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
12-12-2017
5088
Axillary Artery and Vein Cannulation
07-29-2015
5984
Blunt Cardiac Trauma
09-28-2016
2588
Free Flap Management
03-04-2018
1197
Hypertension Management
11-25-2015
5308
Noninvasive Hemodynamic Monitoring
09-28-2016
2579
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
695
Vasopressors and Inotropes in Shock
04-19-2011
24718


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2239
Hyperglycemia Control in the Critically Ill
12-06-2011
3428


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
8915
Fluid Resuscitation
11-02-2017
4443
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2408
Rhabdomyolysis: Prevention and Treatment
08-11-2018
3089


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
2938
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3516
Blunt Splenic Injury
09-29-2015
2933
Cirrhotic Management
02-24-2016
1783
Clostridium difficile Infection
06-28-2015
2452
Diverticulitis
09-29-2015
1846
Enteral Feeding Guidelines
04-09-2017
4416
Intra-abdominal Pressure Monitoring
03-22-2015
1863
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
4883
Percutaneous Endoscopic Gastrostomy
06-03-2014
1404
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1882
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3315
Small Bowel Obstruction
06-03-2014
1710
Stress Ulcer Prophylaxis
11-02-2017
3116


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1450
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
4436
Disseminated Intravascular Coagulation
04-09-2017
1372
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1714
Erythropoietin Use in the Critically Ill
02-05-2008
3100
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1959
Heparin Induced Thrombocytopenia
09-04-2013
1694
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1742
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
17651
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2463
Thromboelastography (TEG) in Trauma
12-03-2014
2831
Venous Thromboprophylaxis in Obesity
02-24-2016
8499
Warfarin Dosing
08-31-2009
2348
Warfarin Reversal
11-29-2017
2879


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1708
Antibiotic Prophylaxis in Surgery
11-29-2013
8052
Candida Infections in Surgical Patients
04-09-2017
3501
Continuous Antibiotic Infusions
05-15-2007
1471
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3906
Presumptive Chest Tube Antibiotics
03-06-2013
1866


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
3733
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
15944
Blunt Cerebrovascular Injury
09-29-2015
2580
Brain Death Determination / Apnea Test Procedure
09-29-2015
3392
Cervical Spine Clearance
12-12-2017
2100
Delirium Management in the ICU
08-11-2018
2505
Hypertonic Saline Solution Instructions
05-06-2008
2098
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5477
Pain Management in Surgery
09-29-2015
2224
Sedation and Agitation Management in the ICU
10-24-2009
2097
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
19607
Severe Traumatic Brain Injury Management
05-04-2017
4841
Syncope Evaluation in the Trauma Patient
09-28-2016
1537
Therapeutic Hypothermia
02-24-2016
1818


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1837
Chest Tube Management
09-28-2016
2401
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
770
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1583
Independent Lung Ventilation
12-03-2014
1365
Multi-modality Rib Fracture Management
11-30-2010
2870
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3011
Peri-Procedural Tracheostomy Complications
01-03-2013
1368
Post-Extubation Stridor
07-31-2017
4393
Post-Tracheostomy Hemorrhage
07-29-2015
2166
Rescue Ventilation
08-21-2018
710
Retained Hemothorax
04-27-2016
4570
Surgical Fixation of Rib Fractures
02-06-2013
8164
Timing of Tracheostomy
09-29-2015
2956
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
1990
Ventilator-Associated Pneumonia
02-24-2016
1922


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1959
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
2977
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
1208
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1821
Snakebite/crotalid Antivenoms
09-27-2018
1901


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2005
Central Venous Catheterization
12-03-2009
4450
Fever Assessment
01-30-2013
2882
Gabapentin in Post-operative Pain Management
09-28-2016
3876
Ketamine for Analgesia
12-12-2017
2107
Laparoscopy in Trauma
02-24-2016
1706
Mangled Extremity
04-27-2016
2468
Muscle Relaxants in Multimodal Pain Management
01-25-2017
2519
Necrotizing Soft Tissues Infections
09-27-2018
1784
Negative Pressure Wound Therapy
02-05-2014
1394
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
3523



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