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
5522
Axillary Artery and Vein Cannulation
07-29-2015
6757
Blunt Cardiac Trauma
09-28-2016
2797
Free Flap Management
03-04-2018
1540
Hypertension Management
11-25-2015
6130
Noninvasive Hemodynamic Monitoring
09-28-2016
2797
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
1165
Vasopressors and Inotropes in Shock
04-19-2011
25080


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2422
Hyperglycemia Control in the Critically Ill
12-06-2011
3869


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
9923
Fluid Resuscitation
11-02-2017
4914
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2815
Rhabdomyolysis: Prevention and Treatment
08-11-2018
3875


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
3214
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3978
Blunt Splenic Injury
09-29-2015
3136
Cirrhotic Management
02-24-2016
1935
Clostridium difficile Infection
06-28-2015
2657
Diverticulitis
09-29-2015
1997
Enteral Feeding Guidelines
04-09-2017
5281
Intra-abdominal Pressure Monitoring
03-22-2015
2028
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
6062
Percutaneous Endoscopic Gastrostomy
06-03-2014
1514
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
2059
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3658
Small Bowel Obstruction
06-03-2014
1856
Stress Ulcer Prophylaxis
11-02-2017
3491


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1570
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
4843
Disseminated Intravascular Coagulation
04-09-2017
1500
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1852
Erythropoietin Use in the Critically Ill
02-05-2008
3353
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
2070
Heparin Induced Thrombocytopenia
09-04-2013
1825
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1887
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
20095
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2812
Thromboelastography (TEG) in Trauma
12-03-2014
3131
Venous Thromboprophylaxis in Obesity
02-24-2016
9242
Warfarin Dosing
08-31-2009
2479
Warfarin Reversal
11-29-2017
3151


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1850
Antibiotic Prophylaxis in Surgery
11-29-2013
8571
Candida Infections in Surgical Patients
04-09-2017
3644
Continuous Antibiotic Infusions
05-15-2007
1592
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
4097
Presumptive Chest Tube Antibiotics
03-06-2013
1989


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
5084
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
18470
Blunt Cerebrovascular Injury
09-29-2015
2754
Brain Death Determination / Apnea Test Procedure
09-29-2015
3702
Cervical Spine Clearance
12-12-2017
2259
Delirium Management in the ICU
08-11-2018
3239
Hypertonic Saline Solution Instructions
05-06-2008
2267
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5616
Pain Management in Surgery
09-29-2015
2388
Sedation and Agitation Management in the ICU
10-24-2009
2271
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
22338
Severe Traumatic Brain Injury Management
05-04-2017
5174
Syncope Evaluation in the Trauma Patient
09-28-2016
1673
Therapeutic Hypothermia
02-24-2016
1962


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1987
Chest Tube Management
09-28-2016
2667
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
955
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1711
Independent Lung Ventilation
12-03-2014
1521
Multi-modality Rib Fracture Management
11-30-2010
3105
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3225
Peri-Procedural Tracheostomy Complications
01-03-2013
1478
Post-Extubation Stridor
07-31-2017
4554
Post-Tracheostomy Hemorrhage
07-29-2015
2370
Rescue Ventilation
08-21-2018
1355
Retained Hemothorax
04-27-2016
5046
Surgical Fixation of Rib Fractures
02-06-2013
8340
Timing of Tracheostomy
09-29-2015
3195
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
2221
Ventilator-Associated Pneumonia
02-24-2016
2038


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
2120
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
3082
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
1725
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1995
Snakebite/crotalid Antivenoms
09-27-2018
2227


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2177
Central Venous Catheterization
12-03-2009
4816
Fever Assessment
01-30-2013
3207
Gabapentin in Post-operative Pain Management
09-28-2016
4046
Ketamine for Analgesia
12-12-2017
2614
Laparoscopy in Trauma
02-24-2016
1808
Mangled Extremity
04-27-2016
2774
Muscle Relaxants in Multimodal Pain Management
01-25-2017
2922
Necrotizing Soft Tissues Infections
09-27-2018
2205
Negative Pressure Wound Therapy
02-05-2014
1512
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
4286



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