TAM guideline updates

January 2023:

New guidance

• TAM535 ADHD pilot pathway

Amended guidance 

• TAM528 Delirium management
• TAM281 Parkinsons disease
• TAM148 Achieving control in type 2 diabetes
• TAM481 Giant cell arthritis (GCA)
• TAM331 Non-IgE Cows Milk Protein Allergy Guidance 
• TAM135 Acute coronary care syndrome
• AMT101 Amikacin
• AMT152 Influenza treatment
• Urinary tract (UTI)
• TAM508 Pre-Diabetes and type 2 referrals

Removed guidance 

• COVID078 Emergency management of tracheostomy patient on LTV 
• COVID019 Rheumatology COVID-19
• COVID102 Anticoagulant COVID-19
• COVID004 Cancer COVID-19
• COVID052 End of life Acute COVID-19
• COVID006 Diabetes COVID-19 
• TAM302 Management following colposcopy 
• TAM299 Cervical smear recall 
• TAM387 Incontinence dermatitis
• FCR110 Inner Moray Firth Investigation and Treatment Room Service 
• COVID021 SKIN COVID-19
• COVID020 Sexual Health
• COVID013 Mental Health COVID-19

February 2023:

NB this section is being updated on a daily basis throughout the month.

New guidance

• Refugee and asylum seeker support
• Protocol for the administration of intravenous mannitol to reduce raised intra-ocular pressure

Amended guidance 

• TAM310 GP Out of Hours HSCP
• COVID111 Non hospitalised patients with symptomatic COVID-19 infection 
• COVID039 Aeroso generating procedures
• TAM185 Ophthalmology diagnosis/flowcharts 
• TAM148 Achieving control in type 2 diabetes 
• TAM UTI guidance 

March 2023:

New guidance

• ADHD pilot pathway

Updated guidance

• Stress and distress in dementia

Removed guidance

• Incontinence dermatitis
• Skin COVID-19
• Sexual Health COVID-19

April 2023:

New guidance

• Protocol for the administration of intravenous mannitol to reduce raised intra-ocular pressure
• VTEP guidance: New Craigs

Updated guidance

• Aerosol generating procedures COVID-19
• Eyes
• Genital tract
• Highest Risk List: COVID-19
• HIV pre-exposure prophylaxis PrEP
• Infective endocarditis
• Influenza treatment
• Microbiology susceptibility reporting
• Non-hospitalised patients with symptomatic COVID-19 infection
• Smoking cessation
• Ultrasound referral guidelines
  
  • Neck lump added

Removed guidance

• Long term ventilation: Primary Care: COVID-19

May 2023:

New guidance

• ECG monitoring of patient on drugs known to prolong the QT interval
• Gender identity guidance
• Palpable cervical lymph nodes (paediatrics)
• Ultrasound follow-up of gall bladder polyp
• Vancomycin in haemodiafiltration

Updated guidance

• Chronic and persistent pain

June 2023:

Updated guidance

• Hyperkalaemia
• FAQ for GP CT Referral for Cancer
• Imaging pathway for Primary Care direct access to CT chest/abdomen/pelvis for suspected malignancy
• Ophthalmology referral guidelines, including Out of Hours
• Ophthalmology emergency admission protocol: Raigmore and NTC
• Orbital cellulitis
• Lower limb lymphoedema
• Upper Limb lymphoedema
• Age-related macular degeneration (nhsh.scot)
• Patient information - Stroke (nhsh.scot)
• Imaging pathway for Primary Care direct access to CT chest/abdomen/pelvis for suspected malignancy (nhsh.scot)
• FAQ for GP CT Referral for Cancer Pathway (nhsh.scot)
• Referral to Community Diabetes Specialist Nurses (nhsh.scot)

July 2023:

Updated guidance

• Sayana Press
• Armed forces and veterans 

August 2023:

New Guidelines

• Major haemorrhage protocol 

Updated Guidelines 

• Computerised cognitive behaviour (cCBT) 
• Referral to community diabetes
• FAQ for GP CT Referral for cancer pathway 
• Imaging pathway for Primary Care direct access
• Age related macular degeneration 
• Patient information stroke 
• Hyperkalaemia
• Colorectal investigation and referral
• Incorrect use of combined hormonal contraception 
• Acute treatment and secondary prevention of transient ischaemic attacks (TIA) and ischaemic stroke 
• Adrenarche
• Sleep onset difficulties 

September 2023:

New guidance:

• Oral buprenorphine in opioid dependence (Guidelines) 
• Medication assisstend treatment (MAT) (Guidelines)

Updated Guidance:

