TAM guideline updates

*New Guidance* (ratified at previous TAMSG):

• Items will be added as published. 

*Major updates* (ratified at previous TAMSG): 

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Termination of pregnancy (Guidelines) | Right Decisions
• Early Medical Abortion at Home (EMAH) (Guidelines) | Right Decisions

Minor updates (awaiting ratification at next TAMSG): 

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Short synacthen test protocol (Primary Care, HHSCP only) (Guidelines) | Right Decisions
• Spinal opioids (Guidelines) | Right Decisions
• Local anaesthetic infusion (Guidelines) | Right Decisions
• Naloxone and managing opioid complications (Guidelines) | Right Decisions
• Patient controlled analgesia (PCA) (Guidelines) | Right Decisions
• Post-operative nausea and vomiting (Guidelines) | Right Decisions
• Epidural analgesia (Guidelines) | Right Decisions
• Adult oral analgesia (Guidelines) | Right Decisions
• Major haemorrhage protocol: Argyll & Bute HSCP (Guidelines) | Right Decisions
• Antibiotic posters: Common, community-acquired infections in adults (Antimicrobial) | Right Decisions
• Community Acquired Pneumonia (CAP) (Antimicrobial) | Right Decisions

Reviewed with no changes: 

• Covid-19 the green book chapter 14 (Guidelines)
• Ketamine (Guidelines) | Right Decisions
• Subcutaneous opioid (Guidelines) | Right Decisions
• Naloxone and managing complications of opioids (Paediatric Guidelines) | Right Decisions

Removed Guidance:

• Amputation pain (Raigmore in-patient) (Guidelines)

New Guidance: 

• Radiology referral: Walk-in for chest imaging (Guidelines) | Right Decisions
• Continuous glucose monitoring (CGM): Inpatient (Guidelines) | Right Decisions
• Eating disorder: Children and young people (Paediatric Guidelines) | Right Decisions
• Eating disorder: Children and young people (OOH) (Paediatric Guidelines) | Right Decisions
• Sudden onset sensorineural hearing loss (<72 hours) (Guidelines) | Right Decisions
• Depot and long-acting antipsychotic injections (Guidelines) | Right Decisions
• Infectious diseases: Management of contacts (Guidelines) | Right Decisions
• Identifying patients at risk of adrenal suppression (Guidelines) | Right Decisions
• Anticoagulant reversal (Guidelines) | Right Decisions
• Diabetes referral pathways (Guidelines) | Right Decisions
• Neutropenic sepsis: Antifungal treatment (Antimicrobial) | Right Decisions

Updated Guidance: 

To view the changes to the guidance, see the 'What's new' section of each guideline.

• ARMED FORCES AND VETERANS (Resources) | Right Decisions
• Management of device-detected atrial fibrillation (Guidelines) | Right Decisions
• Diagnosis unclear, infection source likely respiratory or urinary-tract (hospital in-patients) (Antimicrobial) | Right Decisions
• Severe Sepsis - Unknown Focus (Antimicrobial) | Right Decisions
• Abnormal liver blood results referral pathway (Over 16’s) (Guidelines) | Right Decisions
• Cardiac rehabilitation (Guidelines) | Right Decisions
• Flu (Guidelines) | Right Decisions
• Vitamin D deficiency (Guidelines) | Right Decisions
• Achieving control in type 2 diabetes (guidelines)
• Pulmonary embolism (Guidelines) | Right Decisions
• Suspected seizure: ED / AMAU (Guidelines) | Right Decisions
• Bone and Joint Infections (Antimicrobial) | Right Decisions
• Complex bronchiectasis referral pathway (Guidelines) | Right Decisions
• Major haemorrhage and emergency invasive procedures in patients on direct oral anticoagulants (DOACs) (Guidelines) | Right Decisions
• Clostridioides Difficile (Antimicrobial) | Right Decisions
• Clostridioides Difficile (CDI) Information pack for general practitioners (Antimicrobial) | Right Decisions
• Peri-operative guidance for patients with or at risk of adrenal insufficiency (Guidelines) | Right Decisions
• COVID-19: Long covid (Guidelines) | Right Decisions
• Raised triglycerides (Guidelines) | Right Decisions

Removed guidance:

