Guidelines

3,191 entries

NDOH Standard Treatment Guidelines and clinical protocols

SinusitisInfection Sinusitis Brief outline/clinical setting Sinusitis refers to inflammation of the sinuses. Acute sinusitis is commonly caused by respiratory viruses, which then predisposes to secondary bacterial infection. Allergy, trauma and dental infection may also predispose to acute bacterial sinusitis. Indications for antibiotics in patients with acute bacterial sinusitis include: Symptoms &Other→
Sinusitis, Acute, BacterialEar, Nose and Throat ConditionsPrimary Care→
Sinusitis, Bacterial, ComplicatedStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 EditionEML (Adult)→
Sinusitis, ComplicatedSinusitis, complicatedPEML (Paeds)→
Skin and Mucosal Disorders in HIVSkin and mucosal disorders are more severe in immune suppressed (HIV-infected) patients and may be worsened by IRIS. HIV may present initially with skin or mucosal lesions, or these lesions may develop during the course of the illness. Lesions respond to antiretroviral therapy together with treatment for the specific skin and/or mucosal disorder. Skin eruptions or rashes are relatively common inPEML (Paeds)→
Skin and Soft Tissue InfectionsThis guideline aims to assist healthcare workers with antibiotic prescribing for common clinical syndromes in adult patients in South Africa, utilizing Local and International guidelines, key publications, and expert opinion.Other→
Snake BitesDescription General measures Medicine treatment Cytotoxic and neurotoxic snakebite Boomslang snake bite Snake venom in the eye T63.0 + (X20.99/W59.99) DESCRIPTION In the majority of snakebite incidents, the offending snake is not identified. The table below illustrates the three main envenomation syndromes seen in South Africa: cytotoxic, neurotoxic and haemotoxic. Snake species Envenomation syndEML (Adult)→
Snake Venom in the EyeDescription General measures Referral ICD-10 code: S05.9 + (X20.99) DESCRIPTION Direct or indirect snake venom exposure to the eye, particularly from various species of spitting cobras and rinkhals, can cause chemical injury with varying clinical presentations ranging from periocular swelling and mild conjunctival and corneal inflammation to frank corneal ulceration and perforation with evePEML (Paeds)→
SnakebiteDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: T63.0 DESCRIPTION The effects of snakebites may be cytotoxic, neurotoxic and/or haemotoxic. The overall effect is determined by the predominant toxin in the snake venom. In the majority of cases, the species of snake is unknown. The patients can be divided into: no evidence of bite, no ePEML (Paeds)→
Snakebite EmergenciesThis guideline was approved in December 2014 and will be reviewed in December 2016, or sooner if important evidence becomes available.Other→
SnakebitesDescription General Measures Medical Treatment Referral ICD-10 code: T63.0 + (X20.99/W59.99) DESCRIPTION Of all the snake species found in South Africa less than 10% are potentially harmful to humans. However, all snakebites should be considered dangerous until proven otherwise. In the majority of snakebite incidents, the offending snake is not identified. South African poisonous snPrimary Care→
Soft Tissue InjuriesSee Primary Health Care STGs and EML; Soft tissue injuries . 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)→
Soft Tissue InjuriesDescription Emergency Management Management of Wounds and Lacerations Medicine Treatment Referral ICD-10 code: T14.0-1/T14.9 DESCRIPTION Injuries may be minor, moderate or major: Major injuries: it is important to recognise potentially life-threatening injuries. Indicators of such injuries are: Mechanism of injury: motor vehicle collision at speed exceeding 60 km/hour, ejecPrimary Care→
Soft Tissue NeoplasmSoft Tissue NeoplasmOther→
Soft Tissue Sepsis and Necrotising FasciitisSoft Tissue Sepsis and Necrotising FasciitisOther→
Somerset Hospital Weekly ScheduleSomerset Hospital weekly scheduleOther→
Soothe the Throat, Relieve the CoughIMCI - Child (Age 2 months up to 5 years)IMCI→
South African Guidelines on the Determination of DeathGeneral statements Definitions Brain death Circulatory death Organ donation Training and documentation Strengths and limitations Conclusion General statements Death is the clinical point of irreversible loss of the capacity for consciousness and the irreversible loss of the capacity to breathe. [16] Death is determined by either neurological or circulatory criteria and must be made in accordanceOther→
South African National Health and Nutrition Examination Survey-1 (SANHANES-1)South African National Health and Nutrition Examination Survey-1 (SANHANES-1)Other→
