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
02-13-2012
1591
Axillary Artery and Vein Cannulation
07-29-2015
2212
Blunt Cardiac Trauma
09-28-2016
951
Hypertension Management
11-25-2015
1455
Noninvasive Hemodynamic Monitoring
09-28-2016
1033
Vasopressors and Inotropes in Shock
04-19-2011
15701


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
872
Hyperglycemia Control in the Critically Ill
12-06-2011
1190


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
3192
Fluid Resuscitation
09-11-2014
1284
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
519
Rhabdomyolysis: Prevention and Treatment
07-29-2015
897


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1118
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
1137
Blunt Splenic Injury
09-29-2015
1178
Cirrhotic Management
02-24-2016
652
Clostridium difficile Infection
06-28-2015
968
Diverticulitis
09-29-2015
705
Enteral Feeding Guidelines
04-09-2017
1093
Intra-abdominal Pressure Monitoring
03-22-2015
700
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
598
Percutaneous Endoscopic Gastrostomy
06-03-2014
476
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
712
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1143
Small Bowel Obstruction
06-03-2014
624
Stress Ulcer Prophylaxis
09-15-2011
944


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
513
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1632
Disseminated Intravascular Coagulation
04-09-2017
324
DVT Prophylaxis in Solid Organ Injury
12-04-2013
637
Erythropoietin Use in the Critically Ill
02-05-2008
1194
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
569
Heparin Induced Thrombocytopenia
09-04-2013
664
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
678
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
4714
Non-Vitamin K Anticoagulation Reversal
03-29-2016
855
Thromboelastography (TEG) in Trauma
12-03-2014
1076
Venous Thromboprophylaxis in Obesity
02-24-2016
3314
Warfarin Dosing
08-31-2009
651
Warfarin Reversal
01-03-2012
780


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
638
Antibiotic Prophylaxis in Surgery
11-29-2013
3211
Candida Infections in Surgical Patients
04-09-2017
1625
Continuous Antibiotic Infusions
05-15-2007
556
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1806
Presumptive Chest Tube Antibiotics
03-06-2013
914


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1141
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3776
Blunt Cerebrovascular Injury
09-29-2015
1115
Brain Death Determination / Apnea Test Procedure
09-29-2015
1206
Cervical Spine Clearance
10-24-2009
589
Delirium Management in the ICU
01-04-2011
696
Hypertonic Saline Solution Instructions
05-06-2008
829
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
3124
Pain Management in Surgery
09-29-2015
901
Sedation and Agitation Management in the ICU
10-24-2009
755
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
7518
Severe Traumatic Brain Injury Management
05-04-2017
1540
Syncope Evaluation in the Trauma Patient
09-28-2016
556
Therapeutic Hypothermia
02-24-2016
716


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
727
Chest Tube Management
09-28-2016
866
Extubation and the Open Abdomen
01-25-2017
485
High frequency oscillatory ventilation in the surgical patient
03-03-2009
549
Independent Lung Ventilation
12-03-2014
503
Multi-modality Rib Fracture Management
11-30-2010
986
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1226
Peri-Procedural Tracheostomy Complications
01-03-2013
522
Post-Extubation Stridor
07-31-2017
2943
Post-Tracheostomy Hemorrhage
07-29-2015
759
Retained Hemothorax
04-27-2016
1449
Surgical Fixation of Rib Fractures
02-06-2013
5336
Timing of Tracheostomy
09-29-2015
1073
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
513
Ventilator-Associated Pneumonia
02-24-2016
778


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
700
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
605
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1208
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
671
Snakebite/crotalid Antivenoms
11-30-2010
620


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
748
Central Venous Catheterization
12-03-2009
1866
Fever Assessment
01-30-2013
1139
Gabapentin in Post-operative Pain Management
09-28-2016
1046
Laparoscopy in Trauma
02-24-2016
636
Mangled Extremity
04-27-2016
696
Muscle Relaxants in Multimodal Pain Management
01-25-2017
447
Necrotizing Soft Tissues Infections
06-03-2014
586
Negative Pressure Wound Therapy
02-05-2014
504
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1282



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