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
1905
Axillary Artery and Vein Cannulation
07-29-2015
2643
Blunt Cardiac Trauma
09-28-2016
1144
Hypertension Management
11-25-2015
1879
Noninvasive Hemodynamic Monitoring
09-28-2016
1225
Vasopressors and Inotropes in Shock
04-19-2011
18484


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
1082
Hyperglycemia Control in the Critically Ill
12-06-2011
1428


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
3891
Fluid Resuscitation
09-11-2014
1508
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
652
Rhabdomyolysis: Prevention and Treatment
07-29-2015
1094


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1375
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
1312
Blunt Splenic Injury
09-29-2015
1409
Cirrhotic Management
02-24-2016
786
Clostridium difficile Infection
06-28-2015
1156
Diverticulitis
09-29-2015
854
Enteral Feeding Guidelines
04-09-2017
1322
Intra-abdominal Pressure Monitoring
03-22-2015
881
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
755
Percutaneous Endoscopic Gastrostomy
06-03-2014
593
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
876
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1393
Small Bowel Obstruction
06-03-2014
776
Stress Ulcer Prophylaxis
09-15-2011
1154


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
636
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1993
Disseminated Intravascular Coagulation
04-09-2017
497
DVT Prophylaxis in Solid Organ Injury
12-04-2013
796
Erythropoietin Use in the Critically Ill
02-05-2008
1482
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
785
Heparin Induced Thrombocytopenia
09-04-2013
823
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
805
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
5612
Non-Vitamin K Anticoagulation Reversal
03-29-2016
1026
Thromboelastography (TEG) in Trauma
12-03-2014
1293
Venous Thromboprophylaxis in Obesity
02-24-2016
4044
Warfarin Dosing
08-31-2009
798
Warfarin Reversal
01-03-2012
963


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
769
Antibiotic Prophylaxis in Surgery
11-29-2013
3995
Candida Infections in Surgical Patients
04-09-2017
1772
Continuous Antibiotic Infusions
05-15-2007
686
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
2125
Presumptive Chest Tube Antibiotics
03-06-2013
1044


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1421
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3950
Blunt Cerebrovascular Injury
09-29-2015
1374
Brain Death Determination / Apnea Test Procedure
09-29-2015
1513
Cervical Spine Clearance
10-24-2009
744
Delirium Management in the ICU
01-04-2011
866
Hypertonic Saline Solution Instructions
05-06-2008
1043
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
3599
Pain Management in Surgery
09-29-2015
1131
Sedation and Agitation Management in the ICU
10-24-2009
935
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
7729
Severe Traumatic Brain Injury Management
05-04-2017
1853
Syncope Evaluation in the Trauma Patient
09-28-2016
699
Therapeutic Hypothermia
02-24-2016
868


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
901
Chest Tube Management
09-28-2016
1079
Extubation and the Open Abdomen
01-25-2017
606
High frequency oscillatory ventilation in the surgical patient
03-03-2009
673
Independent Lung Ventilation
12-03-2014
621
Multi-modality Rib Fracture Management
11-30-2010
1142
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1462
Peri-Procedural Tracheostomy Complications
01-03-2013
637
Post-Extubation Stridor
07-31-2017
3151
Post-Tracheostomy Hemorrhage
07-29-2015
922
Retained Hemothorax
04-27-2016
2025
Surgical Fixation of Rib Fractures
02-06-2013
6179
Timing of Tracheostomy
09-29-2015
1321
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
631
Ventilator-Associated Pneumonia
02-24-2016
978


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
839
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
749
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1449
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
803
Snakebite/crotalid Antivenoms
11-30-2010
778


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
922
Central Venous Catheterization
12-03-2009
2236
Fever Assessment
01-30-2013
1320
Gabapentin in Post-operative Pain Management
09-28-2016
1500
Laparoscopy in Trauma
02-24-2016
784
Mangled Extremity
04-27-2016
904
Muscle Relaxants in Multimodal Pain Management
01-25-2017
599
Necrotizing Soft Tissues Infections
06-03-2014
718
Negative Pressure Wound Therapy
02-05-2014
623
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1558



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