• SGLT2 inhibitors in type 2 diabetes (T2D) (Guidelines) removed and incorporated in Achieving control in type 2 diabetes (Guidelines)
• Glucagon-like peptide-1 (GLP-1) analogues (Guidelines) removed and incorporated in Achieving control in type 2 diabetes (Guidelines)
• Pioglitazone prescribing algorithm (Guidelines) removed and incorporated in Achieving control in type 2 diabetes (Guidelines)
• Diabetes regular follow up. Replaced with: Diabetes referral pathways (Guidelines)
• Referral to Community Diabetes Specialist Nurses. Replaced with: Diabetes referral pathways (Guidelines)

Updated Guidance 

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Palpitation (Guidelines) | Right Decisions
• Red eye (Guidelines) | Right Decisions
• INTERPRETATION GUIDANCE (Resources) | Right Decisions
• Palliative Care resources (Guidelines) | Right Decisions
• Asthma in adults (Guidelines) | Right Decisions
• Syphilis referral pathway (Guidelines) | Right Decisions
• Referral pathway for Deep Subdermal Implant (SDI) removal (Guidelines) | Right Decisions
• Emergency Contraception (Guidelines) | Right Decisions
• Chlamydia (uncomplicated) in Primary Care (Guidelines) | Right Decisions
• Protected antimicrobials (Antimicrobial) | Right Decisions
• Unplanned alcohol withdrawal (Guidelines) | Right Decisions
• Polypharmacy | Right Decisions
• Post-menopausal bleeding and endometrial cancer (Guidelines) | Right Decisions
• Flu (Guidelines) | Right Decisions
• Lyme disease (Antimicrobial) | Right Decisions
• Parkinson's disease (Guidelines) | Right Decisions

New Guidance

• Metabolic dysfunction-associated steatotic liver disease (MASLD): Primary Care (Guidelines) | Right Decisions (Replacing Pathway B MASLD)
• Lyme disease (Guidelines) | Right Decisions

Removed guidance

• Neutropenic sepsis: Ongoing management: in-patients with febrile neutropenia: Day 2 to 3 (Antimicrobial)
• Urokinase with blocked central venous access device (Paediatric Guidelines): Moved to CWard Formulary

New Guidance

• Legionnaires' disease: information for clinical team | Right Decisions (scot.nhs.uk)
• Fluid balance (Guidelines) | Right Decisions
• Mental Health Assessment Unit (MHAU) (Guidelines) | Right Decisions
• Head injury (Guidelines) | Right Decisions
• Optic neuritis (Guidelines)

Updated Guidance 

To view the changes to the guidance, see the 'What's new' section of each guideline.

• SOCIAL PRESCRIBING | Right Decisions (scot.nhs.uk)
• Transfusion special requirements | Right Decisions
• Highland Eating Disorder Service (HEDS) & Medical Emergency Eating Disorder (MEED) (Guidelines) | Right Decisions
• Stroke thrombolysis pathway - Raigmore (Guidelines) | Right Decisions
• Palpitation (GUIDELINES) | Right Decisions
• Pre-Diabetes and type 2 diabetes referrals (Guidelines) | Right Decisions
• Asthma in adults (Guidelines) | Right Decisions
• Asthma in children aged 2 to 5 years (Paediatric Guidelines) | Right Decisions
• Major haemorrhage protocol: Argyll & Bute HSCP (Guidelines)
• Amikacin (Antimicrobial) | Right Decisions
• Rapid tranquilisation (Guidelines) | Right Decisions

New Guidance: 

• INFECTION PREVENTION & CONTROL | Right Decisions (scot.nhs.uk)
• SNBTS Handbook | Right Decisions (scot.nhs.uk) 
• Food Allergy Service (Paediatric Guidelines) | Right Decisions
• Hyperkalaemia: Primary Care (Guidelines) | Right Decisions
• Parenteral nutrition (Guidelines) | Right Decisions
• Vascular access in adult patients (Guidelines) | Right Decisions

Updated Guidance:

