Guidelines
3,191 entriesNDOH Standard Treatment Guidelines and clinical protocols
- An Approach to a Soft Tissue Leg MassDoctor, I have a lump on my leg! An approach to a soft tissue massOther→
- An Approach to a Soft Tissue MassDoctor, I have a lump!Other→
- An Approach to an Open WoundDoctor, I have an ulcer on my skin!Other→
- An Approach to the Abdominal MassDoctor, I feel a lump in my abdomen ! An Approach to the Abdominal MassOther→
- An Approach to the Acute AbdomenDoctor, I have excruciating abdominal pain ! An Approach to the Acute AbdomenOther→
- An Approach to the Acutely Painful LimbDoctor, my leg is very sore!Other→
- An Approach to the Different Types of Bowel ObstructionDoctor, I am vomiting! An approach to the different types of bowel obstructionOther→
- AnaemiaDescription Diagnosis Referral DESCRIPTION A condition characterised by low haemoglobin (Hb), clinically recognised by pallor, tiredness, shortness of breath. It is commonly caused by: Nutritional deficiency of iron or folate or vitamin B 12 . Chronic systemic diseases such as HIV, TB, malignancy. Blood loss (bleeding/haemorrhage) e.g. caused by parasites, ulcers, tumours, abnormal menstruation.Primary Care→
- AnaemiaDESCRIPTION Defined as a reduction in the absolute number of circulating red blood cells and most commonly diagnosed when the haemoglobin (Hb) concentration falls below the reference range for age and sex (Hb reference range males 13.0–17.0 g/dL; females 12.0–15.0 g/dL). The clinical features depend on the severity of anaemia, the rate at which it developed and the oxygen demands of the patient.EML (Adult)→
- AnaemiaPlease 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→
- Anaemia & TransfusionThe 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→
- Anaemia (Age 2 months up to 5 years)IMCI - Child (Age 2 months up to 5 years)IMCI→
- Anaemia - Follow-upIMCI - Child (Age 2 months up to 5 years)IMCI→
- Anaemia and Blood TransfusionsAn approach to symptom management to guide decision-making in the management of patients with life-threatening illnessOther→
- Anaemia in Critical CareDescription General Measures Medicine Treatment ICD-10 code: D64.9 Description Anaemia is common in critical illness. Anaemia results in reduced tissue oxygen delivery which may cause or worsen organ dysfunction. The underlying cause should be investigated and treated. Avoid unnecessary phlebotomy to reduce the risk of iatrogenic anaemia. The benefits of treating anaemia must always be weigEML (Adult)→
- Anaemia in PregnancyStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 EditionEML (Adult)→
- Anaemia in PregnancyDescription General measures Medicine treatment Referral O99.0 + (D64.9) DESCRIPTION Anaemia in pregnancy is a Hb < 11 g/dL, most commonly due to iron deficiency. Hb levels should be checked at the booking visit, between 28 and 32 weeks, and at ± 36 weeks. Treatment is recommended when the Hb falls below 10 g/dL. Women with iron deficiency often have 'pica', e.g. eating substances such aPrimary Care→
- Anaemia of Chronic Disorders (Infection or Disease)Description Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D63 DESCRIPTION Anaemia caused by chronic infection or disease. This may be due to interference with nutrient supply or suppression of haemopoiesis. Iron may be trapped in the reticuloendothelial system resulting in relative iron deficiency. Symptomatic anaemia may manifest with tachypnoPEML (Paeds)→
- Anaemia, AplasticDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D61.0 DESCRIPTION Pancytopenia caused by bone marrow failure with a hypocellular bone marrow without infiltration or fibrosis. May be acquired or inherited. Inherited bone marrow failure syndromes include Fanconi anaemia, which has specific associated phenotypic features and chromosomalPEML (Paeds)→
- Anaemia, AplasticDescription Medicine treatment Referral D60.0-1/D60.8-9/D61.0-3/D61.8-9 DESCRIPTION Pancytopenia due to a hypoplastic bone marrow. Clinical features: Pallor Purpura Petechiae Bleeding Frequent or severe infections Pancytopenia in PLHIV B23.2 + (D61.2/D61.9) Most common causes include: Direct effect of HIV. Medication (e.g. carbamazepine, valproic acid, phenytoin or pure red cell aplasia witEML (Adult)→
- Anaemia, Chronic DisorderDescription General Measures D63.0/D63.8 DESCRIPTION Anaemia due to chronic inflammation. This is characteristically a normochromic normocytic anaemia. Common causes of anaemia of chronic disorder include: Malignancy, e.g. haematological or solid tumours. Autoimmune disorders, e.g. rheumatoid arthritis. Chronic infections, e.g. HIV and TB. Chronic kidney disease. GENERAL MEASURES Investigate andEML (Adult)→
