Guidelines

176 entries

NDOH Standard Treatment Guidelines and clinical protocols

The HIV Exposed InfantDescription Management of HIV-Exposed Infants HIV Testing ICD-10 code: Z20.6 DESCRIPTION Infants and children born to mothers living with HIV until HIV infection in the infant or child is reliably excluded and the infant or child is no longer exposed through breastfeeding are defined as HIV-exposed. Transmission of HIV infection may occur during pregnancy, during delivery, or via breastfeedPEML (Paeds)→
The HIV Infected Infant/Child (< 10 Years)Description General and supportive measures Standardised national monitoring for infants & children with HIV Medicine treatment ART Regimens Recommended regimen in ART-naïve Neonates, Infants, Children 0 to < 10 years of age Switching existing clients to DTG-containing regimens Transition from ABC/3TC/LPV/r to DTG based regimens Switching children on PI-containing regimens to DTG regPEML (Paeds)→
The HIV Infected Neonate (< 1 Month of Age)Description Medicine treatment ICD-10 codes: B20-B24 DESCRIPTION Defined as an infant < 1 month of age, in whom HIV infection has been confirmed with two appropriate tests. For confirmation of HIV infection, see: Human immunodeficiency virus infections . MEDICINE TREATMENT This treatment protocol is meant as a guide, and there is allowance for flexibility after discussion withPEML (Paeds)→
The HIV-Exposed InfantPlease 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→
The Infant Of A Diabetic Mother (IDM)Description Diagnostic criteria General and supportive measures Medicine treatment Referral DESCRIPTION Infants born to a mother with established or newly diagnosed diabetes mellitus. The foetus will be exposed to high levels of insulin in utero if maternal glycaemic control is not achieved, with foetal pancreatic hypertrophy as an adaptive measure. The infant of a diabetic mother is at increasedPEML (Paeds)→
The Neurobiology of PainPostoperative pain Procedural pain Even extremely premature neonates are able to process and experience pain. Repeated painful stimuli experienced in the neonatal period have been associated with adverse longterm consequences, including poor cognitive outcomes. Neonates and infants are particularly vulnerable because of the plasticity of their nervous systems. Inhibitory descending pathwaysOther→
The New Ballard Maturational Score (Physical Maturity and Neuromuscular Maturity)Management 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→
The Normal PuerperiumThe 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→
The Painful Red EyeThe Painful Red EyeOther→
The Partogram: Alert & Action LinesThe 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→
The Physiology of Acute PainDefinitions Understanding nociceptive pathways Neurotransmitters Intracellular events Receptors and ligands Nociceptive pathways Receptors Autonomic nervous system Psychological aspects of acute pain The progression of acute to chronic pain Adverse effects of pain Definitions Pain is defined by the International Association for the Study of Pain (IASP) as an “unpleasant sensory and emotional expeOther→
The Postanaesthesia PeriodCare of patients recovering from anaesthesia Transfer from theatre to recovery room Guidelines for the handover of postoperative patients to the staff of the theatre recovery area Aldrete score Management and supervision Care of patients recovering from anaesthesia Recovery from anaesthesia must occur under appropriate supervision in an area designed for this purpose. This area should either be iOther→
The Preanaesthesia Period: Preoperative Anaesthesia ClinicIntroduction Value in health care has been described as quality divided by cost, where quality is the sum of patient outcomes and experience. A well-run preoperative anaesthesia clinic (PAC) offers many opportunities to improve the value of the care delivered to patients by reducing the associated costs and improving the quality of care, i.e., reduction in excessive preoperative testing, reductioOther→
The Preanaesthesia Period: Preoperative ConsultationClinical assessment Preoperative testing Consent and explanation Telephonic and electronic prescription of premedication drugs These standards apply to all patients who receive general or regional anaesthesia, sedation or monitored anaesthesia care. Under unusual circumstances, e.g., extreme emergencies, these standards may be modified. When this is the case, the circumstances must be documentedOther→
