Guidelines
3,191 entriesNDOH Standard Treatment Guidelines and clinical protocols
- Non-Pharmacological Pain Techniques: AdultsPhysical interventions Psychological interventions Other interventions Conclusion Non-pharmacological pain techniques refer to interventions that do not involve the use of medication to treat pain. These techniques may be used as an adjunct to pharmacotherapy and are usually not used in isolation. The goals of non-pharmacological techniques are to decrease fear, distress and anxiety,&nOther→
- Non-Pharmacological Pain Techniques: PaediatricsPain management Preparation One Voice Language Positions of comfort Coping strategies Pain management It is imperative that effective pain management is standardised for all paediatric patients. Even minor painful events or procedures, such as needle pricks, can affect children’s longterm emotional wellbeing. Timely administration of pain management techniques can affect the paediatric patient’sOther→
- Non-Respiratory Manifestations of COVID-19Part one and twoOther→
- Non-Severe Tuberculosis DiseaseIndications Includes smear-negative pulmonary TB (low bacillary load) or with no more than mild to moderate lymph node enlargement and/or lung field opacification, or simple pleural effusion. See: https://theunion.org/sites/default/files/2022-03/The%20Union_Diagnostic%20Atlas%20for%20TB%20in%20Children_2022.pdf Dosing Adjust treatment dosages to current body weight. If calculating dosages,PEML (Paeds)→
- Nonopioid Analgesics and Co-AnalgesicsGeneral principles and management of cancer pain in adultsOther→
- Normal Blood Values NeonateManagement 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→
- Normal CSF – Values In The NeonateManagement 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→
- Normal ECG values for childrenNormal ECG values for childrenOther→
- Normal vital signs according to ageNormal vital signs according to ageOther→
- Nose Bleed (Epistaxis)Description Management Referral ICD-10 code: R04.0 DESCRIPTION Nose bleed may be caused by local or systemic diseases, or local trauma, especially nose picking, and occurs from an area anterior and inferior to the nasal septum. Consider other conditions associated with nosebleeds, especially if recurrent, e.g. hypertension and bleeding tendency. MANAGEMENT Acute episode Control bleeding by pinchiPrimary Care→
- Not growing well (including failure to thrive/growth faltering) *New*ICD-10 codes: R62.0 / R62.8 / R62.9 Description General measures Conditions which justify recommending that mothers do not breastfeed Medicine treatment Referral DESCRIPTION Children and infants who have either: Unsatisfactory weight gain (growth curve flattening or weight loss) on the Road to Health chart/ booklet. OR Low weight for age (but WHZ > -2) Note: Babies who were premature andPrimary Care→
- Notice 14 March 2025: Supply Constraints with Docetaxel 200mg/ml Injection 1ml for Oncology Treatment and Interim Therapeutic AlternativesThe Tertiary and Quaternary Essential Medicines List (EML) currently recommends the use of a taxanes (paclitaxel or docetaxel) for the management of various cancers including breast, prostate and lung. Docetaxel 20mg/ml, 1ml injection, which is on National Contract from Accord Healthcare (Pty) Ltd, is currently unavailable. The docetaxel 20mg injection, will only be available at the end of AprilOther→
- Notice 23 April 2026: Publication of the NEMLC Approved Updates to the Primary Healthcare (PHC) and Adult Hospital Level (AHL) Chapters for the Standard Treatment Guidelines (STGs) and Essential Medicines List (EML): 2025 - 2029 Review CycleIn the document below, is a list of the recently published 2026 chapter updates to previous editions of the PHC and AHL STGs and EML. Updates to chapters and supporting technical documents (medicine reviews, costing reports, NEMLC reports, implementation slides for PHC level) for the 2025 - 2029 review cycle are uploaded onto the National Health Insurance (NHI) webpage following finalisation forOther→
- Notifiable medical conditions - Referral flowchartNotifiable medical conditions - Referral flowchartOther→
- Nutrition and Anaemia NEMLC recommendations for medicine amendments (2020-2023 review cycle) *New*South African Primary Healthcare Essential Medicine List & Standard Treatment Guidelines. NEMLC Recommendations for Medicine Amendments (2020-2023 Review Cycle). Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, Updated for the 2023 EditionPrimary Care→
