Guidelines
3,191 entriesNDOH Standard Treatment Guidelines and clinical protocols
- Candidiasis, Oral (thrush)ICD-10 codes: B37.0 Description General Measures Medicine Treatment Referral DESCRIPTION A candida infection of the mouth and sometimes of the pharynx Commonly presents as painful creamy white patches that can be scraped off the tongue and buccal mucosa Often occurs in healthy babies up to one month of age Risk factors for candidiasis include: Poor oral hygiene ImmunosuppressionPrimary Care→
- Candidiasis, SkinFungal Infections of the SkinPrimary Care→
- Candidiasis, Systemic and OtherDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: B37 DESCRIPTION Superficial and/or disseminated (systemic) fungal infection caused by C. albicans , C. tropicalis and other candida species. Risk factors include: Prolonged, broad-spectrum antibiotic therapy. Compromised immune system, including patients infected with HIV or on caPEML (Paeds)→
- Cannot Intubate and Cannot Ventilate (CICV) in a Paralysed Anaesthetised ChildCannot Intubate and Cannot Ventilate (CICV) in a Paralysed Anaesthetised Child Aged 1 - 8 YearsOther→
- Carbon Monoxide PoisoningDescription General measures Medicine treatment ICD-10 code: Y17 DESCRIPTION Poisoning caused by accidental or intentional exposure to fires in poorly ventilated areas, combustion engines, faulty stoves and faulty heating systems. Patients present with: dizziness, headache, seizures and other CNS symptoms, nausea and vomiting, chest pain, tachycardia, high arterial carboxyhaemoglobinPEML (Paeds)→
- Carbon Monoxide PoisoningDescription General measures Medicine treatment T58 + (X47.99/X67.99/Y17.99) DESCRIPTION Poisoning caused by accidental or intentional exposure to fires in poorly ventilated areas, combustion engines, faulty stoves, and faulty heating systems. Patients present with: dizziness impaired level of consciousness headache tachycardia seizures and other CNS symptoms chest pains nausea and vomiting retinEML (Adult)→
- Cardiac Arrest in AdultsDescription Covid-19 considerations Emergency treatment Additional guidance ICD-10 code: I46.0/I46.9 DESCRIPTION Described as the loss of a heart beat and a palpable pulse, irrespective of the electrical activity captured on ECG tracing. Irreversible brain damage can occur within 2–4 minutes. Clinical features include: sudden loss of consciousness absent carotid and all other pulses loss oEML (Adult)→
- Cardiac Arrest, AdultsDescription Covid-19 considerations General Measures Emergency Treatment Immediate Emergency Medicine Treatment Additional Guidance Referral ICD-10 code: I46.0/I46.9 Figure 21.1: Advanced cardiac arrest algorithm ( adapted with permission from the Resuscitation Council of South Africa ) Click on the image to enlarge. Figure 21.2: Advanced cardiac arrest algorithm - suspected respiratory communicaPrimary Care→
- Cardiac Arrest, Cardio-Pulmonary ResuscitationCardiac Arrest, Cardio-Pulmonary ResuscitationPrimary Care→
- Cardiac ArrhythmiasDescription Diagnostic criteria General and supportive measures Medicine Treatment Referral ICD-10 code: I49.9 DESCRIPTION A heart rate that is either abnormally slow or fast for age or irregular. Normal heart rate/minute for age: Newborn 100–160 < 1 year 110–160 1–2 years 100–150 2–5 years 95–140 5–12 years 80–120 > 12 years 60–100 DIAGNOSTIC CRITERIA Clinical Presenting features mayPEML (Paeds)→
- Cardiac DysrhythmiasSee: Cardiac dysrhythmias . Click here for the pdf . Standard Treatment Guidelines And Essential Medicines List For South Africa, Adult Hospital level, 2020-4_Version 1_June 2024 Chapter 20: Emergencies and InjuriesEML (Adult)→
- Cardiac DysrhythmiasStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Cardiac Failure, Congestive (CCF), AdultsCardiac Failure, CongestivePrimary Care→
- Cardiac Failure, Congestive (CCF), ChildrenCardiac Failure, Congestive (CCF)Primary Care→
- Cardiac Prophylaxis for Invasive ProceduresCardiac prophylaxis for invasive proceduresOther→
- Cardiac TherapyMinoxidil Angiotensin receptor blockers (ARBs) Atorvastatin - high dose (80mg/day) Ezetimibe ATC Code C02DC01 Medicine Minoxidil Indication Severe hypertension not responding to other drugs NEMLC Recommendation Approved Review Indicators n/a Date Ratified 20 September 2007 ATC Code C09CA Medicine Angiotensin receptor blockers (ARBs) Indication Add on therapy in cardiac failurOther→