- Anaemia, HaemolyticDescription General Measures Medicine Treatment Referral/Consultation D55.0-3/D55.8-9/D56.0-4/D56.8-9/D58.0-2/D58.8-9/D59.0-6/D59.8-9 DESCRIPTION Anaemia due to destruction of red blood cells. Destruction may be due to: Extracellular factors such as auto-immunity or mechanical factors, e.g. disseminated intravascular coagulation (DIC), hypersplenism, mechanical heart valves. Abnormalities of theEML (Adult)→
- Anaemia, HaemolyticDescription Diagnostic criteria General and supportive measures Medicine treatment Surgical treatment Referral ICD-10 code: D55–59 DESCRIPTION Anaemia caused by excessive destruction of red blood cells. Destruction may be due to: Corpuscular defects: abnormalities of the cell membrane (e.g. hereditary spherocytosis), enzyme abnormalities (e.g. G6PD deficiency), or abnormal haemoglobin (e.g.PEML (Paeds)→
- Anaemia, Iron DeficiencyDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D50.9 DESCRIPTION Iron deficiency is the most common cause of anaemia. The commonest causes of iron deficiency anaemia are poor nutritional intake, excessive milk ingestion and blood loss due to parasites (whipworm and hookworm). Lower limits of normal haemoglobin: Age Hb (g/dL) Birth 13PEML (Paeds)→
- Anaemia, Iron DeficiencyDescription General Measures Medicine Treatment Referral/Consultation D50.0-1/D50.8-9 DESCRIPTION Anaemia due to iron deficiency. Common causes of iron deficiency are chronic blood loss, poor iron absorption or poor nutritional intake. Investigations Low MCV and low MCH (mean corpuscular hemoglobin <26 pg) – note that these are often normal in early stages. Full blood count (FBC) and peripheraEML (Adult)→
- Anaemia, MegaloblasticDescription General measures Medicine treatment D51.0-2/D51.2/D51.8-9/D52.0-1/D52.8-9/D53.1/D53.8-9 DESCRIPTION Anaemia caused by a deficiency of folate and/or vitamin B 12 . Note that several medicines can cause macrocytic anaemia (e.g. hydroxyurea, methotrexate, zidovudine, azathioprine, valproic acid, and phenytoin) without deficiencies of folate and/or vitamin B 12 . Clinical manifestations oEML (Adult)→
- Anaemia, MegaloblasticDescription Diagnostic Criteria General and supportive measures Medicine treatment Referral ICD-10 code: D53.1 DESCRIPTION Anaemia caused by a deficiency of folate and/or vitamin B 12 . DIAGNOSTIC CRITERIA Clinical Pallor and fatigue. History of chronic diarrhoea. Investigations Megaloblastic anaemia: elevated MCV (mean corpuscular volume) and MCH (mean corpuscular haemoglobin). Macro-ovaloPEML (Paeds)→
- Anaemia, Sickle CellDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: D57 DESCRIPTION Haemolytic anaemia due to homozygous inheritance of sickle cell mutation. Patients may experience complications: Painful vaso-occlusive crises Haemolytic crises (usually secondary to infection) Aplastic crises Thrombotic crises, e.g. acute chest syndrome, priapism or stroPEML (Paeds)→
- Anaemia, Sickle CellDescription Vaso-Occlusive Episodes General Measures Medicine Treatment Referral D57.0-3/D57.8 DESCRIPTION Sickle cell disease (SCD) is a genetic, inherited condition resulting in abnormal red blood cells. Homozygous SCD is the commonest and most severe form, characterised by recurrent vaso-occlusive episodes (“sickle crises”) and chronic haemolytic anaemia. Adults develop hyposplenism, predisposEML (Adult)→
- Anaemia, iron deficiencyICD-10 codes: D50.0 / D50.8 / D50.9 Description General measures Medicine treatment Referral DESCRIPTION A common cause of anaemia in young children and women of childbearing age. A full blood count showing a low MCV suggests the diagnosis of iron deficiency anaemia. A full blood count is not required for children, unless referral criteria above are present. Note: Iron deficiency anaePrimary Care→
- Anaemia, macrocytic or megaloblasticICD-10 codes: D52.0 / D52.1 / D52.8 / D52.9 / D53.1 Description Investigations General measures Medicine treatment Referral DESCRIPTION Anaemia with large red blood cells is commonly due to folate or vitamin B 12 deficiency. Folate deficiency is common in pregnant women and in the postpartum period, and in alcoholics. Macrocytic anaemia in these patients can be assumed to be due to folate dPrimary Care→
- Anaesthesia Equipment and Anaesthetising Facilities: Equipment Anaesthesia equipment Anaesthesia mixture components Breathing circuits Ancillary equipment per theatre Monitors Recovery room equipment Equipment and drugs Routines for checking, cleaning, servicing and storage of equipment Every item on the list of essential equipment should be available at every site where anaesthesia is provided, even if anaesthesia is only provided occasionally. EssenOther→
