Guidelines
3,191 entriesNDOH Standard Treatment Guidelines and clinical protocols
- Hypertensive Disorders in PregnancyDescription Referral DESCRIPTION Hypertension in pregnancy, pre-eclampsia and eclampsia may have very serious and fatal consequences for both the mother and the baby. Hypertension is defined by: A systolic BP ≥ 140 and/or a diastolic BP ≥ 90 mmHg measured on 2 occasions, 4 hours apart. OR A systolic BP ≥ 160 and/or a diastolic BP ≥ 110 mmHg measured on a single occasion. (Always measure BP in thePrimary Care→
- Hypertensive Disorders in PregnancyStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 EditionEML (Adult)→
- Hypertensive EmergencyHypertensive EmergencyPrimary Care→
- HyperthyroidismStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Hyperthyroidism in AdultsHyperthyroidismPrimary Care→
- Hyperthyroidism in Children and AdolescentsHyperthyroidismPrimary Care→
- Hyperthyroidism, Graves DiseaseDescription Diagnostic criteria Medicine treatment Referral ICD-10 Code: E05.9 / E05.0 DESCRIPTION Hyperthyroidism is a pathological syndrome in which tissue is exposed to excessive amounts of circulating thyroid hormones. The most common cause is Grave’s disease, although thyroiditis may also present with thyrotoxicosis. DIAGNOSTIC CRITERIA Clinical Poor school performance. Warm moist hands. TacPEML (Paeds)→
- HypocalcaemiaHypocalcaemiaOther→
- HypocalcaemiaStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Hypocalcaemia in ChildrenDescription Diagnostic criteria Medicine treatment Referral ICD-10 Code: E83.5 DESCRIPTION The main causes of hypocalcaemia in children are: vitamin D deficiency, calcium deficiency, magnesium deficiency, reduced parathyroid hormone production or resistance, impaired renal function, and hyperventilation. DIAGNOSTIC CRITERIA Clinical Signs and symptoms of tetany include: paraesthesia, positiPEML (Paeds)→
- Hypocalcaemic, NeonatalDescription Diagnostic criteria Medicine treatment Referral ICD-10 code: P71.1 DESCRIPTION Acute symptomatic hypocalcaemia may present within the first 72 hours of birth (early hypocalcaemia) or after 72 hours of birth (late hypocalcaemia) with apnoea, irritability, seizures, jitteriness or prolonged QTc interval on ECG. Causes of early hypocalcaemia include: Prematurity. Respiratory distrePEML (Paeds)→
- HypoglycaemiaManagement of Hypoglycaemia in Children in Emergency CentresOther→
- HypoglycaemiaHypoglycaemia in type 2 DiabetesOther→
- HypoglycaemiaThe target blood glucose of critically ill children is 4–10 mmol/L. It is essential to check the blood glucose of all critically ill children as hypoglycaemia (< 3.5 mmol/L) is an emergency. Immediate treatment is with an IV glucose bolus and depends on the nature of the available IV access. Peripheral line: 5 mL/kg of a 10% dextrose solution. Central line: 2 mL/kg of a 25% dextrose solution.PEML (Paeds)→
- Hypoglycaemia In DiabeticsDiabetic EmergenciesPrimary Care→
- Hypoglycaemia and HyperglycaemiaHypoglycaemia Hyperglycaemia Hypoglycaemia ICD-10 code: E10.0/E10.6/E11.0/E11.6/E12.0/E12.0/E12.6/E13.0/E13.6/E14.0/E14.6/E16.0/E16.1/E 16.2 Description Hypoglycaemia, defined as a glucose concentration <4 mmol/L, is common in critically ill patients, and is associated with increased mortality. Risk factors associated with hypoglycaemia in critically ill patients include severity of illnEML (Adult)→
- Hypoglycaemia and Hypoglycaemic ComaDescription Emergency Treatment Referral ICD-10 code: E10.0/E11.0/E12.0/E13.0/E14.0/E16.0/E16.1/E16.2 DESCRIPTION Hypoglycaemia is a blood sugar < 3 mmol/L (< 2.6 mmol/L in neonate) and may rapidly cause irreversible brain damage and/or death. Clinical features include: tremor confusion sweating delirium tachycardia coma dizziness convulsions hunger transient aphasia or speech disorders heaPrimary Care→
