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


The Evidence-Based Medicine Guidelines Committee is pleased to share these guidelines for clinical use in your intensive care unit. If you choose to do so, the Committee requests that the time and effort involved in developing these guidelines be appropriately recognized. All guidelines contained on this site are copyrighted by SurgicalCriticalCare.net unless otherwise indicated.

Guidelines should be referenced in the following manner: Rojas K, Birrer K, Cheatham M, Smith C. Seizure Prophylaxis following Traumatic Brain Injury. http://www.surgicalcriticalcare.net/Guidelines/Seizure prophylaxis in TBI 2017.pdf. Updated July 26, 2017. Accessed November 13, 2017.



Cardiovascular

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Atrial Fibrillation in the Surgical Patient
02-13-2012
2115
Axillary Artery and Vein Cannulation
07-29-2015
2925
Blunt Cardiac Trauma
09-28-2016
1236
Hypertension Management
11-25-2015
2118
Noninvasive Hemodynamic Monitoring
09-28-2016
1341
Vasopressors and Inotropes in Shock
04-19-2011
20218


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
1176
Hyperglycemia Control in the Critically Ill
12-06-2011
1575


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
4281
Fluid Resuscitation
11-02-2017
1685
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
717
Rhabdomyolysis: Prevention and Treatment
07-29-2015
1211


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1497
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
1406
Blunt Splenic Injury
09-29-2015
1543
Cirrhotic Management
02-24-2016
862
Clostridium difficile Infection
06-28-2015
1268
Diverticulitis
09-29-2015
942
Enteral Feeding Guidelines
04-09-2017
1427
Intra-abdominal Pressure Monitoring
03-22-2015
963
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
833
Percutaneous Endoscopic Gastrostomy
06-03-2014
657
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
968
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1567
Small Bowel Obstruction
06-03-2014
846
Stress Ulcer Prophylaxis
11-02-2017
1287


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
705
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
2239
Disseminated Intravascular Coagulation
04-09-2017
574
DVT Prophylaxis in Solid Organ Injury
12-04-2013
876
Erythropoietin Use in the Critically Ill
02-05-2008
1661
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
934
Heparin Induced Thrombocytopenia
09-04-2013
908
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
878
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
5944
Non-Vitamin K Anticoagulation Reversal
03-29-2016
1104
Thromboelastography (TEG) in Trauma
12-03-2014
1410
Venous Thromboprophylaxis in Obesity
02-24-2016
4476
Warfarin Dosing
08-31-2009
1463
Warfarin Reversal
01-03-2012
1272


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
834
Antibiotic Prophylaxis in Surgery
11-29-2013
4450
Candida Infections in Surgical Patients
04-09-2017
1843
Continuous Antibiotic Infusions
05-15-2007
755
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
2335
Presumptive Chest Tube Antibiotics
03-06-2013
1117


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1552
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
4104
Blunt Cerebrovascular Injury
09-29-2015
1503
Brain Death Determination / Apnea Test Procedure
09-29-2015
1674
Cervical Spine Clearance
10-24-2009
828
Delirium Management in the ICU
01-04-2011
955
Hypertonic Saline Solution Instructions
05-06-2008
1136
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
3828
Pain Management in Surgery
09-29-2015
1218
Sedation and Agitation Management in the ICU
10-24-2009
1026
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
7856
Severe Traumatic Brain Injury Management
05-04-2017
2038
Syncope Evaluation in the Trauma Patient
09-28-2016
770
Therapeutic Hypothermia
02-24-2016
937


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
984
Chest Tube Management
09-28-2016
1176
Extubation and the Open Abdomen
01-25-2017
678
High frequency oscillatory ventilation in the surgical patient
03-03-2009
755
Independent Lung Ventilation
12-03-2014
683
Multi-modality Rib Fracture Management
11-30-2010
1323
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1579
Peri-Procedural Tracheostomy Complications
01-03-2013
703
Post-Extubation Stridor
07-31-2017
3248
Post-Tracheostomy Hemorrhage
07-29-2015
1011
Retained Hemothorax
04-27-2016
2214
Surgical Fixation of Rib Fractures
02-06-2013
6626
Timing of Tracheostomy
09-29-2015
1470
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
697
Ventilator-Associated Pneumonia
02-24-2016
1047


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
936
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
829
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1637
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
894
Snakebite/crotalid Antivenoms
11-30-2010
846


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1022
Central Venous Catheterization
12-03-2009
2512
Fever Assessment
01-30-2013
1436
Gabapentin in Post-operative Pain Management
09-28-2016
1793
Laparoscopy in Trauma
02-24-2016
868
Mangled Extremity
04-27-2016
1028
Muscle Relaxants in Multimodal Pain Management
01-25-2017
676
Necrotizing Soft Tissues Infections
06-03-2014
792
Negative Pressure Wound Therapy
02-05-2014
681
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1703



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