South African Society of Anaesthesiologists (SASA): AbbreviationsList of abbreviations Abbreviations Definitions AA Agent analysis AAGBI Association of Anaesthetists of Great Britain and Ireland ADR Adverse drug reaction APPSA Association for Peri-Operative Practitioners in South Africa ASA American Society of Anesthesiologists BIS Bispectral index BP Blood pressure CanMEDS Canadian Medical Education Directives for Specialists CEUs Continuing education units COther→
South African Society of Anaesthesiologists (SASA): IntroductionGoals of the guidelines Establishment of guidelines (methodology) Format of practice guidelines Date of next review Outline of the 2022 revision Strength of recommendations Conclusion The South African Society of Anaesthesiologists’ (SASA) mission is “leading the science and practice of safe anaesthesia at the highest standard and ensuring the sustainability of anaesthesiology services. SASA is dOther→
Special ConsiderationsIntellectual Disability Older Patients (≥45 years) Sexual Health and Sexuality Maternal Mental Health Intellectual Disability ICD-10 code: F70.0-1/F70.8-9/F71.0-1/F71.8-9/F72.0-1/F72.8-9/F73.0-1/F73.8-9/F78.0-1/F78.8-9/F79.0-1/F79.8- 9/F84.1/F84.4 + (Z13.3/Z81.0/Z81.8) Difficulty with verbal communication in the patient may result in over diagnosis of psychiatric conditions. More time is neePrimary Care→
Special Considerations in Asthma ManagementCOVID-19 Well-controlled asthma, without significant comorbidities, not requiring high-dose ICS or regular oral corticosteroids, and not having frequent acute exacerbations requiring extra bursts of systemic corticosteroids, is not associated with a higher risk of infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus or its complications. Individuals with sevOther→
Special Considerations in HIV Infected Children & ThrombocytopeniaSpecial Considerations In HIV-Infected Children Thrombocytopenia Description Diagnostic criteria General and supportive measures Medicine treatment Referral SPECIAL CONSIDERATIONS IN HIV-INFECTED CHILDREN In addition to the usual causes of blood disorders in childhood, HIV-infected children are at increased risk of developing anaemia, thrombocytopenia and neutropenia secondary to drugs (espPEML (Paeds)→
Special Considerations in Paediatric PatientsDecision making around renal replacement therapy Management options for children with ESKD Choice of treatment modality Suitability for renal replacement therapy Renal transplantation The role of paediatric palliative care in paediatric renal supportive care Where consultation may be required with specialty palliative care during renal supportive care Specific paediatric requirements for symptomOther→
Special Forms of HaemodialysisOnline Haemodiafiltration (HDF) Extended Dialysis Online Haemodiafiltration (HDF) Three meta-analyses came to disparate conclusions regarding potential benefits of convective therapies on cardiovascular mortality. Published data currently show that convective therapies, compared with conventional haemodialysis, have better removal of beta-2 microglobulin and improved haemodynamic stability.Other→
Special SituationsMajor haemorrhage Critical care Obstetrics Paediatrics Trauma Cardiac surgery Neuroanaesthesia Minimising anaemia and transfusion Antifibrinolytic therapy Cell salvage Major haemorrhage Major haemorrhage – initial resuscitation Consensus Grade 5.1 FDP can be substituted for FFP in the South African context. Yes B 5.2 15–20 ml/kg is the correct initial dose of FDP. Yes B 5.3 15–20 ml/Other→
Specialist Clinic RosterDistrict level hospital guidelines applicable for interns and comm service doctors. Published in 2016Other→
Specialist ClinicsDistrict level hospital guidelines applicable for interns and comm service doctors. Published in 2016Other→
Specific Considerations in Different Surgical DisciplinesGeneral surgery Vascular surgery Cardiothoracic surgery Neurosurgery Orthopaedic surgery General surgery Local anaesthesia and regional anaesthesia, especially epidural analgesia after laparotomy, should be offered whenever possible. Vascular surgery Patients presenting for vascular surgery often suffer from several comorbidities, including hypertension, ischaemic heart disease, lung disease, renOther→
Specific InfectionsImpetigo Cellulitis Abscess BCG Adenitis Necrotising Skin and Soft Tissue Infection Pyomyositis Toxic Shock Syndrome (TSS) Impetigo Impetigo are discrete, purulent lesions which occur most commonly on exposed body parts (such as face and extremities). They are most common between the age 2 - 5 years but can occur outside this age bracket. Lesions may be bullous or non-buOther→
Spider BitesICD-10 code: T63.3 The vast majority of spiders are not harmful to humans. Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition Chapter 18: Poisoning, 18.2 Envenomation, 18.2.5 Spider Bites Click here for Spider Bites, Neurotoxic (Button/Widow Spiders) Click here for Spider Bites, Necrotic ArachnidismPEML (Paeds)→