- Nutritional Care in the ICUMalnutrition is common (25%) among critically ill children and is associated with increased morbidity, delayed recovery and increased mortality. Nutritional goals in PICU include: Prevention and/or treatment of malnutrition – both macro and micronutrient deficiencies as well as overfeeding. Maintenance of gut integrity with enteral nutrition. Optimization of organ function. Standard Treatment GuiPEML (Paeds)→
- Nutritional Status (Age 2 months up to 5 years)IMCI - Child (Age 2 months up to 5 years)IMCI→
- ObesityObesityPEML (Paeds)→
- Obesity in DiabetesCardiovascular Risk in DiabetesPrimary Care→
- Obesity in PregnancyObesity in PregnancyOther→
- Objectives of Antenatal CareThe 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→
- Obsessive Compulsive Disorder (OCD)Obsessive Compulsive Disorder (OCD)PEML (Paeds)→
- Obstetric EmergenciesObstetric EmergenciesOther→
- Obstetric TerminologyThe 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→
- Obstructive ShockDescription Treatment ICD-10 code: R57.8 DESCRIPTION Occurs when there is an obstruction to the filling of the right ventricle or an obstruction in blood flow. Clinical signs include hypotension, tachycardia, cold peripheries and distended neck veins. Causes include: cardiac tamponade, tension pneumothorax, acute pulmonary embolism, and severe bronchospasm. TREATMENT Treat the cause. Acute pulmonEML (Adult)→
- Obstructive Sleep ApnoeaDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: G47.3 DESCRIPTION Affects all ages as either partial or complete airway obstruction that disrupts gas exchange and sleep patterns. Associated with truncal obesity and increased BMI, recurrent otitis media, allergic rhinitis/asthma and syndromic conditions e.g. Down syndrome, TPEML (Paeds)→
- Odynophagia - Paediatric Palliative CareDescription General and supportive measures Medication and treatment ICD-10 code: R13 DESCRIPTION Pain that arises from the oropharynx and/or pain with swallowing. Not only does it lead to irritability and discomfort but can affect intake of feeds and medication. May be an unrecognised source of pain in neurologically impaired non-verbal children. GENERAL AND SUPPORTIVE MEASURES Perform a tPEML (Paeds)→
- Oedema, CerebralStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Open FracturesOpen FracturesOther→
- Open Multi-Dose Vial PolicyInjection safety Opened vials of TT HepB and OPV vaccines: May be used in subsequent immunisation sessions for a maximum of one month , if each of the following conditions have been met: The expiry date has not passed Each vial must be dated when opened The vaccines are stored under appropriate cold chain conditions (2–8°C with temperature monitoring and recording) The vaccine vial septum haPrimary Care→
- Opioid AnalgesicsGeneral principles and management of cancer pain in adultsOther→
- Opioid Minimisation for Acute Pain ManagementPrescription opioid addiction and overdose Postoperative opioid respiratory depression Interventions to reduce opioid requirements following general anaesthesia Opioid-free analgesia Conclusion For at least 10 000 years, opiates derived from the opium poppy were the only reliable analgesics used by humans. During the twentieth century, synthetic opioids were increasingly used, particularly iOther→
- Opioid PharmacologyThis guideline is endorsed by the following professional groups: Cape Pelvic Pain Society, PainSA, South African Rheumatism and Arthritis Association, and South African Society of Anaesthesiologists.Other→
- Opioid PoisoningDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T40.2 DESCRIPTION Codeine is a common drug of abuse. The duration of action of morphine is 3–6 hours. Other oral agents, e.g. codeine and long acting morphine, demonstrate a delayed effect of up to 4–12 hours. DIAGNOSTIC CRITERIA Altered level of consciousness. Classic triad of CNPEML (Paeds)→
- Opioid ToleranceAlso see opioid tolerance in the ICU – Intensive Care Unit Opioid tolerance is a common cause for the failure of opioid analgesia. Exposure to an opioid, particularly as the sole analgesic, gives rise to pharmacodynamic tolerance (loss of activity, not due to faster drug clearance but to decreased analgesic effect). Tolerance develops to the adverse effects of opioids, namely sedation, hypoventilOther→