The Preanaesthesia Period: Preoperative FastingIn adults In children In adults The following fasting guidelines have been adopted from the Canadian Anesthesiologists’ Society, with permission: Fasting policies apply to all forms of anaesthesia, including sedation. Emergent or urgent procedures should be undertaken after considering the risk of delaying surgery vs the risk of aspiration of gastric contents. Pre-existing medical conditions likeOther→
The Rhesus Negative WomanStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 EditionEML (Adult)→
The Second Stage of 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→
The South African Dysphagia Screening ToolClick on the image to enlarge. Click here for the pdf . Angels Initiative South Africa _ Registered Nurse Stroke Patient Acute Treatment Form_2024Other→
The Ten Steps to Successful BreastfeedingAll Health Facilities must support mothers to breastfeed as a standard of care by implementing the following... Click here for the pdf . South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023Other→
The Third Stage of 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→
The Ultrasound Scan at 11-14 WeeksThe 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→
The Ultrasound Scan at 18-23 WeeksThe 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→
The Unconscious Obstetric PatientThe 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→
The eFAST Exam (Trauma)Summary of indications, technique and findings in clinician-performed, bedside ultrasound for traumatic injuries. Adapted from the Partners In Health Manual of Ultrasound for use by health care providers.Other→
Theophylline PoisoningTheophylline poisoningOther→
Theophylline PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T48.6 DESCRIPTION Agents such as aminophylline and caffeine have similar features in overdose. Sustained release preparations can cause prolonged toxicity. Toxicity can occur with therapeutic dosing. DIAGNOSTIC CRITERIA Clinical Mainly affects the gastrointestinal, cardiovascular and cenPEML (Paeds)→
Theophylline PoisoningDescription General measures Medicine treatment Referral T48.6 + (X44.99/X64.99/Y14.99) DESCRIPTION Patients present with: tachycardia and tachyarrhythmias, hyperventilation nausea and vomiting tremor agitation profound hypokalaemia seizures GENERAL MEASURES Monitor ECG and treat dysrhythmias. Monitor and correct fluid status and electrolyte abnormalities. Monitor theophylline concentrations, ifEML (Adult)→
Therapeutic Approaches of Psoriatic Arthritis (PsA)Non-steroidal anti-inflammatory drugs Glucocorticoids Disease-modifying antirheumatic drugs Important notes on b/tsDMARDs Choice of b/tsDMARD Switching therapy Non-steroidal anti-inflammatory drugs Non-steroidal anti-inflammatory drugs (NSAIDs) are useful and frequently used for symptomatic treatment in patients with PsA, particularly those with oligoarthritis, axial disease and enthesitis.Other→
Therapeutic Drug Monitoring (TDM)Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
Therapeutic Drug Monitoring for Aminoglycosides and VancomycinThe 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→
Therapy of axSpAGoal of therapy Details of therapies Sequential therapy for axSpA Choice of b/tsDMARD Tapering of bDMARDs Special notes on comorbidities Goal of therapy The goal of therapy is to achieve remission (ASDAS <1.3), or at least low disease activity (ASDAS <2.1). Details of therapies Disease-modifying antirheumatic drugs (DMARDs) These agents are divided into three broad groups: conventional syntOther→
Thinking of becoming a paediatric registrar?District level hospital guidelines applicable for interns and comm service doctors. Published in 2016Other→
Thrombocytopaenia and Platelet Dysfunction in Critical CareDescription General measures Medicine treatment Referral ICD-10 code: D69.6 Description Qualitative and quantitative platelet disorders are common in critically ill patients and may be due to decreased production of platelets or increased consumption/sequestration. Common causes of thrombocytopaenia and/or platelet dysfunction include sepsis, blood loss, dilutional thrombocytopaenia, medicaEML (Adult)→
Thromboembolic DiseaseThe 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→