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Outpatient Antibiotic Therapy (OPAT) | Right Decisions (scot.nhs.uk)
• Post-fall medication review (Guidelines) | Right Decisions (scot.nhs.uk)
• Pulmonary embolism (Guidelines) | Right Decisions (scot.nhs.uk)
• Computerised cognitive behavioural therapy (cCBT) (Guidelines) | Right Decisions (scot.nhs.uk)
• Aerosol generating procedures (AGP) (Guidelines) | Right Decisions (scot.nhs.uk)
• Testosterone replacement in menopausal women (Guidelines) | Right Decisions (scot.nhs.uk)
• Hypertension (Guidelines) | Right Decisions (scot.nhs.uk)
• Food allergy referral (Paediatrics Guidelines) | Right Decisions (scot.nhs.uk)
• Sleep pathway (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Hypercalcaemia (Secondary Care) (Guidelines) | Right Decisions (scot.nhs.uk)
• Chronic kidney disease (Guidelines) | Right Decisions (scot.nhs.uk)
• Anaphylaxis (Guidelines) | Right Decisions (scot.nhs.uk)
• Sleep pathway (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Stroke thrombolysis pathway - Raigmore (Guidelines) | Right Decisions
• Sore throat (Guidelines) | Right Decisions (scot.nhs.uk)
• Resuscitation (Guidelines) | Right Decisions
• Smoking cessation (Guidelines) | Right Decisions (scot.nhs.uk)
• Incorrect use of combined hormonal contraception (CHC) (Guidelines) | Right Decisions
• Orbital cellulitis (Guidelines) | Right Decisions (scot.nhs.uk)
• Unscheduled bleeding on HRT (Guidelines) | Right Decisions
• Sayana press (Guidelines) | Right Decisions
• PALPITATION (Guidelines) | Right Decisions
• Abnormal liver blood results referral pathway (Over 16’s) | Right Decisions (scot.nhs.uk)
• Secondary prevention post myocardial infarction (Guidelines) | Right Decisions
• Lower limb lymphoedema (Guidelines) | Right Decisions
• Wet legs / Lymphorrhoea (Guidelines) | Right Decisions 
• Ophthalmology diagnosis/triage flowcharts (Guidelines) | Right Decisions
• Hypertension (Guidelines) | Right Decisions (scot.nhs.uk)
• Bell's Palsy (Guidelines) | Right Decisions
• Community Mental Health Team (CMHT) (Guidelines) | Right Decisions (scot.nhs.uk)

Guidance reviewed with no changes:

• COVID-19: Fingers & Toes (Guidelines) | Right Decisions (scot.nhs.uk)
• Seroma drainage following breast surgery (Guidelines) | Right Decisions
• Diagnosing familial hypercholesterolaemia (guidelines) | Right Decisions
• SOCIAL PRESCRIBING | Right Decisions
• Suspected blood transfusion reaction (Guidelines) | Right Decisions
• ICDs - home page (Implantable cardioverter defibrillators) (Guidelines) | Right Decisions
• Acute Coronary Syndrome (ACS) (Guidelines) | Right Decisions
• Stable Angina Management (Guidelines) | Right Decisions
• Emergency Medical Retrieval Service (EMRS) (Guidelines) | Right Decisions
• Penthrox (methoxyflurane) (Guidelines) | Right Decisions
• Emergency Department (Guidelines) | Right Decisions
• Paracetamol overdose (Guidelines) | Right Decisions
• Blood Sciences and Microbiology blood test tube guide (Guidelines) | Right Decisions
• Lipid lowering therapy in the prevention / treatment of atherosclerosis (Guidelines) | Right Decisions
• Suspected ischaemic chest pain (Guidelines) | Right Decisions
• Upper limb lymphoedema (Guidelines) | Right Decisions
• Prevention and treatment of post-operative vomiting in children (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Erectile Dysfunction (Guidelines) | Right Decisions
• PSA (prostate-specific antigen) Testing and Male Lower Urinary Tract Symptoms (LUTS) (Guidelines) | Right Decisions
• Diagnosis of UTI (Guidelines) | Right Decisions
• Recurrent UTI in females (Guidelines) | Right Decisions
• Recurrent UTI in males (Guidelines) | Right Decisions

Guidance removed and archived:

• COVID-19: When to refer to Infectious Diseases Team (In-patient) (Guidelines)
• COVID-19: Aerosol Generating Procedures (Guidelines) 
• Sleep onset difficulties (Paediatric Guidelines)
• CKD: Screening and diagnosis & CKD: Management. These have been combined into the one CKD guideline. 
• TAM515: Lymphoedema, Assessing vascular status (Guidelines) Guideline not developed as awaiting national guidance. 

