Evidence Based-Medicine Guidelines

The following is a collection of best practice guidelines currently in use by the Surgical Critical Care and Acute Care Surgery teams at Orlando Regional Medical Center (ORMC). They are based upon the most recent medical literature and are reviewed and updated on a regular basis. Guidelines that are either or have been within the past 180 days are marked accordingly. Please note that certain aspects of these guidelines, such as antibiotic sensitivities and recommendations, are specific to the adult ICU's at ORMC and may not be applicable to other patient populations. These guidelines may be downloaded and adapted for use in your own intensive care unit. Please contact the Webmaster if you have questions or suggestions regarding these guidelines.

Are you rotating on the ORMC Surgical Critical Care team? If so, watch this brief video describing your involvement with the Evidence-Based Medicine Guideline Committee


Cardiovascular

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Atrial Fibrillation in the Surgical Patient
02-13-2012
1036
Axillary Artery and Vein Cannulation
07-29-2015
1391
Blunt Cardiac Trauma
09-28-2016
626
Hypertension Management
11-25-2015
890
Noninvasive Hemodynamic Monitoring
09-28-2016
708
Vasopressors and Inotropes in Shock
04-19-2011
10980


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
565
Hyperglycemia Control in the Critically Ill
12-06-2011
771


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
1892
Fluid Resuscitation
09-11-2014
815
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
264
Rhabdomyolysis: Prevention and Treatment
07-29-2015
575


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
672
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
603
Blunt Splenic Injury
09-29-2015
755
Cirrhotic Management
02-24-2016
419
Clostridium difficile Infection
06-28-2015
603
Diverticulitis
09-29-2015
446
Enteral Feeding Guidelines
04-09-2017
664
Intra-abdominal Pressure Monitoring
03-22-2015
435
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
382
Percutaneous Endoscopic Gastrostomy
06-03-2014
296
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
462
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
730
Small Bowel Obstruction
06-03-2014
395
Stress Ulcer Prophylaxis
09-15-2011
569


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
329
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
987
Disseminated Intravascular Coagulation
04-09-2017
42
DVT Prophylaxis in Solid Organ Injury
12-04-2013
380
Erythropoietin Use in the Critically Ill
02-05-2008
745
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
311
Heparin Induced Thrombocytopenia
09-04-2013
410
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
418
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
3054
Non-Vitamin K Anticoagulation Reversal
03-29-2016
573
Thromboelastography (TEG) in Trauma
12-03-2014
681
Venous Thromboprophylaxis in Obesity
02-24-2016
2046
Warfarin Dosing
08-31-2009
416
Warfarin Reversal
01-03-2012
468


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
380
Antibiotic Prophylaxis in Surgery
11-29-2013
2010
Candida Infections in Surgical Patients
04-09-2017
1376
Continuous Antibiotic Infusions
05-15-2007
332
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1379
Presumptive Chest Tube Antibiotics
03-06-2013
716


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
795
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3473
Blunt Cerebrovascular Injury
09-29-2015
723
Brain Death Determination / Apnea Test Procedure
09-29-2015
743
Cervical Spine Clearance
10-24-2009
362
Delirium Management in the ICU
01-04-2011
423
Hypertonic Saline Solution Instructions
05-06-2008
513
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2290
Pain Management in Surgery
09-29-2015
540
Sedation and Agitation Management in the ICU
10-24-2009
481
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
5144
Severe Traumatic Brain Injury Management
03-29-2016
945
Syncope Evaluation in the Trauma Patient
09-28-2016
367
Therapeutic Hypothermia
02-24-2016
425


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
480
Chest Tube Management
09-28-2016
570
Extubation and the Open Abdomen
01-25-2017
233
High frequency oscillatory ventilation in the surgical patient
03-03-2009
340
Independent Lung Ventilation
12-03-2014
313
Multi-modality Rib Fracture Management
11-30-2010
671
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
739
Peri-Procedural Tracheostomy Complications
01-03-2013
318
Post-Extubation Stridor
05-01-2012
1839
Post-Tracheostomy Hemorrhage
07-29-2015
493
Retained Hemothorax
04-27-2016
699
Surgical Fixation of Rib Fractures
02-06-2013
3550
Timing of Tracheostomy
09-29-2015
646
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
327
Ventilator-Associated Pneumonia
02-24-2016
477


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
420
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
354
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
729
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
411
Snakebite/crotalid Antivenoms
11-30-2010
363


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
459
Central Venous Catheterization
12-03-2009
1141
Fever Assessment
01-30-2013
753
Gabapentin in Post-operative Pain Management
09-28-2016
513
Laparoscopy in Trauma
02-24-2016
417
Mangled Extremity
04-27-2016
353
Muscle Relaxants in Multimodal Pain Management
01-25-2017
201
Necrotizing Soft Tissues Infections
06-03-2014
349
Negative Pressure Wound Therapy
02-05-2014
303
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
871



Need Adobe Acrobat Reader?