• Malignant spinal cord compression
• Uncomplicated chlamydia in Primary Care
• Patient information stroke 
• Acute treatment and secondary prevention of transient ischaemic attacks (TIA) and ischaemic stroke
• Management of children under 16yrs under the influence of drugs/alcohol 
• Improving the Safety of Patients with a Tracheostomy
• Ultrasound scan (USS) referral guidelines 

October 2023:

New guidance

• Personality disorder integrated care pathway

Updated guidance

• Prolonged seizure / status epilepticus in adults (Primary Care)
• Osteoporosis
• Computerised cognitive behavioural therapy (cCBT) 
• Glucose monitoring
• Red eye
• Gender identity guidance 
• Corticosteroids (dexamethasone, prednisolone and hydrocortisone for patients confirmed SARS-CoV-2 infection
• Acute otitis media 
• Acute otitis externa
• Tuberculosis
• Acute Coronary Syndrome
• Emergency contraception 
• Heart Failure assessment and investigations
• Heat Failure diagnosis 
• Heart Failure Medical management
• Heart Failure Management of decompensation 
• Non-hospitalised patients with symptomatic COVID-19 infection
• Hospital in-patient with hospital-acquired/hospital onset COVID-19 infection
• Lymphopenia assessment
• ED Stroke Thrombolysis 
• Ophthalmology referral guidelines, including Out of Hours 
• Treatment COVID19
• Antivirals and neutralising monoclonal antibodies COVID19
• Hospital in-patient Tocilixumab and Sarilumab
• Generalised anxiety disorder
• Depression

November2023: 

Updated Guidance

• Gender identity guidance (Guidelines) | Right Decisions (scot.nhs.uk)
• Acute coronary syndrome
• Highland Eating Disorder Service (HEDS) & Medical Emergency Eating Disorder (MEED)
• Hospital in-patient with hospital-acquired/hospital onset COVID-19 infection 
• Non-hospitalised patients with symptomatic COVID-19 infection
• Chronic Kidney Disease 
• Acute Kidney Injury
• Polycythaemia erythrocytosis
• Psychotic Disorders
• Thrombocytosis
• Post-menopausal bleeding

December 2023: 

Updated Guidance

• Feeling of lump in throat
• Vascular
• Treatment COVD19
• Female urinary incontinence

September 2022:

New guidance:

• Short synacthen test
• Resuscitation
• Hypercalcaemia
• Plasma metanephrines measurement
• Delirium management
• Child healthy weight
• Faecal incontinence
• Investigation of primary hyperaldosteronism

Updated guidance:

• SGLT2 inhibitors type 2 diabetes

Guidance removed:

• Toddler and young children; food, mood and health guidance

October 2022:

New guidance:

• Colorectal secondary guidance

Updated guidance:

• Testosterone replacement in menopause TAM492 
• Gestational diabetes
• Computerised cognitive behaviour (cCbt)
• Folate testing and management
• B12 deficiency testing and management
• Children empirical antibiotic therapy
• Intermittent claudication/critical ischaemia
• Baricitinib for adults and children aged 2 years and older
• Clostridium dificile
• NTproBNP
• Pre diabetes and type 2 diabetes referrals

Guidance removed:

• Toddler and young children food mood and health guidance 

November 2022:

New guidance:

• Bronchiolitis 
• Emergency admission of adults with acute constipation
• Groin hernia pathway 
• Gallstone disease 
• Anti reflux surgery

Updated guidance:

• Amputation pain Raigmore
• Ketamine
• Teicoplanin
• Gentamicin dosing in infective endocarditis in adults 
• Naloxone and managing opioid
• Post operative nausea and vomiting
• Patient controlled analgesia PCA 
• Subcutaneous opioid
• Epidural analgesia
• Local anaesthetic infusion
• Wet legs lymphorrehoea

Guidance removed: 

• None 

December 2022:

New Guidance: 

• Silver Diamine fluoride
• Bronchiolitis 
• Raigmore emergency ophthalmology admission protocol

Updated Guidance: 

• Pre diabetes and type 2 diabetes referrals
• Testosterone replacement in menopause
• Gentamicin
• Subcutaneous Methotrexate
• Highland eating disorder (HEDS) and MEED 
• Subcutaneous opioids
• Acute pain management in adults with renal impairment
• Epidural analgesia 
• Assessing vascular status
• Wet legs lymphorrhoea
• Ketamine infusion
• Amputation
• Pain assessment
• Pain controlled analgesia
• Post operative nausea and vomiting 
• Naloxone and managing opioid
• Local anaesthetic infusion 

Removed guidance: 

• Information for patients, carers and families 
• Treatment of medically unwell patients with anorexia nervosa 
• MARSIPAN checklist 
• Summary of a dieticians role 
• Increased levels of care