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
1291
Axillary Artery and Vein Cannulation
07-29-2015
1792
Blunt Cardiac Trauma
09-28-2016
758
Hypertension Management
11-25-2015
1145
Noninvasive Hemodynamic Monitoring
09-28-2016
859
Vasopressors and Inotropes in Shock
04-19-2011
13573


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
705
Hyperglycemia Control in the Critically Ill
12-06-2011
966


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
2341
Fluid Resuscitation
09-11-2014
1006
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
394
Rhabdomyolysis: Prevention and Treatment
07-29-2015
727


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
857
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
900
Blunt Splenic Injury
09-29-2015
946
Cirrhotic Management
02-24-2016
526
Clostridium difficile Infection
06-28-2015
758
Diverticulitis
09-29-2015
565
Enteral Feeding Guidelines
04-09-2017
863
Intra-abdominal Pressure Monitoring
03-22-2015
560
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
484
Percutaneous Endoscopic Gastrostomy
06-03-2014
381
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
577
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
905
Small Bowel Obstruction
06-03-2014
492
Stress Ulcer Prophylaxis
09-15-2011
694


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
411
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1253
Disseminated Intravascular Coagulation
04-09-2017
171
DVT Prophylaxis in Solid Organ Injury
12-04-2013
498
Erythropoietin Use in the Critically Ill
02-05-2008
970
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
421
Heparin Induced Thrombocytopenia
09-04-2013
522
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
545
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
3873
Non-Vitamin K Anticoagulation Reversal
03-29-2016
715
Thromboelastography (TEG) in Trauma
12-03-2014
870
Venous Thromboprophylaxis in Obesity
02-24-2016
2667
Warfarin Dosing
08-31-2009
526
Warfarin Reversal
01-03-2012
610


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
504
Antibiotic Prophylaxis in Surgery
11-29-2013
2530
Candida Infections in Surgical Patients
04-09-2017
1507
Continuous Antibiotic Infusions
05-15-2007
433
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1547
Presumptive Chest Tube Antibiotics
03-06-2013
810


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
959
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3631
Blunt Cerebrovascular Injury
09-29-2015
907
Brain Death Determination / Apnea Test Procedure
09-29-2015
957
Cervical Spine Clearance
10-24-2009
464
Delirium Management in the ICU
01-04-2011
549
Hypertonic Saline Solution Instructions
05-06-2008
667
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2730
Pain Management in Surgery
09-29-2015
699
Sedation and Agitation Management in the ICU
10-24-2009
597
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
6413
Severe Traumatic Brain Injury Management
05-04-2017
1248
Syncope Evaluation in the Trauma Patient
09-28-2016
452
Therapeutic Hypothermia
02-24-2016
575


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
588
Chest Tube Management
09-28-2016
708
Extubation and the Open Abdomen
01-25-2017
362
High frequency oscillatory ventilation in the surgical patient
03-03-2009
441
Independent Lung Ventilation
12-03-2014
403
Multi-modality Rib Fracture Management
11-30-2010
774
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
999
Peri-Procedural Tracheostomy Complications
01-03-2013
412
Post-Extubation Stridor
05-01-2012
2380
Post-Tracheostomy Hemorrhage
07-29-2015
605
Retained Hemothorax
04-27-2016
1048
Surgical Fixation of Rib Fractures
02-06-2013
4471
Timing of Tracheostomy
09-29-2015
861
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
411
Ventilator-Associated Pneumonia
02-24-2016
594


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
541
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
467
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
945
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
537
Snakebite/crotalid Antivenoms
11-30-2010
482


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
602
Central Venous Catheterization
12-03-2009
1468
Fever Assessment
01-30-2013
938
Gabapentin in Post-operative Pain Management
09-28-2016
680
Laparoscopy in Trauma
02-24-2016
520
Mangled Extremity
04-27-2016
520
Muscle Relaxants in Multimodal Pain Management
01-25-2017
321
Necrotizing Soft Tissues Infections
06-03-2014
456
Negative Pressure Wound Therapy
02-05-2014
403
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1079



Need Adobe Acrobat Reader?