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
5979
Axillary Artery and Vein Cannulation
07-29-2015
7321
Blunt Cardiac Trauma
09-28-2016
3032
Free Flap Management
03-04-2018
1832
Hypertension Management
11-25-2015
6749
Noninvasive Hemodynamic Monitoring
09-28-2016
3006
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
1509
Vasopressors and Inotropes in Shock
04-19-2011
25447


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2605
Hyperglycemia Control in the Critically Ill
12-06-2011
4245


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
10767
Fluid Resuscitation
11-02-2017
5282
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
3138
Rhabdomyolysis: Prevention and Treatment
08-11-2018
4408


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
3508
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
4311
Blunt Splenic Injury
09-29-2015
3339
Cirrhotic Management
02-24-2016
2101
Clostridium difficile Infection
06-28-2015
2856
Diverticulitis
09-29-2015
2161
Enteral Feeding Guidelines
04-09-2017
5995
Intra-abdominal Pressure Monitoring
03-22-2015
2186
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
6968
Percutaneous Endoscopic Gastrostomy
06-03-2014
1625
Post-Splenectomy Vaccine Prophylaxis
01-26-2019
2585
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3914
Small Bowel Obstruction
06-03-2014
1989
Stress Ulcer Prophylaxis
11-02-2017
3758


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1693
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
5167
Disseminated Intravascular Coagulation
04-09-2017
1614
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1976
Erythropoietin Use in the Critically Ill
02-05-2008
3560
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
2183
Heparin Induced Thrombocytopenia
09-04-2013
1959
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
2023
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
21693
Non-Vitamin K Anticoagulation Reversal
08-11-2018
3008
Thromboelastography (TEG) in Trauma
12-03-2014
3426
Venous Thromboprophylaxis in Obesity
02-24-2016
9791
Warfarin Dosing
08-31-2009
2617
Warfarin Reversal
11-29-2017
3377


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
2002
Antibiotic Prophylaxis in Surgery
11-29-2013
9040
Candida Infections in Surgical Patients
04-09-2017
3784
Continuous Antibiotic Infusions
05-15-2007
1711
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
4281
Presumptive Chest Tube Antibiotics
03-06-2013
2104


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
6110
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
20675
Blunt Cerebrovascular Injury
09-29-2015
2943
Brain Death Determination / Apnea Test Procedure
09-29-2015
4017
Cervical Spine Clearance
12-12-2017
2432
Delirium Management in the ICU
08-11-2018
3664
Hypertonic Saline Solution Instructions
05-06-2008
2433
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5768
Pain Management in Surgery
09-29-2015
2518
Sedation and Agitation Management in the ICU
10-24-2009
2455
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
24116
Severe Traumatic Brain Injury Management
05-04-2017
5552
Syncope Evaluation in the Trauma Patient
09-28-2016
1807
Therapeutic Hypothermia
02-24-2016
2095


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
2119
Chest Tube Management
09-28-2016
2897
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
1155
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1834
Independent Lung Ventilation
12-03-2014
1653
Multi-modality Rib Fracture Management
11-30-2010
3309
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3438
Peri-Procedural Tracheostomy Complications
01-03-2013
1590
Post-Extubation Stridor
07-31-2017
4691
Post-Tracheostomy Hemorrhage
07-29-2015
2548
Rescue Ventilation
08-21-2018
1597
Retained Hemothorax
04-27-2016
5423
Surgical Fixation of Rib Fractures
02-06-2013
8504
Timing of Tracheostomy
09-29-2015
3422
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
2465
Ventilator-Associated Pneumonia
02-24-2016
2176


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
2341
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
3192
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
2212
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
2135
Snakebite/crotalid Antivenoms
09-27-2018
2597


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2344
Central Venous Catheterization
12-03-2009
5067
Fever Assessment
01-30-2013
3532
Gabapentin in Post-operative Pain Management
09-28-2016
4220
Ketamine for Analgesia
12-12-2017
3070
Laparoscopy in Trauma
02-24-2016
1913
Mangled Extremity
04-27-2016
3004
Muscle Relaxants in Multimodal Pain Management
01-25-2017
3284
Necrotizing Soft Tissues Infections
09-27-2018
2611
Negative Pressure Wound Therapy
02-05-2014
1617
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
4917



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