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
5756
Axillary Artery and Vein Cannulation
07-29-2015
7103
Blunt Cardiac Trauma
09-28-2016
2901
Free Flap Management
03-04-2018
1700
Hypertension Management
11-25-2015
6485
Noninvasive Hemodynamic Monitoring
09-28-2016
2890
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
1344
Vasopressors and Inotropes in Shock
04-19-2011
25250


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2497
Hyperglycemia Control in the Critically Ill
12-06-2011
4063


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
10344
Fluid Resuscitation
11-02-2017
5118
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2968
Rhabdomyolysis: Prevention and Treatment
08-11-2018
4166


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
3363
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
4162
Blunt Splenic Injury
09-29-2015
3224
Cirrhotic Management
02-24-2016
2007
Clostridium difficile Infection
06-28-2015
2744
Diverticulitis
09-29-2015
2075
Enteral Feeding Guidelines
04-09-2017
5749
Intra-abdominal Pressure Monitoring
03-22-2015
2096
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
6598
Percutaneous Endoscopic Gastrostomy
06-03-2014
1560
Post-Splenectomy Vaccine Prophylaxis
01-26-2019
2286
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3793
Small Bowel Obstruction
06-03-2014
1915
Stress Ulcer Prophylaxis
11-02-2017
3631


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1620
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
5013
Disseminated Intravascular Coagulation
04-09-2017
1547
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1908
Erythropoietin Use in the Critically Ill
02-05-2008
3460
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
2117
Heparin Induced Thrombocytopenia
09-04-2013
1880
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1949
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
21175
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2914
Thromboelastography (TEG) in Trauma
12-03-2014
3259
Venous Thromboprophylaxis in Obesity
02-24-2016
9585
Warfarin Dosing
08-31-2009
2532
Warfarin Reversal
11-29-2017
3274


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1909
Antibiotic Prophylaxis in Surgery
11-29-2013
8848
Candida Infections in Surgical Patients
04-09-2017
3707
Continuous Antibiotic Infusions
05-15-2007
1639
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
4164
Presumptive Chest Tube Antibiotics
03-06-2013
2036


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
5738
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
19721
Blunt Cerebrovascular Injury
09-29-2015
2837
Brain Death Determination / Apnea Test Procedure
09-29-2015
3879
Cervical Spine Clearance
12-12-2017
2340
Delirium Management in the ICU
08-11-2018
3466
Hypertonic Saline Solution Instructions
05-06-2008
2336
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5678
Pain Management in Surgery
09-29-2015
2449
Sedation and Agitation Management in the ICU
10-24-2009
2356
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
23477
Severe Traumatic Brain Injury Management
05-04-2017
5319
Syncope Evaluation in the Trauma Patient
09-28-2016
1731
Therapeutic Hypothermia
02-24-2016
2026


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
2049
Chest Tube Management
09-28-2016
2788
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
1046
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1766
Independent Lung Ventilation
12-03-2014
1579
Multi-modality Rib Fracture Management
11-30-2010
3225
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3329
Peri-Procedural Tracheostomy Complications
01-03-2013
1526
Post-Extubation Stridor
07-31-2017
4612
Post-Tracheostomy Hemorrhage
07-29-2015
2448
Rescue Ventilation
08-21-2018
1491
Retained Hemothorax
04-27-2016
5245
Surgical Fixation of Rib Fractures
02-06-2013
8413
Timing of Tracheostomy
09-29-2015
3311
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
2352
Ventilator-Associated Pneumonia
02-24-2016
2100


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
2212
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
3125
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
1995
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
2058
Snakebite/crotalid Antivenoms
09-27-2018
2471


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2249
Central Venous Catheterization
12-03-2009
4938
Fever Assessment
01-30-2013
3382
Gabapentin in Post-operative Pain Management
09-28-2016
4110
Ketamine for Analgesia
12-12-2017
2901
Laparoscopy in Trauma
02-24-2016
1856
Mangled Extremity
04-27-2016
2898
Muscle Relaxants in Multimodal Pain Management
01-25-2017
3134
Necrotizing Soft Tissues Infections
09-27-2018
2492
Negative Pressure Wound Therapy
02-05-2014
1558
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
4665



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