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
12-12-2017
2494
Axillary Artery and Vein Cannulation
07-29-2015
3275
Blunt Cardiac Trauma
09-28-2016
1416
Hypertension Management
11-25-2015
2514
Noninvasive Hemodynamic Monitoring
09-28-2016
1500
Vasopressors and Inotropes in Shock
04-19-2011
22336


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
1324
Hyperglycemia Control in the Critically Ill
12-06-2011
1806


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
4815
Fluid Resuscitation
11-02-2017
2023
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
858
Rhabdomyolysis: Prevention and Treatment
07-29-2015
1354


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1667
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
1603
Blunt Splenic Injury
09-29-2015
1756
Cirrhotic Management
02-24-2016
991
Clostridium difficile Infection
06-28-2015
1432
Diverticulitis
09-29-2015
1051
Enteral Feeding Guidelines
04-09-2017
1663
Intra-abdominal Pressure Monitoring
03-22-2015
1079
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
998
Percutaneous Endoscopic Gastrostomy
06-03-2014
753
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1087
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1756
Small Bowel Obstruction
06-03-2014
948
Stress Ulcer Prophylaxis
11-02-2017
1523


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
815
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
2522
Disseminated Intravascular Coagulation
04-09-2017
669
DVT Prophylaxis in Solid Organ Injury
12-04-2013
988
Erythropoietin Use in the Critically Ill
02-05-2008
1847
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1098
Heparin Induced Thrombocytopenia
09-04-2013
1006
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
985
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
6542
Non-Vitamin K Anticoagulation Reversal
03-29-2016
1237
Thromboelastography (TEG) in Trauma
12-03-2014
1590
Venous Thromboprophylaxis in Obesity
02-24-2016
5016
Warfarin Dosing
08-31-2009
1585
Warfarin Reversal
11-29-2017
1468


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
960
Antibiotic Prophylaxis in Surgery
11-29-2013
4950
Candida Infections in Surgical Patients
04-09-2017
2149
Continuous Antibiotic Infusions
05-15-2007
844
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
2594
Presumptive Chest Tube Antibiotics
03-06-2013
1213


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1769
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
4990
Blunt Cerebrovascular Injury
09-29-2015
1681
Brain Death Determination / Apnea Test Procedure
09-29-2015
1940
Cervical Spine Clearance
12-12-2017
1026
Delirium Management in the ICU
01-04-2011
1084
Hypertonic Saline Solution Instructions
05-06-2008
1308
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
4096
Pain Management in Surgery
09-29-2015
1346
Sedation and Agitation Management in the ICU
10-24-2009
1151
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
8389
Severe Traumatic Brain Injury Management
05-04-2017
2272
Syncope Evaluation in the Trauma Patient
09-28-2016
868
Therapeutic Hypothermia
02-24-2016
1053


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1085
Chest Tube Management
09-28-2016
1303
Extubation and the Open Abdomen
01-25-2017
807
High frequency oscillatory ventilation in the surgical patient
03-03-2009
875
Independent Lung Ventilation
12-03-2014
783
Multi-modality Rib Fracture Management
11-30-2010
1574
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1773
Peri-Procedural Tracheostomy Complications
01-03-2013
790
Post-Extubation Stridor
07-31-2017
3442
Post-Tracheostomy Hemorrhage
07-29-2015
1138
Retained Hemothorax
04-27-2016
2507
Surgical Fixation of Rib Fractures
02-06-2013
7182
Timing of Tracheostomy
09-29-2015
1659
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
788
Ventilator-Associated Pneumonia
02-24-2016
1188


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1056
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
922
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1878
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1010
Snakebite/crotalid Antivenoms
11-30-2010
944


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1128
Central Venous Catheterization
12-03-2009
2795
Fever Assessment
01-30-2013
1572
Gabapentin in Post-operative Pain Management
09-28-2016
2189
Ketamine for Analgesia
12-12-2017
192
Laparoscopy in Trauma
02-24-2016
987
Mangled Extremity
04-27-2016
1195
Muscle Relaxants in Multimodal Pain Management
01-25-2017
839
Necrotizing Soft Tissues Infections
06-03-2014
895
Negative Pressure Wound Therapy
02-05-2014
781
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1881



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