- Cardiogenic ShockDescription General measures Medicine treatment ICD-10 code: R57.0 DESCRIPTION Patients are hypotensive, cold and clammy and their pulse rate may be variable. Causes include an acute myocardial infarction, myocardial contusion, myocarditis, dysrhythmias, valvular heart disease, aortic dissecting aneurysm etc. Consult with specialist and consider referring patients after initial emergency measuresEML (Adult)→
- Cardiopulmonary Arrest, ChildrenDescription General Measures Emergency Treatment Immediate Emergency Medicine Treatment Additional Guidance Referral ICD-10 code: I46.0/I46.9 Figure 21.3 Advanced cardiac arrest algorithm for children Click on image to enlarge DESCRIPTION Cardiopulmonary arrest is the cessation of respiration or cardiac function and in children is usually a pre-terminal event as a result of a critical illnPrimary Care→
- Cardiopulmonary ResuscitationFigure 20.1: Advanced cardiac arrest algorithm (adapted with permission from the Resuscitation Council of South Africa) Abbreviations: CPR = Cardiopulmonary Resuscitation; PEA = Pulseless Electrical Activity; VF = Ventricular Fibrillation; VT = Ventricular Tachycardia Click on the image to enlarge. Figure 20.2: Advanced cardiac arrest algorithm - suspected respiratory communicable disease ( adaptEML (Adult)→
- Cardiopulmonary Resuscitation (CPR) 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→
- Cardiorespiratory ArrestDescription General and supportive measures Medicine treatment Referral ICD-10 code: I46.9 Click on the image to enlarge DESCRIPTION Cardiorespiratory arrest in children usually follows a period of circulatory or respiratory insufficiency and less commonly is precipitated by a sudden cardiac event. It is, therefore, important to pre-empt cardiorespiratory arrest inPEML (Paeds)→
- Cardiovascular Risk and the Management of DyslipidaemiaCardiovascular Risk and the Management of Dyslipidaemia in Patients with Type 2 Diabetes MellitusOther→
- Cardiovascular Risk in DiabetesCardiovascular Risk in DiabetesPrimary Care→
- Cardiovascular SupportDescription General Measures Description Patients are often admitted to ICU for cardiovascular support, the commonest reason being for the treatment of shock. Although it is important to treat the underlying cause, patients may need cardiovascular monitoring and support in ICU while this is happening. General Measures In the critically ill patient, the following should be considered: Parenteral dEML (Adult)→
- Care Pathway for People with Diabetic Foot ProblemsCare Pathway for People with Diabetic Foot ProblemsOther→
- Care of Sick and Small NeonatesDescription General measures Medicine treatment Referral DESCRIPTION Neonates can become ill very rapidly and signs of disease are often not readily appreciated unless specifically looked for. Neonates should be referred urgently. Neonates < 2.5 kg are at higher risk of feeding and growth problems and need careful follow-up. Urgently manage and refer neonates with any of the following signs ofPrimary Care→
- Care of the HIV-Exposed Infant after BirthHIV Testing and Early Infant Diagnosis Confirmatory Test for HIV Infant Prophylaxis Other Routine Care HIV Testing and Early Infant Diagnosis 3 - 6 Days Follow-up results of birth HIV-PCR and manage accordingly. Any HIV positive neonate should be discussed/referred to a clinician experienced in managing an HIVpositive neonate. ART should be initiated even if the infants weighs less than 2,5 kg. 6Other→
- Care of the HIV-Exposed infantSee: The HIV-exposed infant. Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2025-9_Version 1.0_26 March 2026 Chapter 6: Obstetrics and Gynaecology_6.6.4 Care of the HIV-exposed InfantPrimary Care→
- Care of the Mother after BirthTesting for HIV Antiretrovirals VL Monitoring and Management Screening for TB and other OI's Testing for HIV 6 days Retest the HIV negative mother if she was not retested in labour 10 weeks Retest every HIV-negative mother at the 10-week visit (~three months postpartum), the six-month visit , and every three months whilst breastfeeding. Remember to offer partner testing. If no longerOther→
- Care of the Pregnant Adolescent Living with HIVPregnant adolescents are a vulnerable group that have psycho-social stressors and medical risks that may result poor health outcomes 14 Click on image to enlarge. The pregnant adolescent requires non-judgmental, confidential, and quality youth friendly SRH services that are sensitive to the challenges and stressors experienced by adolescents. This care should include: For ART Regimens applicableOther→