- Anaesthesia Equipment and Anaesthetising Facilities: FacilitiesIntroduction The requirements for healthcare facilities providing surgical services are described in the Infrastructure Unit Support Systems (IUSS) Health Facility Guides: Facilities for Surgical Procedures (Gazetted 30 June 2014 – Appendix B ) that supersedes regulation R158 on Infrastructure and should be interpreted in conjunction with the current National Core Standards (NCS) Regulations ( ApOther→
- Anaesthesia Equipment and Anaesthetising Facilities: Low Flow Anaesthesia GuidelinesDefinition Classification of fresh gas flow rates Equipment How to do it The delivery of anaesthesia gases in the most efficient, economical, and environmentally friendly manner is a requirement of modern anaesthesia practice. This practice requires an understanding of the physics of the delivery system and the properties of the agents being used. It is an appropriate technique for the current adOther→
- Anaesthesia Equipment and Anaesthetising Facilities: MedicationEssential Drugs Programme Off-label drug use Ampoule labelling standard Substitution of medicines and devices National Pharmacovigilance Programme Ampoule sharing Essential Drugs Programme To provide equal access to medicines for all South Africans, whilst improving the supply of listed items at a lower cost, the Essential Drugs Programme (EDP) of South Africa was established in terms of the NatiOther→
- Anaesthesia Outside a Hospital SettingIntroduction Context Guidance Introduction Clinicians may be called upon to provide services including patient assessment, monitored care, sedation, anaesthesia and resuscitation outside of the traditional hospital environment. This is not limited to sedation/anaesthesia in day surgery units and consulting rooms for proceduralists but extends to the prehospital and interfacility transfer environmOther→
- Anaesthesia and NeurotoxicityPACSA position statement for Parents.Other→
- Anaesthesia, EpiduralStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Anaesthesia, GeneralStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Anaesthesia, Spinal (Intrathecal)Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Anaesthesia, TopicalStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Anaesthesiology and Intensive Care, IntroductionStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Anaesthetic Equipment DecontaminationManagement of reusable equipment Definitions and classifications Laryngoscopes Bronchoscopes Magill forceps Nasopharyngeal and rectal temperature probes Suction bowl Suction tubing 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 equipmentOther→
- Anaesthetic Pre-operative Workup for PatientsAdapted from the NICE 2016 GuidelinesOther→
- Anal FissuresDescription General Measures Medicine Treatment Referral ICD-10 code: K60.0-2 DESCRIPTION Painful small cracks just inside the anal margin, sometimes a linear ulcer. It is often seen together with a sentinel pile or external haemorrhoids. These may cause spasm of the anal sphincter, or bleeding on defaecation. GENERAL MEASURES Dietary advice to promote soft stools. MEDICINE TREATMENT Children LacPrimary Care→
- Analgesia during Pregnancy, Childbirth, the Puerperium and LactationPregnancy Childbirth The puerperium Lactation Bibliography Pregnant women and new mothers are both at high risk of experiencing pain. The antenatal changes in anatomy can result in back pain, pelvic pain and an altered centre of gravity, predisposing women to falls and other injuries. Physiological changes during pregnancy can also result in increased headaches. Giving birth is painful, and the pOther→
- Analgesia for Acute Non-Surgical PainStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
- Analgesia in 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→
- Analgesic Medication for Children with Cancer PainManagement of cancer pain in childrenOther→
- Analgesic PoisoningParacetamol poisoning Salicylate poisoning Opioid poisoning PARACETAMOL POISONING T39.1 + (X40.99/X60.99/Y10.99) DESCRIPTION Liver damage, due to the depletion of glutathione and accumulation of toxic metabolites, can occur in any individual with paracetamol overdose. Patients with predisposing risk factors for hepatotoxicity (“high risk” patients, see below) may experience toxicity at lower ingeEML (Adult)→