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
4978
Axillary Artery and Vein Cannulation
07-29-2015
5725
Blunt Cardiac Trauma
09-28-2016
2493
Free Flap Management
03-04-2018
1096
Hypertension Management
11-25-2015
5075
Noninvasive Hemodynamic Monitoring
09-28-2016
2507
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
535
Vasopressors and Inotropes in Shock
04-19-2011
24587


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2178
Hyperglycemia Control in the Critically Ill
12-06-2011
3283


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
8519
Fluid Resuscitation
11-02-2017
4280
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2275
Rhabdomyolysis: Prevention and Treatment
08-11-2018
2838


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
2845
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3368
Blunt Splenic Injury
09-29-2015
2854
Cirrhotic Management
02-24-2016
1721
Clostridium difficile Infection
06-28-2015
2376
Diverticulitis
09-29-2015
1795
Enteral Feeding Guidelines
04-09-2017
4143
Intra-abdominal Pressure Monitoring
03-22-2015
1817
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
4533
Percutaneous Endoscopic Gastrostomy
06-03-2014
1367
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1820
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3209
Small Bowel Obstruction
06-03-2014
1659
Stress Ulcer Prophylaxis
11-02-2017
2990


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1423
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
4305
Disseminated Intravascular Coagulation
04-09-2017
1337
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1668
Erythropoietin Use in the Critically Ill
02-05-2008
3000
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1924
Heparin Induced Thrombocytopenia
09-04-2013
1651
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1691
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
16759
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2339
Thromboelastography (TEG) in Trauma
12-03-2014
2750
Venous Thromboprophylaxis in Obesity
02-24-2016
8257
Warfarin Dosing
08-31-2009
2305
Warfarin Reversal
11-29-2017
2798


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1646
Antibiotic Prophylaxis in Surgery
11-29-2013
7831
Ascorbic Acid in Sepsis
03-31-2018
2592
Candida Infections in Surgical Patients
04-09-2017
3457
Continuous Antibiotic Infusions
05-15-2007
1432
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3836
Presumptive Chest Tube Antibiotics
03-06-2013
1820


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
3317
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
15038
Blunt Cerebrovascular Injury
09-29-2015
2525
Brain Death Determination / Apnea Test Procedure
09-29-2015
3247
Cervical Spine Clearance
12-12-2017
2040
Delirium Management in the ICU
08-11-2018
2314
Hypertonic Saline Solution Instructions
05-06-2008
2032
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5429
Pain Management in Surgery
09-29-2015
2177
Sedation and Agitation Management in the ICU
10-24-2009
2032
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
18778
Severe Traumatic Brain Injury Management
05-04-2017
4721
Syncope Evaluation in the Trauma Patient
09-28-2016
1495
Therapeutic Hypothermia
02-24-2016
1759


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1780
Chest Tube Management
09-28-2016
2302
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
649
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1525
Independent Lung Ventilation
12-03-2014
1324
Multi-modality Rib Fracture Management
11-30-2010
2799
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
2954
Peri-Procedural Tracheostomy Complications
01-03-2013
1331
Post-Extubation Stridor
07-31-2017
4343
Post-Tracheostomy Hemorrhage
07-29-2015
2089
Rescue Ventilation
08-21-2018
531
Retained Hemothorax
04-27-2016
4397
Surgical Fixation of Rib Fractures
02-06-2013
8104
Timing of Tracheostomy
09-29-2015
2870
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
1914
Ventilator-Associated Pneumonia
02-24-2016
1879


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1897
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
1575
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
2941
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
997
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1770
Snakebite/crotalid Antivenoms
09-27-2018
1780


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1951
Central Venous Catheterization
12-03-2009
4341
Fever Assessment
01-30-2013
2765
Gabapentin in Post-operative Pain Management
09-28-2016
3816
Ketamine for Analgesia
12-12-2017
1944
Laparoscopy in Trauma
02-24-2016
1654
Mangled Extremity
04-27-2016
2351
Muscle Relaxants in Multimodal Pain Management
01-25-2017
2380
Necrotizing Soft Tissues Infections
09-27-2018
1658
Negative Pressure Wound Therapy
02-05-2014
1350
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
3271



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