- Opioid WithdrawalOpiod WithdrawalPEML (Paeds)→
- Opportunistic DiseasesPlease 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)→
- Opportunistic Infections, Prophylaxis in ChildrenPlease 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→
- Opportunistic Infections, Treatment in ChildrenPlease 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→
- Oral (Contraception, Hormonal)Monophasic preparations Triphasic preparations Contraindications and guidance to starting the hormonal oral pill Medicine interactions Referral Z30.0/Z30.4 Dual contraception with barrier methods, are recommended to reduce the risk of STIs, including HIV. Monophasic preparations Progestin only pills, e.g.: Levonorgestrel, oral, 30 mcg daily LoE:IIIa 18 Progestins and estrogen, fixed combinations,Primary Care→
- Oral Amoxicillin-Clavulanate Dosing Guidance for Children >3 Months with Normal Renal FunctionKEY POINTS TO REMEMBER - Oral amoxicillin-clavulanate exists in various formulations of varying amoxicillin-to-clavulanate ratios (liquid – 14:1 & 4:1; tablet – 7:1) - Medication errors may occur if the different formulations are not considered. - Look up the amoxicillin dose in the tables below against the patient’s weight for the various formulations, given the specific indicOther→
- Orbital CellulitisOrbital CellulitisOther→
- Ordering Group and Screen (G+S) Pre-operativelyOrdering Group and Screen (G+S) Pre-operativelyOther→
- Ordering and Administration of BloodSANBS Clinical Guideline, 6th Edition, 2023Other→
- Organisation of Anaesthesia Services: Anaesthesia Support PersonnelNursing staff Management, supervision and organisation of anaesthesia services Anaesthetic nurses/assistants Recovery room nurses Conclusion and recommendations regarding anaesthesia support personnel The availability of competent assistance to the anaesthesiologist/ anaesthetist/anaesthesia provider (hereafter called anaesthesiologist) by an anaesthetic/anaesthesia assistant, i.e., a dedicated aOther→
- Organisation of Anaesthesia Services: Duties of an Anaesthesia ProviderOrganisation of anaesthesia services Duties of an anaesthesia provider Anaesthesia providers Organisation of anaesthesia services In medicine, including anaesthesia, teamwork is emphasised. A proposed ideal surgical team would include: Surgeons Surgeon assistants Anaesthesiologists Anaesthesia assistants Nursing personnel (including a scrub nurse and floor nurse) Clinical technicians Clinical anaOther→
- Organisation of Anaesthesia Services: Guidelines on Professional Health and WellbeingIntroduction Personal responsibilities of the anaesthesia provider Institutional responsibilities Recommendations Responsibilities toward healthcare workers, trainees and colleagues Legal responsibilities Introduction Many factors can contribute to the provider’s inability to function at their highest performance level, which ultimately impacts patient safety. These include work-related factors,Other→
- Organisation of Anaesthesia Services: Hours of Work Background Recommendations Categories of staff and level of hospital Staff-to-workload ratios Background The basis for consideration of working hours in anaesthesia care is the need for clinical services to be provided 24 hours a day, 7 days a week. This necessitates a shift system with regular and after-hours work, as well as work on weekends and public holidays. For clinical platforOther→
- Organisation of Anaesthesia Services: Peer ReviewClinical governance is defined as a system through which health services are responsible and accountable for: continuously improving services, safeguarding high standards of care, and ensuring the best clinical outcomes for patient care. The system of governance includes the following aspects of clinical risk management: Mortality and morbidity reviews. Adverse events and near-misses reporting anOther→
- Organisation of Anaesthesia Services: Training and AccreditationBackground Education and training Diploma in Anaesthetics Fellowship training for the specialist anaesthesiologist Sub-speciality training: critical care General training Background Education and training of anaesthesia care providers in South Africa needs to take cognisance of the social setting within which such practice occurs, making them sensitive to both the system and individual needs. SucOther→