January 2024

Updated Guidance

• Psychotic disorders
• Liver
• Raigmore Rib fracture management in trauma 
• Aerosol generating procedures 

February 2024

Updated guidance

• Ocular trauma 
• Lipid lowering therapy in the prevention/treatment of atherosclerosis
• Urology referral guideline 
• Frank Haematuria 
• Occult or non visible haematuria 

Removed guidance

• Introduction to treatment of low electrolytes as the information is within the guidance

March 2024

New guidance

• Haematology Full guideline suite reviewed with updates to guidelines and new guidelines added: 
  • Thrombocytopenia
  • Neutropenia
  • Neutrophilia
  • Lymphocytosis
  • Eosinophilia
  • Basophilia
  • Monocytosis
  • Splenomegaly
  • Lymphadenopathy
  • Elevated plasma viscosity
  • Iron deficiency
  • Hyperferritinaemia
  • Abnormal coagulation screen and bruising
  • VTE and travel
  • Blood parasite investigation
• ADHD Guidelines

Updated guidance

• Haematology Full guideline suite reviewed with updates to guidelines and new guidelines added:
  • Anaemia
  • Macrocytosis
  • Microcytosis
  • Lymphopenia
  • Vitamin B12 or Folate deficiency
  • Thrombophilia testing
• Vaccines and antisera (Formulary)
  • UK immunisation schedule
  • Vaccines and antisera for at risk groups
  • Vaccines and medicines for travel
• Bariatric surgery
• Psychotic disorders
• Tuberculosis
• Chronic kidney disease management

Removed guidance

• ADHD Pilot Pathway 
• Post partum haemorrhage 
• Physical monitoring with mental health

April 2024

New Guidance

• Raynaud's Phenomenon 
• Anaemia in chronic kidney disease (CKD): NHS Highland renal service (Guidelines)
• Pre-operative fluid fasting (Guidelines) | Right Decisions (scot.nhs.uk)
• Pre-operative indications for echocardiography | Right Decisions (scot.nhs.uk)
• Radiation proctitis | Right Decisions (scot.nhs.uk)
• Acute urinary tract infection
• Penicillin allergy poster

Updated Guidance (with changes)

• Menopause and HRT (Guidelines) | Right Decisions (scot.nhs.uk)
• Orthopaedics musculoskeletal pathways
• Unplanned alcohol withdrawal (Guidelines) | Right Decisions (scot.nhs.uk)
• Warfarin and DOACs in adults undergoing surgery or invasive procedures (Guidelines) | Right Decisions (scot.nhs.uk)
• Antimicrobial Guidelines for Adult In-Patients poster
• Critical care - empiric second line antibiotic guidelines for level 2 and 3
• Hospital acquired pneumonia
• Lyme disease
• Skin and soft tissue landing page
• Cellulitis/wound infections
• Acute lower urinary tract infection in adults (no fever or flank pain)
• Acute upper urinary tract infection
• Intra-abdominal sepsis
• Long covid (Guidelines) | Right Decisions (scot.nhs.uk)

Updated Guidance (no changes)

• AMT131 Gentamicin Prescribing Tips in Sepsis
• AMT118 Pre-op oral antibiotics prior to elective colorectal surgery
• AMT164 Cold sores
• AMT165 Fungal nail and skin infections
• AMT172 Varicella zoster/chicken pox - Herpes zoster/shingles
• AMT117 Gastroenteritis
• AMT120 Threadworm
• AMT122 Pancreatitis
• TAM414 PSA (Prostate-specific antigen) follow-up monitoring

Removed Guidance 

• COVID115 Management of surgical patients who decline a COVID19 test
• AMT136 Prophylaxis following tick bite
• AMT137 Erythema migrans (EM) and/or non-focal symptoms (eg 'flu-like' symptoms)
• AMT138 Lyme disease affecting the cranial nerves or peripheral nervous system
• AMT139 Lyme disease affecting the central nervous system
• AMT140 Lyme disease arthritis, Acrodermatitis chronic atrophicans
• AMT141 Lyme carditis: haemodynamically stable
• AMT142 Lyme carditis: haemodynamically unstable

