Remote Primary Health Care Manuals

⚠️ Corrections, updates, and changes to practice in the RPHCM

RPHCM Corrections and updates to content or formatting

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PROTOCOL MANUAL
AND PAGE		 CONTENT CLARIFICATION
OR CORRECTION
Alcohol withdrawal
Table 5.4
Modified Clinical Institute Withdrawal Assessment (CIWA)		 STM 281

Multiple errors due to transposed formatting

Please file-pdf iconclick hereeye icon for corrected version of the table
(can be cut out and glued over current table)

Anaemia (weak blood) in children and youth

Oral iron supplementation

 STM 178

Iron doses throughout protocol

Clarification:
Please note that iron doses throughout protocol are expressed as elemental iron

Antibiotic doses table
Benzathine benzylpenicillin
(Bicillin L-A)

 STM 502
WBM 365

Benzathine benzylpenicillin for Chickenpox, Skin sores, Sore throat

Note: Comment re paediatrician consult belongs in the RHD row 

Correction:
Benzathine benzylpenicillin for RHD

For child less than 10kg paediatrician consult for secondary prophylaxis regime

Antibiotic doses table
Pyrantel dose

 STM 509
WBM 372

Pyrantel dose for 10yrs or 32kg patient
320mg
or 3 sq
or 3½ tab – 125mg
(tablet dose  incorrect)

Correction:
Pyrantel dose for
10yrs or 32kg patient
320mg
or 3 sq
or 2½ tab – 125mg

Assessing and reducing cardiovascular risk
Table 4.5 HIGH cardiovascular risk
(if one or more present)		 STM 231

Diabetes AND kidney disease with urine ACR 5mg/mmol or more for males, 3.5mg/mmol or more for females 

 Correction:
Diabetes AND kidney disease with urine ACR 2.5mg/mmol or more for males, 3.5mg/mmol or more for females 
Ear and hearing problems
Otoscopy examination		 STM 395

Do not syringe if any pain or any holes in ear drum

 Correction:
Do not syringe if painful

Ear and hearing problems
Chronic suppurative otitis media (CSOM)

 STM 401

(DO)
Clean until ear drum visible using tissue spears

Correction:
(DO)
Clean until ear drum visible using tissue spears or syringe with dilute betadine (1:20). Syringing should be done first if the pus is thick or if eardrum cannot be seen
(adapted from 2020 OTITIS MEDIA guidelines for Aboriginal and Torres Strait Islander Children)

Early recognition of sepsis (deteriorating patient)
Obstetric REWS Table		 STM 3
WBM 15		 Obstetric REWS score of 3 for RR is 9 or less

Correction:
Obstetric REWS score of 3 RR is
8 or less
(Note: the versions in ‘Printable resources’ have been updated)

Early recognition of sepsis (deteriorating patient)
STM Flowchart 1.1
WBM Flowchart 1.2		 STM 7
WBM 19		 Confusing detail in flowchart under the REWS score 3 or more box

Clarification:
Please go to ‘Printable resources’ for a new version of the flowchart suitable for pasting into the hardcopy of the manuals, or printing out in A3 as a small wall poster

Hypertension
(High BP)
Table 4.17: BP result and action if not already on a BP management plan

 STM 259

Table 4.17 has incorrect cross references to Tables 4.1 and 4.20 

 All cross references to other tables should be to:
Table 4.18 Management of high BP by cardiovascular risk
(located below Table 4.17)
Pain management (acute)
Pain medicines - Paracetamol		 STM 327 Double dose can be given at night — then no more for next 8 hours Instruction applies to children only and should more specifically say:
A single dose of 30mg/kg may be used for night time dosing

Pain management (acute)
Table 7.4
Acute pain relief (Adult)

 STM 331

Intramuscular (IM) morphine doses not included in table.

Morphine doses IM

  • Under 39 years AND over 50kg — 7.5–12.5mg
  • 40–59 years — 5–10mg
  • 60–69 years — 2.5–7.5mg
  • 70–85 years — 2.5–5mg
  • Over 85 years — 2–3mg

Every 2 hours as needed

Please file-pdf iconclick hereeye icon for print out of the doses which can be glued under Table 7.4
Resuscitation reference table
Amiodarone		 STM 36
WBM 6

Undiluted After 3rd shock.
Slow IV push THEN 20mL normal saline flush.

Correction:
Undiluted After 3rd shock.
Slow IV push THEN 20mL flush with glucose 5% or sodium chloride 0.9% 

Worms
Table 7.39
Worm treatment if positive faeces or serology test		 STM 496 Threadworm or pin worm Pyrantel dose:
Oral once a day for 3 days
Repeat dose in 2 weeks

Pyrantel dose should be:
Oral single dose
Repeat dose in 2 weeks
(see STM p509 for doses)




RPHCM Changes to practice

Changes in practice since the printing of the 2022 edition of the RPHCM

PROTOCOL AFFECTED BY CHANGE IN PRACTICE MANUAL AND
PAGE		 CONTENT UPDATE
STI management
Gonorrhoea
Geographical treatment areas for gonorrhoea have changed since publication of manuals.
STM Table 6.1
WBM Tables 5.3, 5.5

STM 311

WBM
256, 265 

Penicillin SENSITIVE
• All of the NT outside of Darwin
• The Kimberley, Goldfields, Midwest and Pilbara regions of WA

Penicillin RESISTANT
• Darwin
• All other areas except those mentioned above

Updated geographical areas:
Penicillin SENSITIVE
• The Kimberley, Goldfields, Midwest and Pilbara regions of WA

Penicillin RESISTANT
• All of the NT
• All other areas except those mentioned above

Please note

  • These updates address the increased cases of penicillin-resistant gonorrhoea in the NT. Please see the NT Centre for Disease Control notification for more information.
  • file-pdf iconClick hereeye icon for a print out of the updated text which can be glued over the existing table in the CARPA STM or Women’s Business Manual