ThromboembolismAn approach to symptom management to guide decision-making in the management of patients with life-threatening illnessOther→
Thromboembolism & ThromboprophylaxisThis 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→
ThromboprophylaxisDescription General measures Medicine treatment Description See: Venous thrombo-embolism . General Measures All critically ill patients should receive pharmacological (i.e. unfractionated heparin, low-molecular-weight heparin [LMWH]) OR mechanical (intermittent pneumatic compression devices) thromboprophylaxis. Pharmacological thromboprophylaxis is superior to mechanical prophylaxis and should beEML (Adult)→
Thromboprophylaxis In ICUThe incidence of venous thrombosis is likely underappreciated in critically ill children. All children with at least one organ failure and central venous access likely require pharmacological prophylaxis against venous thrombo-embolism. Drug Dose Comments Low molecular weight heparin (LMWH), e.g. enoxaparin. < 2 months of age: 0.75 mg/kg/dose, SC, 12 hourly. > 2 months of age: 0.5 mg/kg/dosPEML (Paeds)→
Thrombotic Thrombocytopaenic Purpura/Haemolytic Uraemic SyndromeDescription Diagnostic criteria Medicine treatment Referral ICD-10 code: M31.1/D59.3 DESCRIPTION An acute syndrome that presents with diarrhoea/dysentery (although diarrhoea-negative cases are increasingly recognised) with varying combinations of the following: Non-immune microangiopathic haemolytic anaemia with fragmentation haemolysis (schistocytes), thrombocytopenia often with purpura, aPEML (Paeds)→
Thrombotic Thrombocytopenic Purpura-Haemolytic Uraemic Syndrome (TTP-HUS)Description Medicine Treatment Referral D59.3 + (M31.1) DESCRIPTION Acute syndromes with abnormalities in multiple organ systems and evidence of micro-angiopathic haemolytic anaemia and thrombocytopenia. This condition presents with varying combinations of the following (only some of which may be present): Microangiopathic haemolytic anaemia and thrombocytopenia, often with purpura but not usuallEML (Adult)→
Thrush (Age 2 months up to 5 years)IMCI - Child (Age 2 months up to 5 years)IMCI→
Thyroid Disease in PregnancyThe 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→
Tic DisordersTic DisordersPEML (Paeds)→
Tick Bite FeverDescription Medicine Treatment ICD-10 code: A77.0-3/A77.8-9/A93.8 DESCRIPTION Tick-borne infection due to R. conorii , acquired from dogs, or R. africae , acquired from cattle and game. The hallmark of tick bite fever is the eschar, a round black lesion ± 5 mm in diameter with an inflammatory halo that occurs in about two thirds of patients with R. conorii and in most cases of R. afriEML (Adult)→
Tick Bite FeverDescription General Measures Medicine Treatment Referral ICD-10 codes: A77.1/A79.8/A79.9 DESCRIPTION Tick-borne infection due to Rickettsia conorii , acquired from dogs, or Rickettsia africae , acquired from cattle and game. The hallmark of tick bite fever is the eschar, i.e. round black lesion ± 5 mm in diameter with an inflammatory halo. A rash develops on about the third day of illPrimary Care→
Tick Bite FeverDescription Diagnostic Criteria General and supportive measures Medicine Treatment Referral ICD-10 code: A79.9 DESCRIPTION A tick-borne febrile illness caused by Rickettsia conorii or africae . The rash appears on days 3–5 of the illness. It spreads from the extremities to the trunk, neck, face, palms, and soles within 36 hours. The lesions progress from macular to maculopapular and may perPEML (Paeds)→
Tiered Approach to InterventionsSupporting the Antimicrobial Resistance Strategy Framework and the Guidelines on Implementation of the Antimicrobial Strategy in South Africa: One Health Approach and Governance, 2018Other→
Tinea CapitisICD-10 code: B35.0 Refer to the Primary Healthcare Standard Treatment Guidelines and Essential Medicines List, 2020: Skin Conditions, Scalp infections – Tinea capitis. Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 5: Dermatology, 5.3 Macules And Papules, 5.3.8 Tinea CapitisPEML (Paeds)→
TonsillitisInfection Tonsillitis Brief outline/clinical setting Signs and symptoms of tonsillitis include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck. Aetiologies/organisms Streptococcus pneumoniae Group A beta hemolytic Streptococcus (S. pyogenes) Haemophilus influenza Optimal antimicrobial selection Amoxicillin 1gm 8 hourly AmoxicilOther→
Tonsillitis And PharyngitisEar, Nose and Throat ConditionsPrimary Care→