Guidelines
212 entriesNDOH Standard Treatment Guidelines and clinical protocols
- References: ArthroplastyKakar PN, Roy PM, Pant V, Das J. Anesthesia for joint replacement surgery: Issues with coexisting diseases. J Anaesthesiol Clin Pharmacol. 2011;27(3):315-22. doi:10.4103/0970-9185.83673 Pabinger C, Geissler A. Utilization rates of hip arthroplasty in OECD countries. Osteoarthritis Cartilage. 2014;22(6):734-41. doi:10.1016/j.joca.2014.04.009 Anger M, Valovska T, Beloeil H, Lirk P, Joshi GP, Van deOther→
- References: Infection Control and Prevention1. Smith CM. Origin and uses of primum non nocere: above all, do no harm! J Clin Pharmacol. 2005;45(4):371-7. https://doi.org/10.1177/0091270004273680. 2. Brink A, Feldman C, Duse A, et al. Guideline for the management of nosocomial infections in South Africa. S Afr J Epidemiol Infect. 2006;21(3):152-60. https:// doi.org/10.1080/10158782.2006.11441269. 3. Recommendations for infection control forOther→
- References: South African Society of Anaesthesiologists (SASA) - Practice GuidelinesOrganisation of anaeasthesia services Anaesthesia equipment and anaesthetising facilities The preanaesthesia period The anaesthetic period: Records The postanaesthesia period Anaesthesia outside a hospital setting Appendix A: Governance Appendix F: Position statements Organisation of anaeasthesia services Afonso MA, Cadwell JB, Staffa SJ, Zurakowksi D, Vinson AE. Burnout rate and risk factors amoOther→
- Referral for ERCP with Gallstone DiseaseSurgical Emergencies - Referral for ERCP with Gallstone DiseaseOther→
- Referral of Cases to Forensic Pathology ServicesReferral of cases to Forensic Pathology ServicesOther→
- Referral of Deceased Patients for Potential Corneal DonationReferral of Deceased Patients for Potential Corneal DonationOther→
- Regional AnaesthesiaSee: SASRA guidelines Click here for the full pdf South African Society of Anaesthesiologists (SASA) Practice Guidelines_2022Other→
- Relapsed Psychotic PatientRelapsed Psychotic PatientOther→
- Renal CalculiUrologyPrimary Care→
- Renal CalculiStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Renal Dose Adjustments in AdultsDrug dosing for children with renal impairment should be discussed with experienced clinicians. The table below refers to adults. Drug Recommended dose and frequency for adults with creatinine clearance <30 ml/min or for patients receiving haemodialysis (unless otherwise indicated dose after dialysis) Bedaquiline No dosage adjustment is required in patients with mild to moderate renal impairmeOther→
- Renal SupportDescription General measures Description Acute kidney injury (AKI) in critical care is a complex, heterogenous clinical syndrome presenting with varying severities, trajectories, and outcomes. LoE: IVb xii See Acute Kidney Injury , for further details. Table 23.1: Staging/Severity of Acute Kidney Injury Stage Serum creatinine Urine output 1 1.5-1.9 times baseline OR ≥26.5 µmol/l (≥ 0.3 mg/dl) incEML (Adult)→
- Renally Adjusted Dosing of Amikacin in AdultsThe current recommended empiric antibiotic choices and empiric durations for suspected bacterial infections at CHBAH, based on consensus agreement between Infectious Diseases (ID), Microbiology and specialties after review of our 2018 antibiogram data, is as follows until directed therapy is possible.Other→
- Renally Adjusted Dosing of Vancomycin in AdultsThe current recommended empiric antibiotic choices and empiric durations for suspected bacterial infections at CHBAH, based on consensus agreement between Infectious Diseases (ID), Microbiology and specialties after review of our 2018 antibiogram data, is as follows until directed therapy is possible.Other→
- Replacement FeedsIMCI - Counsel the Mother or Caregiver on Infant and Young Child FeedingIMCI→
- Reporting SystemsDistrict level hospital guidelines applicable for interns and comm service doctors. Published in 2016Other→
- Rescue (XDR-TB) regimensIntroductory remarks Special considerations for persons on long regimens Introductory remarks Clients with RR-TB and suspected or confirmed resistance to linezolid, clofazimine, bedaquiline and pretomanid/delamanid need to be given a rescue regimen. All persons requiring treatment with a rescue regimen should have a specimen or sample sent for EDST. While awaiting the results of that DST, an empiOther→
- Research Approval ProcessDistrict level hospital guidelines applicable for interns and comm service doctors. Published in 2016Other→
- ResourcesRainbow Clinic for Abused Children, April 2020Other→
- Respiratory ConditionsFor Coronavirus Disease-19. See COVID-19: Coronavirus disease-19 . Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_07 November 2024 Chapter 22: Medicines Used in Palliative Care_22.4 Respiratory ConditionsPrimary Care→
