Guidelines

223 entries

NDOH Standard Treatment Guidelines and clinical protocols

Substance Use DisordersDescription General Measures Medicine Treatment Referral ICD-10 code: F10.0-F19.9 + (R40-R46/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8) Consult National Policy guidelines on detoxification of psychoactive substances. Description Substance use disorder consists of mental and physical symptoms caused by the use of one or more substances, despite significant substance-related problems (including abuPrimary Care→
Substance Use DisordersDescription General Measures Referral Alcohol withdrawal Alcohol withdrawal delirium (delirium tremens) Opiate (e.g. heroin, unga, whoonga, nyaope) withdrawal Stimulant withdrawal, including cocaine and amphetamine type stimulants (e.g. methamphetamine/ tik, methcathinone/ cat Methaqualone (mandrax/whitepipe) withdrawal Cannabis withdrawal Benzodiazepine withdrawal Description Substance misuse isEML (Adult)→
Substance WithdrawalSubstance WithdrawalPEML (Paeds)→
Substance-Induced Mood DisorderSubstanced-Induced Mood DisorderPEML (Paeds)→
Substance-Induced Mood DisordersSubstance Related DisordersPrimary Care→
Substance-Induced PsychosisDescription General Measures Medicine Treatment Referral ICD-10 code: F10.0-F19.9 + (R40-R46/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8) Description Psychosis secondary to a substance use or withdrawal such as abuse of alcohol, drugs, e.g. cannabis and methamphetamines. General Measures Most patients with substance-induced psychosis can be managed without medication. Ensure the safety of the patiePrimary Care→
Substanced-Induced Psychotic DisorderSubstanced-Induced Psychotic DisorderPEML (Paeds)→
Sudden Onset WeaknessSudden Onset WeaknessOther→
Sudden Painless Loss of VisionSudden Painless Loss of VisionOther→
Suicide Risk AssessmentDescription General Measures Referral ICD-10 code: R45.8/X60-X84/Z91.5 + (Z81.8) Description Suicide is the act of deliberately killing oneself. Self-harm refers to intentionally self-inflicting injury or poisoning, which may or may not have a fatal intent or outcome. Suicide risk assessment is a process of estimating the probability for a person to commit suicide. There are 5 important componentPrimary Care→
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 DIAGNPEML (Paeds)→
SummaryAttention-deficit/hyperactivity disorder is a common neurodevelopmental disorder of childhood, persisting across the lifespan. It is associated with significant morbidity and economic burden. A comprehensive diagnostic assessment and diagnostic certainty prior to initiating drug treatment are crucial. Effective treatments are available, leading to a significant reduction in impairment and improveOther→
SummaryThis guideline provides an overview of the recommended Adult ADHD assessment steps, differentials to be considered and options for treatment according to the best available evidence based guidelines.Other→
SummaryPurpose Recommendations Conclusion In South Africa (SA), intensive care is faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, and practitioners in low- to middle-income countries experience daily the consequences of limited resources. Critically limited resources necessitate that rationing and triage (pOther→
Summary -Oral Healthcare Facility Preparedness Post- Lockdown MeasuresSADA COVID-19 Guidelines, May 2020Other→
Summary Points Pertaining to the Management of axSpAEarly diagnosis and prompt treatment initiation are essential in the management of axSpA, using the ASAS classification criteria as a reference. Both under-diagnosis and over-diagnosis are prevalent. Management by a rheumatologist-led multidisciplinary team should include pharmacological therapy, physical activity and referral to a patient support organisation. The goal of therapy is to achieve rOther→
Summary Points for the Management of Peripheral SpADisease activity is measured with the global assessment of PsA, MDA or VLDA, and the goal is MDA or VLDA, or DAPSA if peripheral arthritis, with a goal of low disease activity. A treat-to-target approach should be used, with frequent assessments and escalation or switching of therapy until the goal is achieved. Screening and management of comorbidities are essential, and a holistic approach withOther→
Summary Practice GuidelinesAssess GFR using the CKD-EPI equation. A calculator for estimating GFR can be found at http://www.kidney.org/professionals/kdoqi/gfr.cfm . This is also available as a smartphone app Refer to a nephrologist when GFR <60 ml/min An AV fistula should be fashioned when the GFR <25ml/min Start HD when GFR is 5-10 ml/min or if symptomatic Adequacy targets for HD: Kt/V >1.2 or URR &gtOther→
Summary of Changes: Version 1.411. Summary of Changes: Version 1.4 Summary of changes Click on table to enlarge Influenza: NICD recommendations for the diagnosis, management, prevention and public health response, National institute of communicable diseases, 2021 Other→
