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
4626
Axillary Artery and Vein Cannulation
07-29-2015
5239
Blunt Cardiac Trauma
09-28-2016
2300
Free Flap Management
03-04-2018
899
Hypertension Management
11-25-2015
4419
Noninvasive Hemodynamic Monitoring
09-28-2016
2331
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
197
Vasopressors and Inotropes in Shock
04-19-2011
24273


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2037
Hyperglycemia Control in the Critically Ill
12-06-2011
2937


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
7526
Fluid Resuscitation
11-02-2017
3887
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
1906
Rhabdomyolysis: Prevention and Treatment
08-11-2018
2310


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
2553
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3061
Blunt Splenic Injury
09-29-2015
2629
Cirrhotic Management
02-24-2016
1572
Clostridium difficile Infection
06-28-2015
2208
Diverticulitis
09-29-2015
1643
Enteral Feeding Guidelines
04-09-2017
3551
Intra-abdominal Pressure Monitoring
03-22-2015
1687
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
3607
Percutaneous Endoscopic Gastrostomy
06-03-2014
1266
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1671
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
2924
Small Bowel Obstruction
06-03-2014
1528
Stress Ulcer Prophylaxis
11-02-2017
2726


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1325
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
3947
Disseminated Intravascular Coagulation
04-09-2017
1230
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1555
Erythropoietin Use in the Critically Ill
02-05-2008
2762
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1817
Heparin Induced Thrombocytopenia
09-04-2013
1530
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1530
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
14559
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2018
Thromboelastography (TEG) in Trauma
12-03-2014
2554
Venous Thromboprophylaxis in Obesity
02-24-2016
7575
Warfarin Dosing
08-31-2009
2197
Warfarin Reversal
11-29-2017
2586


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1517
Antibiotic Prophylaxis in Surgery
11-29-2013
7162
Ascorbic Acid in Sepsis
03-31-2018
1286
Candida Infections in Surgical Patients
04-09-2017
3357
Continuous Antibiotic Infusions
05-15-2007
1322
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3664
Presumptive Chest Tube Antibiotics
03-06-2013
1721


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
2736
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
12594
Blunt Cerebrovascular Injury
09-29-2015
2386
Brain Death Determination / Apnea Test Procedure
09-29-2015
3008
Cervical Spine Clearance
12-12-2017
1897
Delirium Management in the ICU
08-11-2018
1916
Hypertonic Saline Solution Instructions
05-06-2008
1910
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5255
Pain Management in Surgery
09-29-2015
2049
Sedation and Agitation Management in the ICU
10-24-2009
1869
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
16233
Severe Traumatic Brain Injury Management
05-04-2017
4418
Syncope Evaluation in the Trauma Patient
09-28-2016
1375
Therapeutic Hypothermia
02-24-2016
1635


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1668
Chest Tube Management
09-28-2016
2068
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
379
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1419
Independent Lung Ventilation
12-03-2014
1236
Multi-modality Rib Fracture Management
11-30-2010
2547
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
2751
Peri-Procedural Tracheostomy Complications
01-03-2013
1242
Post-Extubation Stridor
07-31-2017
4235
Post-Tracheostomy Hemorrhage
07-29-2015
1916
Rescue Ventilation
08-21-2018
166
Retained Hemothorax
04-27-2016
3988
Surgical Fixation of Rib Fractures
02-06-2013
7952
Timing of Tracheostomy
09-29-2015
2666
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
1688
Ventilator-Associated Pneumonia
02-24-2016
1769


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1736
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
1486
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
2835
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
550
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1631
Snakebite/crotalid Antivenoms
11-30-2010
1524


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1802
Central Venous Catheterization
12-03-2009
4055
Fever Assessment
01-30-2013
2524
Gabapentin in Post-operative Pain Management
09-28-2016
3633
Ketamine for Analgesia
12-12-2017
1648
Laparoscopy in Trauma
02-24-2016
1531
Mangled Extremity
04-27-2016
2084
Muscle Relaxants in Multimodal Pain Management
01-25-2017
1917
Necrotizing Soft Tissues Infections
06-03-2014
1391
Negative Pressure Wound Therapy
02-05-2014
1248
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
2747



Need Adobe Acrobat Reader?