- Respiratory ConditionsStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- 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 newbornPEML (Paeds)→
- Respiratory InfectionsSee Influenza See Acute bronchitis in adults or adolescents See Acute exacerbation of chronic obstructive pulmonary disease (COPD) See Pneumonia Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4-Version 1.0_16 September 2024 Chapter 17: Respiratory Conditions_17.3. Respiratory infectionsPrimary Care→
- 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 sucPEML (Paeds)→
- Respiratory SupportDescription General Measures Description The purpose of mechanical ventilation is to support the work of breathing, ensure adequate oxygenation, facilitate clearance of carbon dioxide, and minimise the trauma caused by ventilatory support. Indications for mechanical ventilation include: Hypoxaemic respiratory failure Excessive work of breathing: Inability to meet normal respiratory demands due toEML (Adult)→
- Respiratory SystemTiotropium, Glycopyrronium Montelukast ATC Code R03BB04/R03BB06 Medicine Long acting muscarinic antagonists (LAMA): Tiotropium, Glycopyrronium Indication Chronic Obstructive Pulmonary Disease (COPD) NEMLC Recommendation Not Approved Review Indicators Price Date Ratified 14 December 2017 ATC Code R03DC03 Medicine Montelukast Indication Chronic management of severe uncontrolled asthmaOther→
- Response to TreatmentVisual analogue scales (VAS) (visual aids 100 mm long with descriptors of severity on opposite ends) or AR control tests are increasingly used to evaluate control and treatment response, to detect adverse effects and to gauge the need for treatment adjustment in a reproducible manner. 72 Tests of control should be validated and quick and easy to perform in routine clinical practice. 73 ValidatedOther→
- ResultsThe results of the search are summarised in Fig. 1. The electronic search of the two databases yielded a total of 126 articles after duplicates were removed. A total of 78 unrelated articles were removed after title review. After abstract review and article screening, a further 41 articles were excluded (33 review articles, six reviews-of-guidelines type articles, and three articles that were guiOther→
- Results What is the status and capacity of ICU services in SA, including the public and private medical sectors? Are patients who could benefit from intensive care refused ICU admission because of a lack of beds/ facilities, in both the public and private sectors? Are ICU ‘substitutes’ (e.g. high-dependency unit (HDU), ward ventilation), which may not provide an equivalent level of care, acceptablOther→
- Resuscitation ProtocolSee resuscitation manual for more detail. See the resuscitation algorithm ( appendix ) and formulary for doses of resuscitation drugs. Virtually all babies should be offered resuscitation at birth; exceptions would include BW < 500g, previously diagnosed severe congenital abnormalities, macerated stillborns and neonates in which no fetal heart rate was detectable in the last hour pOther→
- 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 overviewPEML (Paeds)→
- 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 needsPEML (Paeds)→
- Retinitis, HIV CMVStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- 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 PrematurityPEML (Paeds)→
- 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 resPEML (Paeds)→
- Retinopathy of Prematurity ScreeningRetinopathy of Prematurity ScreeningOther→
- Rhesus IncompatibilityThe 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→
- Rheumatic Fever, AcuteRheumatic Fever, AcutePrimary Care→
- 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 disPEML (Paeds)→
- Rheumatic Heart DiseaseStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Rhinitis, Allergic, PersistentStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Rhinitis, Allergic/Allergic RhinosinusitisRhinitis, allergic/allergic rhinosinositisPEML (Paeds)→
- 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 daytPEML (Paeds)→
- RicketsRicketsOther→
- 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 developmentalPEML (Paeds)→
- Rifampicin-Resistant (RR), Pre-XDR and XDR Tuberculosis, in ChildrenTB, HIV and AIDSPrimary Care→
- Rifampicin-Resistant Tuberculosis (RR TB), in AdultsTB, HIV and AIDSPrimary Care→
- Ringworm and other TineasFungal Infections of the SkinPrimary Care→
- Risk Assessment and Management of Exposure of Health Care Workers in the Context of COVID-19Version 19 March 2020Other→
- Risk Factors in All Young Infants (Birth up to 2 months)IMCI - Young Infant (Birth up to 2 months)IMCI→