- Hypoglycaemia in ChildrenDescription Diagnostic criteria Medicine treatment Referral ICD-10 Code: E16.2 DESCRIPTION Infants and small children have relatively limited glycogen stores with larger brain/body ratios than adults and are, therefore, at greater risk of hypoglycaemia during starvation. The causes of hypoglycaemia (outside the neonatal period) include: hypopituitarism, adrenal insufficiency, growth hormone deficPEML (Paeds)→
- Hypoglycaemia in DiabeticsHypoglycaemia in DiabeticsPEML (Paeds)→
- Hypoglycaemia, NeonatalDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: P70.4 DESCRIPTION Neonate presenting with whole blood glucose below 2.6 mmol/L. Risk factors include: prematurity, respiratory distress, small for gestational age, rhesus iso-immunisation, neonate of diabetic mother, hyperinsulinism, sepsis, post maturity, hypothermia/hyperthermia, feediPEML (Paeds)→
- HypokalaemiaHypokalaemiaOther→
- HypokalaemiaHypokalaemiaPEML (Paeds)→
- HypokalaemiaStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Hypokalaemia - Emergency Management in ChildrenManagement of hypokalaemiaOther→
- HyponatraemiaStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- HypopituitarismDescription Diagnostic criteria Medicine treatment Referral ICD-10 Code: E23.0 DESCRIPTION Multiple or isolated deficiencies of adrenocorticoid hormone (ACTH), luteinising hormone, thyroid stimulating hormone, prolactin, and growth hormone manifesting as hypoglycaemia, abnormal body proportions and failure to grow and develop. If the posterior pituitary is involved (ADH deficiency), then this conPEML (Paeds)→
- HypothyroidismStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Hypothyroidism in AdultsHypothyroidismPrimary Care→
- Hypothyroidism in Children and AdolescentsHypothyroidismPrimary Care→
- Hypothyroidism in NeonatesHypothyroidismPrimary Care→
- Hypothyroidism in Older Children and AdolescentsHypothyroidism in Older Children and AdolescentsPEML (Paeds)→
- Hypothyroidism, CongenitalDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 Code: E03.1 DESCRIPTION Congenital deficiency of thyroid hormone due to: aplasia/hypoplasia or ectopia of the thyroid gland, thyroglobulin defects, defects in thyroid hormone biosynthesis, or intrauterine exposure to antithyroid medicines. Congenital hypothyroidism is one of the common treatable cauPEML (Paeds)→
- Hypovolaemic ShockNon-trauma related hypovolaemic shock Trauma related hypovolaemic shock Massive transfusion NON-TRAUMA RELATED HYPOVOLAEMIC SHOCK ICD-10 code: R57.1 DESCRIPTION This happens when there is loss of intravascular fluid, e.g. severe diarrhoea and dehydration, haemorrhage or fluid shifts. GENERAL MEASURES Control obvious bleeding with direct pressure. Insert one or two large bore IV catheters; pEML (Adult)→
- Hypoxia-Ischaemia Of The Newborn (Perinatal Hypoxia/Hypoxic-Ischaemic Encephalopathy (HIE))Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: P21.9 DESCRIPTION Ischaemia and decreased oxygen delivery to the foetus/baby during the prepartum, intrapartum or immediate postpartum period, with hypoxic-ischaemic damage to the central nervous system and to other body systems. Complications include: Cardiovascular: heart rate and rhytPEML (Paeds)→
- Hypoxic Ischaemic Encephalopathy (HIE) Score ChartManagement 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→
- ICU MedicationsAdrenaline (epinephrine) Amiodarone Atropine Dexamethasone Dobutamine Furosemide Glycopyrrolate Hydrocortisone IVIG (Intravenous polyvalent human immune globulin.) Labetalol Lidocaine (Lignocaine) Magnesium sulphate Salbutamol Drugs given in ICU are often diluted and given as an infusion. It is essential that one considers intravenous fluids to be drugs and as such need to consider compatibilityPEML (Paeds)→