May 2024

New Guidance:

• Clozapine initiation and re-titration: Specialist Mental Health (Guidelines) | Right Decisions (scot.nhs.uk)
• Perinatal and Infant Mental Health Team | Right Decisions (scot.nhs.uk)
• Unscheduled bleeding on HRT (Guidelines) | Right Decisions (scot.nhs.uk)

Updated Guidance: 

• Embolism prophylaxis for patients with non-valvular, persistent or permanent atrial fibrillation (Guidelines) | Right Decisions (scot.nhs.uk)
• Ocular trauma (Guidelines) | Right Decisions (scot.nhs.uk)
• Ophthalmology referral guidelines, including Out of Hours (Guidelines) | Right Decisions (scot.nhs.uk)
• Oral anticoagulants (Formulary) | Right Decisions (scot.nhs.uk)
• Prazosin for PTSD-related nightmares (Guidelines) | Right Decisions (scot.nhs.uk)

Removed Guidance:

• Anticoagulant recommendations. This is replaced with: Warfarin.

June 2024

New guidance:

• Orthopaedic on-call (Guidelines) | Right Decisions (scot.nhs.uk)

Updated guidance: 

• Pilondial disease (Guidelines) | Right Decisions (scot.nhs.uk)
• Prescribing medicines in renal impairment | Right Decisions (scot.nhs.uk)
• Pre-Diabetes and type 2 diabetes referrals (Guidelines)
• Anticoagulant switching | Right Decisions (scot.nhs.uk)
• Healthy weight Adult (Guidelines) | Right Decisions (scot.nhs.uk)
• Warfarin (Guidelines) | Right Decisions (scot.nhs.uk)
• Unplanned alcohol withdrawal (Guidelines) | Right Decisions (scot.nhs.uk)
• Intra-uterine contraceptive devices (IUCD) (Formulary) | Right Decisions (scot.nhs.uk)
• Vancomycin in haemodiafiltration (HDF) (Guidelines) | Right Decisions (scot.nhs.uk)
• Perinatal and Infant Mental Health Team | Right Decisions (scot.nhs.uk)
• Nephrostomy (Guidelines) | Right Decisions (scot.nhs.uk)
• AMT157 Bronchiectasis
• AMT158 Community Acquired Pneumonia (CAP)
• AMT162 Bites
• AMT163 Cellulitis/Wound Infections
• AMT168 Impetigo
• AMT169 Leg Ulcer
• AMT171 Scabies

Guidance reviewed with no changes: 

• AMT116 Eradication of Helicobacter pylori
• AMT146 Bone and Joint Infections
• AMT170 Necrotising Fasciitis

Removed guidance: 

• Referral to clinical Psychology (Guidelines)
• Orlistat Frequently Asked Questions (Patient information)
• Bariatric Surgery Frequently Asked Questions (Patient information)
• Non-steroidal anti-inflammatory drugs (NSAIDS) (Guidelines)
• Self Help Service - patient information leaflet (Guidelines)

July 2024

New guidance: 

• Myasthenia gravis (Guidelines) | Right Decisions (scot.nhs.uk)
• Orthopaedic on-call (Guidelines) | Right Decisions (scot.nhs.uk)
• Complex bronchiectasis referral pathway (Guidelines) | Right Decisions (scot.nhs.uk)
• Bronchiectasis (Guidelines) | Right Decisions (scot.nhs.uk)
• Pulmonary embolism (Guidelines) | Right Decisions (scot.nhs.uk)
• Food allergy referral (Paediatrics guidelines) | Right Decisions (scot.nhs.uk)
• Egg allergy (Paediatric guidelines) | Right Decisions (scot.nhs.uk)
• Intracerebral Haemorrhage (ICH) (Guidelines) | Right Decisions (scot.nhs.uk)
• Blood delivery (Guidelines) | Right Decisions (scot.nhs.uk)
• Transfusion special requirements | Right Decisions (scot.nhs.uk)
• Drug Management of Adult Hospital In-patients with COVID-19 Infection following LFT/PCR positive | Right Decisions (scot.nhs.uk)
• Risk factors for progression to severe COVID-19 infection | Right Decisions (scot.nhs.uk)
• Hospital prescription forms and prescribing chart example for oral antivirals | Right Decisions (scot.nhs.uk)
• Delayed / precocious puberty (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Short stature (Paediatric guidelines) | Right Decisions (scot.nhs.uk)

Updated Guidance: 

To view the changes to guidance, see the 'What's new' section of each guideline. 