Summary of Content: Antimicrobial Prophylaxis for Surgical ProceduresTable III: Altemeier classification of surgical wounds Procedures that need antibiotic prophylaxis Choice of prophylactic antibiotics Timing of prophylactic antibiotics Duration of prophylactic antibiotic therapy Table III: Altemeier classification of surgical wounds Class I: Clean SSI risk < 1% Sterile area of body. Skin intact before surgical incision. Surgery does not involve opening of gasOther→
Summary of Content: Chain of Infection How microorganisms spread Table I: Modes of transmission How microorganisms spread The chain of infection consists of six links and the healthcare worker’s role (among others) is to prevent or stop the spread of infections by breaking the chain. Causative agent Examples of causative agents are bacteria, viruses, fungi, and protozoa. They are very common in our environment, and most of themOther→
Summary of Content: Environmental Considerations in Infection Control and PreventionOperating theatre ventilation Forced-air warmers Operating theatre temperature and humidity Environmental cleaning of the operating theatre Surgical attire Please refer to the relevant IUSS guidelines that can be found at www.iussonline.co.za as well as the SASA website. Operating theatre ventilation Every operating theatre complex requires effective central humidity ventilation and air-conditionOther→
Summary of Content: General Principles of Infection ControlGeneral principles A senior member of the anaesthesia staff should be appointed at each hospital to liaise with the infection control team to ensure compliance with best practice standards in infection control in all areas of anaesthetic practice. There must be regular training of healthcare workers in infection control practices. This training must be coupled with monitoring and regular auditingOther→
Summary of Content: Infection Control Precautions for the Infectious PatientModes of transmission Type of precautions Healthcare workers donning of PPE Healthcare workers doffing of PPE Non-emergency cases should be postponed until the patient is deemed to no longer be infectious. Precautions should be based on the mode of transmission of the specific microorganism. Modes of transmission Direct contact Physical contact with patient and body fluid, soil or vegetation. DroOther→
Summary of Content: Infection Control Recommendations for Regional AnaesthesiaCentral neuraxial techniques Peripheral nerve blocks Use of ultrasound Central neuraxial techniques In a patient with known or suspected bacteraemia, prophylactic pre-procedural antibiotic therapy should be considered. Aseptic techniques must be applied during preparation of equipment. A caudal anaesthetic is considered to be a neuraxial technique as the caudal space is a continuation of the epidOther→
Summary of Content: LaryngoscopesLaryngoscope blades Laryngoscope handles Magill forceps Nasopharyngeal and rectal temperature probe Suction bowl Suction tube Oropharyngeal airways Bougies, and intubation guides and stylets Breathing filters and breathing circuits Bag valve mask resuscitators Supraglottic devices Storage of semi-critical items Non-critical medical equipment surfaces Disposable devices Trans-oesophageal echocardiOther→
Summary of Content: Prevention of Intravascular Catheter-Related Bloodstream Infection (CRBSI)Placement of central venous catheters Sterile technique for the placement and securing of central venous catheters Catheter dressing and site management Use of catheters and dressings that have associated antimicrobial activity Management of lines and administration sets Placement of peripheral catheters Placement of arterial lines Placement of central venous catheters The subclavian site is prefOther→
Summary of Content: Safe Injection Practices and Preventing the Contamination of Medication and FluidsNeedles and syringes Infusions, administration sets or items in contact with the vascular system or other sterile body compartments Hand hygiene guidelines Anaesthetic equipment decontamination Needles and syringes Needles and syringes are sterile items, intended for singlepatient use only. A syringe and needle should be considered to be contaminated after contact with a patient, infusion bag orOther→
Summary of Meta-Analyses and Systematic Reviews Comparing Rapid-Acting insulin Analogues to Short-Acting Regular Human InsulinSummary of Meta-Analyses and Systematic Reviews Comparing Rapid-Acting insulin Analogues to Short-Acting Regular Human InsulinOther→
Summary of RecommendationsGrading of recommendations Each recommendation has been given a grade, using the following definitions, set by the Australian National Health and Medical Research Council (NHMRC) (Boxes 1 and 2). Box 1. Grading of recommendations Grade A Body of evidence can be trusted to guide practice. Grade B Body of evidence can be trusted to guide practice in most situations. Grade C Body of evidence provideOther→
Summary of RecommendationsGeneral perioperative measures and management General PBM statements and measures PBM measures for patients expected to bleed significantly during surgery General perioperative measures and management Major haemorrhage – initial resuscitation Major haemorrhage – protocol Critical care Obstetrics Paediatrics Trauma Cardiac surgery Predicting perioperative bleeding Management of preoperative anticoOther→
