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
4766
Axillary Artery and Vein Cannulation
07-29-2015
5430
Blunt Cardiac Trauma
09-28-2016
2376
Free Flap Management
03-04-2018
962
Hypertension Management
11-25-2015
4628
Noninvasive Hemodynamic Monitoring
09-28-2016
2390
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
312
Vasopressors and Inotropes in Shock
04-19-2011
24402


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2080
Hyperglycemia Control in the Critically Ill
12-06-2011
3048


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
7838
Fluid Resuscitation
11-02-2017
4029
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2038
Rhabdomyolysis: Prevention and Treatment
08-11-2018
2490


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
2671
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3163
Blunt Splenic Injury
09-29-2015
2728
Cirrhotic Management
02-24-2016
1630
Clostridium difficile Infection
06-28-2015
2269
Diverticulitis
09-29-2015
1704
Enteral Feeding Guidelines
04-09-2017
3747
Intra-abdominal Pressure Monitoring
03-22-2015
1735
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
3939
Percutaneous Endoscopic Gastrostomy
06-03-2014
1297
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1730
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3042
Small Bowel Obstruction
06-03-2014
1580
Stress Ulcer Prophylaxis
11-02-2017
2807


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1358
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
4085
Disseminated Intravascular Coagulation
04-09-2017
1270
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1605
Erythropoietin Use in the Critically Ill
02-05-2008
2879
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1848
Heparin Induced Thrombocytopenia
09-04-2013
1574
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1572
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
15401
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2147
Thromboelastography (TEG) in Trauma
12-03-2014
2629
Venous Thromboprophylaxis in Obesity
02-24-2016
7818
Warfarin Dosing
08-31-2009
2232
Warfarin Reversal
11-29-2017
2662


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1564
Antibiotic Prophylaxis in Surgery
11-29-2013
7382
Ascorbic Acid in Sepsis
03-31-2018
1757
Candida Infections in Surgical Patients
04-09-2017
3395
Continuous Antibiotic Infusions
05-15-2007
1359
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3733
Presumptive Chest Tube Antibiotics
03-06-2013
1754


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
2918
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
13478
Blunt Cerebrovascular Injury
09-29-2015
2434
Brain Death Determination / Apnea Test Procedure
09-29-2015
3091
Cervical Spine Clearance
12-12-2017
1942
Delirium Management in the ICU
08-11-2018
2045
Hypertonic Saline Solution Instructions
05-06-2008
1953
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5351
Pain Management in Surgery
09-29-2015
2093
Sedation and Agitation Management in the ICU
10-24-2009
1924
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
17251
Severe Traumatic Brain Injury Management
05-04-2017
4538
Syncope Evaluation in the Trauma Patient
09-28-2016
1426
Therapeutic Hypothermia
02-24-2016
1678


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1706
Chest Tube Management
09-28-2016
2142
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
472
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1457
Independent Lung Ventilation
12-03-2014
1275
Multi-modality Rib Fracture Management
11-30-2010
2626
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
2805
Peri-Procedural Tracheostomy Complications
01-03-2013
1272
Post-Extubation Stridor
07-31-2017
4274
Post-Tracheostomy Hemorrhage
07-29-2015
1972
Rescue Ventilation
08-21-2018
304
Retained Hemothorax
04-27-2016
4121
Surgical Fixation of Rib Fractures
02-06-2013
8015
Timing of Tracheostomy
09-29-2015
2729
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
1764
Ventilator-Associated Pneumonia
02-24-2016
1809


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1795
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
1514
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
2876
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
704
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1678
Snakebite/crotalid Antivenoms
09-27-2018
1606


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1863
Central Venous Catheterization
12-03-2009
4170
Fever Assessment
01-30-2013
2612
Gabapentin in Post-operative Pain Management
09-28-2016
3692
Ketamine for Analgesia
12-12-2017
1752
Laparoscopy in Trauma
02-24-2016
1575
Mangled Extremity
04-27-2016
2191
Muscle Relaxants in Multimodal Pain Management
01-25-2017
2040
Necrotizing Soft Tissues Infections
09-27-2018
1469
Negative Pressure Wound Therapy
02-05-2014
1286
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
2911



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