• Monoclonal gammopathy of uncertain significance (MGUS) (Guidelines) | Right Decisions (scot.nhs.uk)
• Mastitis and breast abscess (Guidelines) | Right Decisions (scot.nhs.uk)
• Children and young people: deliberate self-harm with suicidal intent (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Ultrasound follow-up of gall bladder polyp (Guidelines) | Right Decisions (scot.nhs.uk)
• Non-hospitalised patients with symptomatic COVID-19 infection (Guidelines) (1) | Right Decisions (scot.nhs.uk)
• Adrenarche (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Referral to community diabetes specialist nurses (guidelines) | Right Decisions (scot.nhs.uk)
• Baricitinib for adults and children aged 2 years and older admitted to hospital with confirmed SARS-CoV-2 infection (Guidelines) | Right Decisions (scot.nhs.uk)
• Antivirals and neutralising Monoclonal Antibodies (nMABs) for COVID-19 | Right Decisions (scot.nhs.uk)
• Endocrine (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Pulmonary embolism (Guidelines) | Right Decisions (scot.nhs.uk)
• Sayana press (Guidelines) | Right Decisions (scot.nhs.uk)
• Warfarin, DOACs and antiplatelets in adults undergoing surgery or invasive procedures (Guidelines) | Right Decisions (scot.nhs.uk)
• Bell's Palsy (Guidelines) | Right Decisions (scot.nhs.uk)
• HIV Post-exposure prophylaxis (PEP/PEPSE) supporting guidelines (Guidelines) | Right Decisions (scot.nhs.uk)
• Human immunodeficiency virus (HIV) (Guidelines) | Right Decisions (scot.nhs.uk)

Removed guidance: 

• Hospital in-patients admitted with symptomatic COVID-19 infection (Guidelines)
• Hospital in-patient with hospital-acquired/hospital onset COVID-19 infection (Guidelines)
• Highest Risk List: COVID-19 (Guidelines):
  Replaced by: Risk factors for progression to severe COVID-19 infection | Right Decisions (scot.nhs.uk)
• Community Pharmacy (Resources):
  Archived as information now available on CP website. 
• Allergy (Paediatric guidelines):
  Replaced by Food allergy referral and Egg allergy guidelines. 
• Epidural (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)

August 2024

New Guidance:

• Asthma in children aged 2 to 5 years (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)

Updated Guidance:

To view the changes to the guidance, see the 'What's new' section of each guideline. 

• Weight and health (Guidelines) | Right Decisions (scot.nhs.uk)
• Malignant spinal cord compression (Guidelines) | Right Decisions (scot.nhs.uk)
• Palliative Care resources (Guidelines) | Right Decisions (scot.nhs.uk)
• Inpatient diabetes guidelines (Guidelines) | Right Decisions (scot.nhs.uk)
• Acute treatment and secondary prevention of transient ischaemic attacks (TIA) and ischaemic stroke (Guidelines) | Right Decisions (scot.nhs.uk)
• Personality disorder integrated care pathway (Guidelines) | Right Decisions (scot.nhs.uk)
• Hyponatraemia (Guidelines) | Right Decisions (scot.nhs.uk)
• Ultrasound follow-up of gall bladder polyp (Guidelines) | Right Decisions (scot.nhs.uk)

Guidance reviewed with no changes:

• Analgesia (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Naloxone and managing complications of opioids (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Subcutaneous opioid (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Local anaesthetic infusion (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)

September 2024

New guidance: 

• Outpatient Antibiotic Therapy (OPAT) | Right Decisions (scot.nhs.uk)
• Suspected blood transfusion reaction (Guidelines) | Right Decisions (scot.nhs.uk)
• Neuropsychology referral (Guidelines) | Right Decisions (scot.nhs.uk)
• Endometriosis (Guidelines) | Right Decisions (scot.nhs.uk)
• Post-fall medication review (Guidelines) | Right Decisions (scot.nhs.uk)
• Time critical medicines (Guidelines) | Right Decisions (scot.nhs.uk)

