- Difficult Mask Ventilation (MV)During routine induction of anaesthesia in a child aged 1 - 8 yearsOther→
- Dilated CardiomyopathyDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: I42.0 DESCRIPTION Dilated cardiomyopathy is a clinical diagnosis characterised by dilation and impaired contraction of the left or both ventricles that is not explained by abnormal loading conditions. It is difficult and sometimes impossible to distinguish myocarditis from dilated cardioPEML (Paeds)→
- DiphtheriaDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A36.9 * Notifiable condition Telephone Hotline NICD hotline (24 hours) 082 883 9920 National Institute of Communicable Diseases 011 555 0327 or 011 555 0352 DESCRIPTION Diphtheria is an acute, communicable infection of the upper respiratory tract, caused by Corynebacterium diphtheriae .PEML (Paeds)→
- Diphtheria and tetanus vaccinesDiphtheria and tetanus vaccinesOther→
- Disadvantages of Continuous Subcutaneous Insulin InfusionDisadvantages of Continuous Subcutaneous Insulin InfusionOther→
- Disaster Management/Evacuation PlanDistrict level hospital guidelines applicable for interns and comm service doctors. Published in 2016Other→
- Discharge ChecklistClick on the image to enlarge. Click here for the pdf . Angels Initiative South Africa _ Treating Doctor_Stroke patient acute treatment forms_2024Other→
- Discharge ChecklistClick on the image to enlarge. Click here for the pdf . Angels Initiative South Africa _ Stroke Physician Discharge Checklist_2024Other→
- Discharge ProcessTo provide a guideline on discharge planning for doctors, nurses and bed managersOther→
- Disclaimer and Process Disclaimer Process Disclaimer These guidelines do not purport to provide a comprehensive review of all the literature pertinent to attention-deficit/hyperactivity disorder (ADHD) but aim to provide a set of diagnostic and treatment guidelines relevant to the South African context. They should be utilised in conjunction with other international guidelines. It remains the responsibility of pOther→
- Discontinuation Symptoms of Serotonin Reuptake InhibitorsICD-10 code: F19.3 + (Y49.2) Discontinuation symptoms are experienced due to receptor adaptation or receptor rebound after stopping of antidepressants. It can be avoided or reduced by slowly tapering the drug over at least 4 weeks. Symptoms include flu-like symptoms, ‘shock-like” sensations, dizziness exacerbated by movement, insomnia, vivid dreaming and irritability, problems with concentrEML (Adult)→
- Disease Course and Expectations, Suctioning & Awake ProningCOVID-19 Rapid Review, Tuesday, 07 April 2020Other→
- Disease Notification ProceduresDisease Notification ProceduresPrimary Care→
- Disease Notification ProceduresStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Disorders of PubertyDisorders of PubertyPEML (Paeds)→
- Disorders of Sex Development (DSD)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 Code: Q52.9/Q55.9 DESCRIPTION The current terminology for neonates or children presenting with incomplete differentiation of the external genitalia is “disorder of sexual development”. DIAGNOSTIC CRITERIA Clinical DSDs present with one or more of the following: varying degrees of hypospadias, maldesPEML (Paeds)→
- Disruptive Mood Dysregulation Disorder (DMDD)Disruptive Mood Dysregulation Disorder (DMDD)PEML (Paeds)→
- Disseminated Intravascular CoagulationDescription Diagnostic criteria Medicine management Referral ICD-10 code: D65 DESCRIPTION Complication of an underlying condition, e.g. severe sepsis that is characterized by widespread activation of the clotting cascade leading to consumption of platelets and clotting factors with generalized bleeding. DIAGNOSTIC CRITERIA Investigations Prolonged INR and PTT. Thrombocytopaenia. Decreased fPEML (Paeds)→
- Distributive ShockNeurogenic shock Septic shock This happens when the blood vessels are abnormally dilated and presents with a low blood pressure, tachycardia and warm peripheries. There are 3 causes of this type of shock: neurogenic shock, septic shock, and anaphylactic shock (see Anaphylaxis/anaphylactic shock ). NEUROGENIC SHOCK ICD-10 code: T09.3 + R57.8 DESCRIPTION Occurs in spinal cord trauma when there is aEML (Adult)→
- DiverticulosisDescription General Measures Medicine Treatment Referral ICD-10 code: K57.0-5/K57.8-9 DESCRIPTION Colonic diverticulosis becomes increasingly common with age. Acute diverticulitis is suspected in patients with lower abdominal pain (typically in the left lower quadrant). The pain is usually constant and is often present for several days prior to presentation. Nausea and vomiting are often presentEML (Adult)→
- Doctor Clinical Decision ProtocolClick on the image to enlarge. Click here for the pdf . Angels Initiative South Africa _ Treating Doctor_Stroke patient acute treatment forms_2024Other→
