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
1770
Axillary Artery and Vein Cannulation
07-29-2015
2455
Blunt Cardiac Trauma
09-28-2016
1076
Hypertension Management
11-25-2015
1717
Noninvasive Hemodynamic Monitoring
09-28-2016
1148
Vasopressors and Inotropes in Shock
04-19-2011
17218


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
998
Hyperglycemia Control in the Critically Ill
12-06-2011
1323


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
3575
Fluid Resuscitation
09-11-2014
1425
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
605
Rhabdomyolysis: Prevention and Treatment
07-29-2015
1011


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1274
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
1242
Blunt Splenic Injury
09-29-2015
1321
Cirrhotic Management
02-24-2016
731
Clostridium difficile Infection
06-28-2015
1092
Diverticulitis
09-29-2015
794
Enteral Feeding Guidelines
04-09-2017
1239
Intra-abdominal Pressure Monitoring
03-22-2015
805
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
697
Percutaneous Endoscopic Gastrostomy
06-03-2014
548
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
807
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1307
Small Bowel Obstruction
06-03-2014
722
Stress Ulcer Prophylaxis
09-15-2011
1077


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
591
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1840
Disseminated Intravascular Coagulation
04-09-2017
426
DVT Prophylaxis in Solid Organ Injury
12-04-2013
725
Erythropoietin Use in the Critically Ill
02-05-2008
1366
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
698
Heparin Induced Thrombocytopenia
09-04-2013
769
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
749
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
5362
Non-Vitamin K Anticoagulation Reversal
03-29-2016
954
Thromboelastography (TEG) in Trauma
12-03-2014
1197
Venous Thromboprophylaxis in Obesity
02-24-2016
3694
Warfarin Dosing
08-31-2009
741
Warfarin Reversal
01-03-2012
893


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
719
Antibiotic Prophylaxis in Surgery
11-29-2013
3604
Candida Infections in Surgical Patients
04-09-2017
1718
Continuous Antibiotic Infusions
05-15-2007
636
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1969
Presumptive Chest Tube Antibiotics
03-06-2013
992


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1282
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3877
Blunt Cerebrovascular Injury
09-29-2015
1258
Brain Death Determination / Apnea Test Procedure
09-29-2015
1392
Cervical Spine Clearance
10-24-2009
686
Delirium Management in the ICU
01-04-2011
801
Hypertonic Saline Solution Instructions
05-06-2008
955
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
3404
Pain Management in Surgery
09-29-2015
1035
Sedation and Agitation Management in the ICU
10-24-2009
866
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
7632
Severe Traumatic Brain Injury Management
05-04-2017
1696
Syncope Evaluation in the Trauma Patient
09-28-2016
646
Therapeutic Hypothermia
02-24-2016
806


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
837
Chest Tube Management
09-28-2016
980
Extubation and the Open Abdomen
01-25-2017
560
High frequency oscillatory ventilation in the surgical patient
03-03-2009
626
Independent Lung Ventilation
12-03-2014
582
Multi-modality Rib Fracture Management
11-30-2010
1088
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1368
Peri-Procedural Tracheostomy Complications
01-03-2013
595
Post-Extubation Stridor
07-31-2017
3078
Post-Tracheostomy Hemorrhage
07-29-2015
856
Retained Hemothorax
04-27-2016
1677
Surgical Fixation of Rib Fractures
02-06-2013
5753
Timing of Tracheostomy
09-29-2015
1219
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
582
Ventilator-Associated Pneumonia
02-24-2016
910


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
790
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
699
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1346
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
755
Snakebite/crotalid Antivenoms
11-30-2010
723


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
856
Central Venous Catheterization
12-03-2009
2068
Fever Assessment
01-30-2013
1240
Gabapentin in Post-operative Pain Management
09-28-2016
1282
Laparoscopy in Trauma
02-24-2016
733
Mangled Extremity
04-27-2016
825
Muscle Relaxants in Multimodal Pain Management
01-25-2017
539
Necrotizing Soft Tissues Infections
06-03-2014
667
Negative Pressure Wound Therapy
02-05-2014
575
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1466



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