Updated guidance:

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Computerised cognitive behavioural therapy (cCBT) (Guidelines) | Right Decisions (scot.nhs.uk)
• DMARD monitoring in Primary Care (Guidelines) | Right Decisions (scot.nhs.uk)
• Lipid lowering therapy in the prevention / treatment of atherosclerosis (Guidelines) | Right Decisions (scot.nhs.uk)
• Inpatient diabetes guidelines (Guidelines) | Right Decisions (scot.nhs.uk)
• CHILDREN - Empirical antibiotic therapy (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Non-hospitalised patients with symptomatic COVID-19 infection (Guidelines) | Right Decisions (scot.nhs.uk)
• Nausea and vomiting (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Risk factors for progression to severe COVID-19 infection | Right Decisions (scot.nhs.uk)
• Antibiotic prophylaxis for infective endocarditis (Dental Guidelines) | Right Decisions (scot.nhs.uk)
• Mucosal Ulceration and Inflammation (Simple Gingivitis) (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Acute Necrotising Ulcerative Gingivitis and Pericoronitis (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Dental Abscess (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Eczema (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Acute Sore Throat (Antimicrobial) | Right Decisions (scot.nhs.uk)

Archived guidance: 

• Antibiotics in children (Paediatric-guidelines). 
  The information is duplicated in: CHILDREN - Empirical antibiotic therapy (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Gynacology (COVID-19): Removed as out of date
• Pericoronitis (Antimicrobial): replaced by: Acute Necrotising Ulcerative Gingivitis and Pericoronitis

October 2024

Updated guidance:

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Highland Sexual Health referral process (Guidelines) | Right Decisions (scot.nhs.uk)
• Beta Blocker (IV) for Hypertension (Critical Care Formulary)
• LIVER (Guidelines) | Right Decisions (scot.nhs.uk)
• Investigating for diabetes in children (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)

Guidance updated with no amendments:

• Croup (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)

Guidance removed and archived:

• Polyarthritis / Polyarthropathy

November 2024

New Guidance:

• Milk allergy (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Finerenone in diabetic kidney disease (Guideline) | Right Decisions (scot.nhs.uk)
• Management of medical chest drains (Guidelines) | Right Decisions (scot.nhs.uk)
• Major haemorrhage protocol (ARGYLL and BUTE) (Guidelines) | Right Decisions (scot.nhs.uk)
• Buprenorphine injection (Buvidal®) for opioid dependence | Right Decisions (scot.nhs.uk)

Updated Guidance:

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Food allergy referral (Paediatrics Guidelines) | Right Decisions (scot.nhs.uk)
• Egg allergy (Paediatric Guidelines) | Right Decisions (scot.nhs.uk)
• Aspiration Pneumonia (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Acute lower urinary tract infection in adults (no fever or flank pain) (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Acute upper urinary tract infection (pyelonephritis/urosepsis) (Antimicrobial) | Right Decisions (scot.nhs.uk)
• Hyperkalaemia (Guidelines) | Right Decisions (scot.nhs.uk)
• Heart Failure: Diagnosis (Guidelines) | Right Decisions (scot.nhs.uk)
• Pharmacy First (Formularies) | Right Decisions (scot.nhs.uk)
• Gender identity guidance (Guidelines) | Right Decisions (scot.nhs.uk) (AWAITING APPROVAL)
• COVID-19: Drug management following positive LFT / PCR test (Guidelines) | Right Decisions (scot.nhs.uk)
• SOCIAL PRESCRIBING | Right Decisions (scot.nhs.uk)
• Scarlet Fever (Antimicrobial) | Right Decisions (scot.nhs.uk)

December 2024

Included in Feb 2025 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 assisted treatment (MAT) (Guidelines)
• Serotonin syndrome (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 

*New Guidance* (ratified at previous TAMSG):

• Items will be added as published. 

*Major updates* (ratified at previous TAMSG): 

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Items will be added as published. 

Minor updates (awaiting ratification at next TAMSG): 

To view the changes to the guidance, see the 'What's new' section of each guideline.

• Items will be added as published. 

Reviewed with no changes: 

• Items will be added as published. 

Removed Guidance:

• Items will be added as removed.