- IMCI Process for All Young Infants (Birth up to 2 months)IMCI - Young Infant (Birth up to 2 months)IMCI→
- IPC Measures Using a Multimodal ApproachSupporting the Antimicrobial Resistance Strategy Framework and the Guidelines on Implementation of the Antimicrobial Strategy in South Africa: One Health Approach and Governance, 2018Other→
- Identifying and Referral of Potential Organ DonorsIdentifying & Referral of Potential Organ DonorsOther→
- Idiopathic Sudden Sensori-neural Hearing Loss (ISSNHL)Idiopathic Sudden Sensori-neural Hearing Loss (ISSNHL)Other→
- Illicit DrugsCocaine poisoning Amphetamine derivative poisoning COCAINE POISONING T40.5 + (X42.99/X62.99/Y12.99) DESCRIPTION Cocaine may be absorbed through any mucous membrane, smoked, ingested, or injected intravenously. Clinical features: Mild toxicity: euphoria, anxiety, altered mental status, tachycardia, mild hypertension. Moderate toxicity: agitation, paranoia, hallucinations, cardiac dysrhythmias. SevEML (Adult)→
- Immediate Care of the NewbornThe 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→
- Immune Reconstitution Inflammatory SyndromeAn approach to symptom management to guide decision-making in the management of patients with life-threatening illnessOther→
- Immune Reconstitution Inflammatory Syndrome (IRIS) Please 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 DePrimary Care→
- Immune Reconstitution Inflammatory Syndrome (IRIS)Description Diagnostic criteria Medicine treatment ICD-10 code: D89.3 DESCRIPTION Clinical deterioration can occur after starting ART due an improvement in the immune system response to organisms already causing infection, e.g. M bovis BCG, C. neoformans, M. tuberculosis (MTB), Aspergillus, M. avium complex, C. albicans, M. leprae, Human Herpes viruses, P. jiroveci, Human Papilloma virus, CMV, HePEML (Paeds)→
- Immune Reconstitution Inflammatory Syndrome (IRIS)Please 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 Adult Hospital Level Chapter 10: HIV_and_AIDS_with_supporting_NEMLC_Report_Reviews_2025-9-VersioEML (Adult)→
- Immune Thrombocytopaenic Purpura (ITP)Description Diagnostic criteria General and supportive measures Medicine treatment Surgical treatment Referral ICD-10 code: D69.3 DESCRIPTION A common bleeding disorder of childhood due to the immune-mediated destruction of platelets. It occurs most frequently in children aged 2 to 5 years and often follows infection with viruses (including HIV) and medications. Chronic ITP (more than 6 months duPEML (Paeds)→
- Immune Thrombocytopenia (ITP)Description General Measures Medicine Treatment Referral D69.3 DESCRIPTION A common bleeding disorder due to immune-mediated destruction of platelets. Clinically apparent associated conditions, drugs (e.g. penicillins, cephalosporins, quinine, rifampicin and heparin), or other agents that may cause thrombocytopenia must be excluded before a diagnosis of ITP can be considered. Patients with suspecEML (Adult)→
- Immune Thrombocytopenic Purpura (ITP)ICD-10 code: D69.3 See: Blood and Blood Forming Organs, Immune thrombocytopaenic purpura (ITP) . Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 5: Dermatology, 5.4. Purpura, 5.4.3 Immune Thrombocytopenic Purpura (ITP)PEML (Paeds)→
- Immunisation ScheduleThe contents of this chapter are based on the current recommendations from the National Advisory Group on Immunisation (NAGI). Any medical incident that takes place after immunisation and may be potentially related to immunisation should be reported (See: Adverse Events Following Immunisation (AEFI) ). Every clinic day is an immunisation day. Never miss a chance to immunise – nevePrimary Care→