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
6100
Axillary Artery and Vein Cannulation
07-29-2015
7477
Blunt Cardiac Trauma
09-28-2016
3100
Free Flap Management
03-04-2018
1918
Hypertension Management
11-25-2015
6890
Noninvasive Hemodynamic Monitoring
09-28-2016
3066
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
1613
Vasopressors and Inotropes in Shock
04-19-2011
25578


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2667
Hyperglycemia Control in the Critically Ill
12-06-2011
4361


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
11049
Fluid Resuscitation
11-02-2017
5386
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
3247
Rhabdomyolysis: Prevention and Treatment
08-11-2018
4622


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
3595
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
4420
Blunt Splenic Injury
09-29-2015
3427
Cirrhotic Management
02-24-2016
2147
Clostridium difficile Infection
06-28-2015
2925
Diverticulitis
09-29-2015
2207
Enteral Feeding Guidelines
04-09-2017
6143
Intra-abdominal Pressure Monitoring
03-22-2015
2245
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
7241
Percutaneous Endoscopic Gastrostomy
06-03-2014
1662
Post-Splenectomy Vaccine Prophylaxis
01-26-2019
2807
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3977
Small Bowel Obstruction
06-03-2014
2041
Stress Ulcer Prophylaxis
11-02-2017
3826


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1745
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
5281
Disseminated Intravascular Coagulation
04-09-2017
1649
DVT Prophylaxis in Solid Organ Injury
12-04-2013
2013
Erythropoietin Use in the Critically Ill
02-05-2008
3618
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
2217
Heparin Induced Thrombocytopenia
09-04-2013
2005
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
2073
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
21869
Non-Vitamin K Anticoagulation Reversal
08-11-2018
3058
Thromboelastography (TEG) in Trauma
12-03-2014
3519
Venous Thromboprophylaxis in Obesity
02-24-2016
9902
Warfarin Dosing
08-31-2009
2662
Warfarin Reversal
11-29-2017
3450


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
2073
Antibiotic Prophylaxis in Surgery
11-29-2013
9167
Candida Infections in Surgical Patients
04-09-2017
3819
Continuous Antibiotic Infusions
05-15-2007
1747
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
4343
Presumptive Chest Tube Antibiotics
03-06-2013
2143


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
6393
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
21256
Blunt Cerebrovascular Injury
09-29-2015
3028
Brain Death Determination / Apnea Test Procedure
09-29-2015
4097
Cervical Spine Clearance
12-12-2017
2492
Delirium Management in the ICU
08-11-2018
3775
Hypertonic Saline Solution Instructions
05-06-2008
2495
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5814
Pain Management in Surgery
09-29-2015
2558
Sedation and Agitation Management in the ICU
10-24-2009
2516
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
24638
Severe Traumatic Brain Injury Management
05-04-2017
5692
Syncope Evaluation in the Trauma Patient
09-28-2016
1849
Therapeutic Hypothermia
02-24-2016
2144


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
2177
Chest Tube Management
09-28-2016
2982
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
1234
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1877
Independent Lung Ventilation
12-03-2014
1692
Multi-modality Rib Fracture Management
11-30-2010
3367
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3495
Peri-Procedural Tracheostomy Complications
01-03-2013
1627
Post-Extubation Stridor
07-31-2017
4748
Post-Tracheostomy Hemorrhage
07-29-2015
2602
Rescue Ventilation
08-21-2018
1673
Retained Hemothorax
04-27-2016
5552
Surgical Fixation of Rib Fractures
02-06-2013
8560
Timing of Tracheostomy
09-29-2015
3483
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
2535
Ventilator-Associated Pneumonia
02-24-2016
2211


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
2407
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
3230
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
2416
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
2177
Snakebite/crotalid Antivenoms
09-27-2018
2671


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2415
Central Venous Catheterization
12-03-2009
5144
Fever Assessment
01-30-2013
3672
Gabapentin in Post-operative Pain Management
09-28-2016
4268
Ketamine for Analgesia
12-12-2017
3199
Laparoscopy in Trauma
02-24-2016
1951
Mangled Extremity
04-27-2016
3087
Muscle Relaxants in Multimodal Pain Management
01-25-2017
3375
Necrotizing Soft Tissues Infections
09-27-2018
2689
Negative Pressure Wound Therapy
02-05-2014
1658
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
5059



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