- Documentation Required for Procedural Sedation and AnalgesiaBefore sedation During sedation During recovery Other Accurate documentation is crucial to protect the SP in case of legal challenges. If it was not written down, it never happened. Before sedation Documentation before sedation is aimed at obtaining information about the child, as well as providing information to the parent/caregiver. Recorded information should include the following: Valid inforOther→
- Does BCG vaccination offer any protection against COVID-19?COVID-19 Rapid Review, Thursday, 09 April 2020Other→
- Dolutegravir (DTG) in Pregnancy and Safe Conception in WomenBenefits of Dolutegavir Switching existing clients to DTG-Containing Regimens BENEFITS OF DOLUTEGRAVIR 16 Superior Efficacy Side-effects are mild and uncommon High genetic barrier to resistance Cost effective Small tablet No interaction with hormonal contraceptives Can be used with TB treatment if boosted Evolving evidence has found there to be no significant difference in neural tube defect (NTDOther→
- Dolutegravir Overview & Drug InteractionsClass of ARV Benefits Formulations Standard Dose DTG dose with concomitant rifampicin-containing TB treatment Side Effects Drug Interactions with Dolutegravir Class of ARV: Integrase Inhibitor (InSTI) Benefits: DTG is a potent antiretroviral that provides rapid viral suppression, has a high genetic barrier to resistance, and has minimal side effects and drug interactions. It is well tOther→
- Donation after Circulatory DeathDonation after circulatory deathOther→
- Dosing Charts for Prophylaxis for the HIV-Exposed InfantSummary of Infant Prophylaxis Regimens Dosing Charts for Infant HIV Prophylaxis in Infants > 2000 g Dosing Charts for Infant HIV Prophylaxis in Preterm Infants < 2000 g Dosing Chart for Intravenous (IV) AZT Prophylaxis Summary of Infant Prophylaxis Regimens Risk Profile NVP AZT At birth (following maternal delivery VL review) Low-risk, whether breastfed or formula-fed 6 weeks Stop AZOther→
- Dosing Schedule of Simple AnalgesicsDosing schedule of simple analgesicsOther→
- Dosing for Isoniazid Preventative Therapy (IPT) in ChildrenDosing for Isoniazid Preventative Therapy (IPT) in ChildrenOther→
- Drug AllergiesDescription Classification Diagnosis ICD-10 code: T88.7 DESCRIPTION Drug allergy is an immune-mediated reaction to the drug. Reactions are idiosyncratic and, unlike side effects, cannot be predicted by physiological action of the pharmaceutical agent. Common drugs involved include penicillin, sulphonamides, non-steroidal anti-inflammatory drugs, anticonvulsants, and chemotherapeutic agents. CLASSPEML (Paeds)→
- Drug FormularyNational Neonatal Resuscitation GuidelinesOther→
- Drug Interaction with DolutegravirMedications for diabetes and epilepsy also have important drug interactions. Pregnant women with co-morbidities, e.g., diabetes or epilepsy are a high risk group who should be discussed with an expert/referred. INTERACTING DRUG EFFECT OF CO-ADMINISTRATION RECOMMENDATION Rifampicin ↓ Dolutegravir Increase DTG dose to 50 mg 12-hourly. If on TLD FDC, add DTG 50 mg 12 hours after TLD dose PolyvalentOther→
- Drug Listings: Enteral and ParenteralOpioids – mainly for severe pain Paracetamol Non-steroidal anti-inflammatory drugs for mild to moderate pain relief Approach to oral combination analgesics Local anaesthetics Bibliography Note: That while examples of generic drugs are listed below, the list should not be considered comprehensive. Drugs are regularly added and removed by pharmaceutical companies and the latest drug indices shouldOther→
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)Severe Cutaneous Adverse Drug ReactionsPrimary Care→
- Drug ReactionsGeneral and supportive measures Medicine treatment Referral ICD-10 code: L27.0 Commonly associated with: sulphur-containing agents, penicillin, antiepileptics (e.g. carbamazepine, lamotrigine), NSAIDs, anti-tuberculosis drugs, and non-nucleoside reverse transcriptase inhibitors. A variety of rashes may occur, including: erythema multiforme (see Erythema Multiforme ) urticarial eruptioPEML (Paeds)→
- Drug Resistant TB (DR-TB)ICD-10 code: U84.3 See the National Department of Health Clinical Reference Guide: Management of Rifampicin-Resistant Tuberculosis , 2019. Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 10: Tuberculosis, 10.7 Drug Resistant TB (DR-TB)PEML (Paeds)→
- Drug Review - Alpha Glucosidase Inhibitors (Acarbose)Alpha Glucosidase Inhibitors (Acarbose)Other→
- Drug Review - Dipeptidyl peptidase- 4 InhibitorsDrug review - Dipeptidyl peptidase-4 InhibitorsOther→
- Drug Review - GLP-1 Receptor AgonistsDrug Review - GLP-1 Receptor AgonistsOther→