Surgicalcriticalcare.net

Evidence Based-Medicine Guidelines

The following is a collection of best practice guidelines currently in use by the Surgical Critical Care service 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.

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 January 13, 2021.


Cardiovascular

EBM Guideline
Revision Date
Times Accessed
Acute Atrial Fibrillation in the Surgical Patient
12-13-2017
10915
Axillary Artery and Vein Cannulation
07-30-2015
13526
Blunt Cardiac Trauma
09-29-2016
5969
Free Flap Management
02-21-2020
7950
Hypertension Management
11-26-2015
12181
Noninvasive Hemodynamic Monitoring
09-29-2016
5552
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
4125
Vasopressors and Inotropes in Shock
09-12-2019
37364

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
5338
Hyperglycemia Control in the Critically Ill
12-07-2011
8242
Thyroid Management in the ICU
06-18-2019
4301

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
21430
Fluid Resuscitation
11-03-2017
12223
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
8014
Rhabdomyolysis: Prevention and Treatment
08-12-2018
11343

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
6920
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
10949
Blunt Splenic Injury
09-30-2015
5873
Cirrhotic Management
02-25-2016
4641
Clostridium difficile Infection
06-29-2015
5359
Diverticulitis
09-30-2015
4886
Enteral Feeding Guidelines
04-10-2017
14736
Intra-abdominal Pressure Monitoring
03-23-2015
4625
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
21059
Percutaneous Endoscopic Gastrostomy
06-11-2020
4581
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
9560
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
7893
Small Bowel Obstruction
06-04-2014
4212
Stress Ulcer Prophylaxis
11-03-2017
7696

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
4980
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
8652
Disseminated Intravascular Coagulation
04-10-2017
3623
DVT Prophylaxis in Solid Organ Injury
12-05-2013
5222
Erythropoietin Use in the Critically Ill
02-06-2008
5958
Heparin Induced Thrombocytopenia
09-14-2019
5628
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
4161
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
39539
Non-Vitamin K Anticoagulation Reversal
08-12-2018
5322
Thromboelastography (TEG) in Trauma
12-04-2014
6941
Ultrasound Guided Peripheral IV Insertion
05-27-2020
2147
Venous Thromboprophylaxis in Obesity
02-25-2016
15217
Warfarin Dosing
09-01-2009
4526
Warfarin Reversal
11-30-2017
5991

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
3887
Antibiotic Prophylaxis in Surgery
11-30-2013
13338
Candida Infections in Surgical Patients
04-10-2017
5663
Continuous Antibiotic Infusions
05-16-2007
3503
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
6684
Facial Fracture Antibiotics
04-29-2020
6568
Presumptive Chest Tube Antibiotics
03-07-2013
3947

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
9627
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
25709
Blunt Cerebrovascular Injury
09-30-2015
5016
Brain Death Determination / Apnea Test Procedure
09-10-2019
12105
Cervical Spine Clearance
12-13-2017
4713
Delirium Management in the ICU
08-12-2018
11947
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
9544
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
7725
Pain Management in Surgery
09-30-2015
4499
Sedation and Agitation Management in the ICU
10-25-2009
4842
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
34402
Severe Traumatic Brain Injury Management
09-11-2019
12221
Syncope Evaluation in the Trauma Patient
09-29-2016
3771
Therapeutic Hypothermia
09-01-2020
4958

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
4168
Chest Tube Management
09-29-2016
5899
Diaphragm Pacing
07-18-2019
2997
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
4857
High frequency oscillatory ventilation in the surgical patient
03-04-2009
3538
Independent Lung Ventilation
12-04-2014
3386
Multi-modality Rib Fracture Management
03-05-2020
9371
Peri-Procedural Tracheostomy Complications
01-04-2013
3245
Post-Extubation Stridor
08-01-2017
6597
Post-Tracheostomy Hemorrhage
07-30-2015
5353
Rescue Ventilation
08-22-2018
4495
Retained Hemothorax
04-28-2016
10100
Surgical Fixation of Rib Fractures
09-04-2020
11060
Timing of Tracheostomy
04-29-2020
7776
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
5823
Ventilator-Associated Pneumonia
02-25-2016
4286

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
6155
Burn Resuscitation
11-26-2019
9969
Ketamine for Analgesia
12-27-2019
6497
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
9237
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
7366
Snakebite/crotalid Antivenoms
09-28-2018
4885

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
4700
Central Venous Catheterization
12-04-2009
7834
Fever Assessment
06-27-2019
9550
Gabapentin in Post-operative Pain Management
09-29-2016
6400
Ketamine for Analgesia
12-13-2017
8872
Laparoscopy in Trauma
02-25-2016
3815
Mangled Extremity
04-28-2016
5816
Muscle Relaxants in Multimodal Pain Management
01-26-2017
10520
Necrotizing Soft Tissues Infections
09-28-2018
6044
Negative Pressure Wound Therapy
02-06-2014
3264
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
9352