Summary of What's New in the 2023 Guideline for Vertical Transmission Prevention of Communicable InfectionsClick on the image to enlarge. Click here for the pdf . South African National Department of Health, Guideline for VerticalTransmission Prevention of Communicable Infections, Version 2_August 2023Other→
Summary of the Care Continuum for Clients 5 years of age and older on ARTClients on ART can be differentiated into those who are: Clinically well and adherent on ART and Those who are clinically non-stable and/or struggling with adherence. Clients that are clinically well at their first clinical review one month after starting ART, only need to be seen again 2 months later for clinical review and their first viral load and serum creatinine. After that, taking treatmenOther→
Summary pointsSummary pointsOther→
Summary pointsThese are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.Other→
Summary pointsThese are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.Other→
Summary pointsThese are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.Other→
Summary pointsThese are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.Other→
Summary pointsThese are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.Other→
Summary pointsThese are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.Other→
Summary pointsThese are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.Other→
Summary, Authors, Affiliations & AcknowledgementsBackground Methods Results Conclusion Contribution Keywords Authors Affiliations Acknowledgements Background Allergic rhinitis (AR) has a significant impact on the community as a whole with regard to quality of life and its relationship to allergic multi-morbidities. Appropriate diagnosis, treatment and review of the efficacy of interventions can ameliorate these effects. Yet, the importance of AOther→
Summary, Objectives and Position Statement DevelopmentSummary Asthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support optimal care. The South African Thoracic Society (SATS) first published a guidelineOther→
Summary: SEMDSA Algorithm for the Management of Type 2 DiabetesSEMDSA Algorithm for the Management of Type 2 DiabetesOther→
Summary: Vaccination guidelines for HIV-infected adolescents & AdultsVaccination guidelines for HIV-infected adolescents & AdultsOther→
Superior Vena Cava ObstructionAn approach to symptom management to guide decision-making in the management of patients with life-threatening illnessOther→
Suppression of Labour for Foetal DistressStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 EditionEML (Adult)→
Suprapubic Urine CollectionManagement guidelines for students, interns and registrars on a variety of routine and emergency situations in our neonatal service at Tygerberg Children’s Hospital. Published in 2014.Other→
Surgery for Ectopic PregnancyThis 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→
Surgical & Other Treatment OptionsManagement options depend on the presumed diagnosis, and on the patient’s wishes regarding pregnancy Medication Drug treatment may be given for at least 3 months, and the patient may be reviewed after that, to continue or to stop treatment. • Tranexamic acid (Cyclokapron) 0.5 to 1 g orally 3 times daily for the first 3 days of bleeding. Can reduce regular heavy bleeding by 50%. Useful for acute bleeding and long term. Does not make irregular bleeding regular. Do not prescribe in patients with a history of thromboembolism. Injectable Medroxyprogesterone acetate (Depo-Provera) 150 mg IM every 3 months, Norethisterone ethanoate(Nur-isterate) 200mg; useful for acute bleeding and long-term. At first, bleeding may be irregular, if this happens add 4 weeks of Norethisterone (Primolut) 10 mg orally twice daily. Reduce bleeding by 95-100%. Progestogens may cause slight weight gain, feeling of heaviness, oily skin, mood changes and rarely headache • Medroxyprogesterone acetate (Provera) 5 mg orally twice daily for 21-28 days per month (never only 5-14 days: has no effect) • Norethisterone (Primolut) 10 mg orally twice daily or 5 mg orally 3 times daily for 21-28 days per month (not 5-14 days, as the package insert suggests – this is ineffective); useful when bleeding is irregular • Combined oral contraceptives. They also reduce dysmenorrhea and provide contraception. Beware of contraindications. Decrease bleeding up to 50%. • Nonsteroidal anti-inflammatory drugs such as Ibuprofen 400 mg orally 3 times daily, mefenamic acid 500 mg orally 3 times daily, or naproxen 500 mg orally 3 times daily for the duration of bleeding. Useful for dysmenorrhea, but decrease bleeding variably 10-45%. Beware of contraindications – peptic ulceration, asthma, renal dysfunction • Levonorgestrel-containing intrauterine system (Mirena) is effective, not available at some public hospitals, irregular spotting may occur at first. Reduce bleeding 95-100%. • For prolonged bleeding following use of Depo Provera, or oral contraceptives, one can give conjugated oestrogen (Premarin) 0.625 mg daily for three weeks, after demonstrating a thin endometrium on ultrasoundOther→