- Care of the Terminally Ill PatientThis 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→
- Caregiver's Health and Maternal Danger Signs (Birth up to 2 months)IMCI - Young Infant (Birth up to 2 months)IMCI→
- Categorisation of Intensive Care UnitsLevel 1 ICU (High care) Level 2 ICU Level 3 ICU There is no universally accepted method of classifying intensive care units. For the purposes of classifying the services offered, and resources required by different levels of ICUs, a system proposed by the (then) World Federation of Societies of Intensive and Critical Care Medicine has been modified for local circumstances 6 : Level 1 ICU (HOther→
- Caudal BlockInformation for ParentsOther→
- Caustic IngestionIntroduction Background Important details on history Important details on examination Emergency management Referral guidance Parental counselling List of typical caustic agents SETTING Primary and Secondary Healthcare Institutions in the Western Cape which refer to Red Cross War Memorial Children’s Hospital (RCWMCH) FOR STAFF Primary and Secondary Doctors and Nurses who refer patients to&nbsOther→
- Cavernous Sinus ThrombophlebitisInfection Cavernous sinus thrombophlebitis Brief outline/clinical setting Septic thrombosis of the cavernous sinus, usually caused by nasal furuncles or bacterial sinusitis. Initial symptoms of cavernous sinus thrombosis are progressively severe headache or facial pain, usually unilateral and localized to retro-orbital and frontal regions. High fever is common. Later, ophthalmoplegia (typically tOther→
- Ceftriaxone (Age 2 months up to 5 years)IMCI - Child (Age 2 months up to 5 years)IMCI→
- CellulitisInfection Cellulitis Brief outline/clinical setting Acute superficial infection involving dermis and subcutaneous tissue, most commonly affects the lower extremities. It causes local signs of inflammation, such as warmth, erythema, pain, lymphangitis, and frequently systemic upset with fever and raised white blood cell count. Aetiologies/organisms Streptococci (e.g. S. pyogenes , group B streptocOther→
- CellulitisBacterial Infections of the SkinPrimary Care→
- Cellulitis And ErysipelasDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: L03.9/A46 DESCRIPTION Infection of the skin and subcutaneous tissue usually caused by streptococci, staphylococci or H. influenzae . In cellulitis, the border of the lesion is indistinct. Erysipelas The affected area is: well demarcated with clear borders, very tender and waPEML (Paeds)→
- Cellulitis and ErysipelasStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Central Chronic Medicine Dispensing and Distribution (CCMDD)Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Central Chronic Medicine Dispensing and Distribution (CCMDD)Central Chronic Medicine Dispensing and Distribution (CCMDD)Primary Care→
- Central Line Associated Blood Stream Infections (CLABSI) and Catheter Associated Urinary Tract Infection (CAUTI)CAUTI & CLABSIOther→
- Cerebral AbscessInfection Cerebral abscess Brief outline/clinical setting May be as a result of contiguous spread of organisms, haematogenous spread, or iatrogenic Discuss with Neurology/Neurosurgery for aspiration and culture Aetiologies/organisms S.aureus, S.anginosus group, Enterobacterales, other Streptococci, anaerobes, Nocardia spp. Optimal antimicrobial selection 3rd gen cephalosporin (cefotaxime 8-12 g/dOther→
- Cerebral Arterial Gas EmbolismCerebral Arterial Gas EmbolismOther→
- Cerebral Oedema in Diabetic Ketoacidosis (DKA)Description Diagnostic criteria General and supportive measures Medicine treatment ICD-10 Code: G93.6 DESCRIPTION A condition of brain swelling during the course of treatment for DKA. Cerebral oedema usually occurs 4–12 hours after the initiation of treatment, but may be present at the time of diagnosis. It often follows an initial period of clinical and biochemical improvement. Cerebral oedema cPEML (Paeds)→
- Cerebral PalsyDescription General measures G80.0-4/G80.8-9 DESCRIPTION Cerebral palsy (CP) is a neurodevelopmental disorder resulting from an injury to the developing brain. The most common type of CP is hypertonia/spasticity (85%), followed by dyskinesia (7%), ataxia (4%), and hypotonia (3%). The distribution of motor impairment may be bilateral (as in diplegia, quadriplegia, or triplegia) or unilateral (as iPrimary Care→
- Cerebral Palsy (CP)Cerebral Palsy (CP)PEML (Paeds)→
- Cerebrovascular DiseaseStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→