Spider Bites, Necrotic ArachnidismDescription Diagnostic criteria General and supportive measures Medicine treatment ICD-10 code: T63.3 DESCRIPTION Violin/recluse (Loxosceles) spiders and sac (Cheiracanthium) spiders can produce local necrotic skin lesions that are mediated by enzymes. DIAGNOSTIC CRITERIA Bites are initially painless. Skin lesions can vary from mildly erythematous lesions to severe local reaction, i.e. blisPEML (Paeds)→
Spider Bites, Neurotoxic (Button/Widow Spiders)Description Diagnostic criteria General and supportive measures Medicine treatment DESCRIPTION The term latrodectism is used to describe the systemic symptoms and signs following envenomation by the bite of the Latrodectus species (button or widow spiders). Most cases are caused by the bite of a black button spider; brown button spider bites are usually milder and characterized by local symPEML (Paeds)→
Spider EnvenomationDescription General measures Medicine treatment T63.3 + (X21.99) DESCRIPTION Local venomous spiders are divided into cytotoxic and neurotoxic groups. To view pictures for the identification of spiders: http://www.cmej.org.za/index.php/cmej/article/view/2547/2582 Cytotoxic spider group The cytotoxic group includes sac, violin, and crab spiders. Lesions may present with significant bite site necrosEML (Adult)→
Spinal Cord CompressionAn approach to symptom management to guide decision-making in the management of patients with life-threatening illnessOther→
Spinal Cord Compression - Paediatric Palliative CareDescription General and supportive measures Medicine treatment Referral DESCRIPTION Loss of neurological function in limbs (usually lower) caused by spinal compression from tumour or other disease process. Should be managed as an emergency in an attempt to delay complete loss of function for as long as possible. Caused in children by intramedullary or intradural metastases or extradural compressiPEML (Paeds)→
Spinal Cord InjuriesDescription General measures Medicine treatment Referral DESCRIPTION Multiple symptoms may manifest in these patients, requiring accompanying medications and rehabilitative therapy at different levels of care. Patients with spinal cord injuries may initially be managed at hospital level before referral to primary care level for long-term management. After referral, patients should be assisted witPrimary Care→
Spinal Cord Injury, AcutePlease 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 14: Neurological Disorders with Supporting NEMLC Report-2020-4-ReviEML (Adult)→
Sprains and StrainsSee Primary Health Care STGs and EML; Sprains and strains . 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)→
Sprains and StrainsDescription Emergency Treatment Referral ICD-10 code: S03.4-5/S13.4-6/S23.3-5/S33.5-7/S43.4-7/S53.4/S63.5-7/S73.1/S83.4-6/S93.4-6/T11.2/T13.2/ T14.3 DESCRIPTION Clinical features include: pain, especially on movement tenderness on touch limited movement history of trauma May be caused by: sport injuries slips and twists overuse of muscles abnormal posture Note: In children always bear non-Primary Care→
Standard Operating Procedure for the Prevention, Containment and Management of COVID-19 in Schools and School CommunitiesMay 2020Other→
Standard Paediatric Dosing TablesPaediatric Dosing TablesPrimary Care→
Standards of MonitoringAnxiety levels and behaviour, such as confusion, restlessness and agitation Level of consciousness and depth of sedation Pain and degree of discomfort Airway patency Oxygenation and mucosal colour Breathing, respiratory rate and ventilation Heart rate and rhythm Non-invasive blood pressure Operator-dependent factors Minimum monitoring standards The principles of monitoring are described by the AcOther→
Staphylococcal Scalded Skin SyndromeDescription General and supportive measures Medicine treatment Referral ICD-10 Code: L00 DESCRIPTION Blistering skin condition that presents like scalded skin. GENERAL AND SUPPORTIVE MEASURES Appropriate wound care. MEDICINE TREATMENT Cloxacillin, IV, 50 mg/kg/dose 6 hourly for 5 days. Neonates: Week 1–2 of age: administer 12 hourPEML (Paeds)→
Staphylococcal SepticaemiaDescription Diagnostic criteria General and supportive measures Medicine treatment Referral ICD-10 code: A41.2 DESCRIPTION Staphylococci cause disease by direct invasion of tissues with liberation of toxins. Septicaemia may occur when haematogenous dissemination occurs from a focus of infection. DIAGNOSTIC CRITERIA Clinical Features of septicaemia should raise an index of suspicion oPEML (Paeds)→
Staphylococcus Aureus BacteraemiaThis guideline aims to assist healthcare workers with antibiotic prescribing for common clinical syndromes in adult patients in South Africa, utilizing Local and International guidelines, key publications, and expert opinion.Other→
Status EpilepticusStatus EpilepticusOther→
Status EpilepticusSeizures (Convulsions/ Fits)Primary Care→
Status EpilepticusSee: Status epilepticus (in Epilepsy ). 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)→