Surgicalcriticalcare.net

Evidence Based-Medicine Guidelines

The following is a collection of best practice guidelines currently in use by the Surgical Critical Care service 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.

The Evidence-Based Medicine Guidelines Committee is pleased to share these guidelines for clinical use in your intensive care unit. If you choose to do so, the Committee requests that the time and effort involved in developing these guidelines be appropriately recognized. All guidelines contained on this site are copyrighted by Surgicalcriticalcare.net unless otherwise indicated.

Guidelines should be referenced in the following manner: Rojas K, Birrer K, Cheatham M, Smith C. Seizure Prophylaxis following Traumatic Brain Injury. http://www.surgicalcriticalcare.net/Guidelines/Seizure prophylaxis in TBI 2017.pdf. Updated July 26, 2017. Accessed January 13, 2021.


Cardiovascular

EBM Guideline
Revision Date
Times Accessed
Acute Atrial Fibrillation in the Surgical Patient
12-13-2017
10070
Axillary Artery and Vein Cannulation
07-30-2015
12303
Blunt Cardiac Trauma
09-29-2016
5436
Free Flap Management
02-21-2020
6951
Hypertension Management
11-26-2015
11389
Noninvasive Hemodynamic Monitoring
09-29-2016
5095
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
3680
Vasopressors and Inotropes in Shock
09-12-2019
36540

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
4883
Hyperglycemia Control in the Critically Ill
12-07-2011
7577
Thyroid Management in the ICU
06-18-2019
3588

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
20113
Fluid Resuscitation
11-03-2017
11649
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
7452
Rhabdomyolysis: Prevention and Treatment
08-12-2018
10595

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
6318
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
9777
Blunt Splenic Injury
09-30-2015
5405
Cirrhotic Management
02-25-2016
4115
Clostridium difficile Infection
06-29-2015
4883
Diverticulitis
09-30-2015
4138
Enteral Feeding Guidelines
04-10-2017
13782
Intra-abdominal Pressure Monitoring
03-23-2015
4197
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
20307
Percutaneous Endoscopic Gastrostomy
06-11-2020
4115
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
9081
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
7056
Small Bowel Obstruction
06-04-2014
3766
Stress Ulcer Prophylaxis
11-03-2017
6876

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
4517
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
8164
Disseminated Intravascular Coagulation
04-10-2017
3213
DVT Prophylaxis in Solid Organ Injury
12-05-2013
4790
Erythropoietin Use in the Critically Ill
02-06-2008
5515
Heparin Induced Thrombocytopenia
09-14-2019
5130
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
3714
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
38038
Non-Vitamin K Anticoagulation Reversal
08-12-2018
4912
Thromboelastography (TEG) in Trauma
12-04-2014
6459
Ultrasound Guided Peripheral IV Insertion
05-27-2020
1665
Venous Thromboprophylaxis in Obesity
02-25-2016
14640
Warfarin Dosing
09-01-2009
4123
Warfarin Reversal
11-30-2017
5553

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
3411
Antibiotic Prophylaxis in Surgery
11-30-2013
12781
Candida Infections in Surgical Patients
04-10-2017
5290
Continuous Antibiotic Infusions
05-16-2007
3125
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
6265
Facial Fracture Antibiotics
04-29-2020
5575
Presumptive Chest Tube Antibiotics
03-07-2013
3539

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
9178
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
25289
Blunt Cerebrovascular Injury
09-30-2015
4610
Brain Death Determination / Apnea Test Procedure
09-10-2019
8040
Cervical Spine Clearance
12-13-2017
4315
Delirium Management in the ICU
08-12-2018
8167
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
7550
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
7325
Pain Management in Surgery
09-30-2015
4099
Sedation and Agitation Management in the ICU
10-25-2009
4360
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
33867
Severe Traumatic Brain Injury Management
09-11-2019
11630
Syncope Evaluation in the Trauma Patient
09-29-2016
3365
Therapeutic Hypothermia
09-01-2020
4445

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
3744
Chest Tube Management
09-29-2016
5361
Diaphragm Pacing
07-18-2019
2497
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
4247
High frequency oscillatory ventilation in the surgical patient
03-04-2009
3182
Independent Lung Ventilation
12-04-2014
3009
Multi-modality Rib Fracture Management
03-05-2020
8144
Peri-Procedural Tracheostomy Complications
01-04-2013
2896
Post-Extubation Stridor
08-01-2017
6226
Post-Tracheostomy Hemorrhage
07-30-2015
4782
Rescue Ventilation
08-22-2018
3969
Retained Hemothorax
04-28-2016
9358
Surgical Fixation of Rib Fractures
09-04-2020
10662
Timing of Tracheostomy
04-29-2020
7223
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
5069
Ventilator-Associated Pneumonia
02-25-2016
3891

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
4601
Burn Resuscitation
11-26-2019
9006
Ketamine for Analgesia
12-27-2019
5985
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
8054
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
3631
Snakebite/crotalid Antivenoms
09-28-2018
4500

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
4320
Central Venous Catheterization
12-04-2009
7367
Fever Assessment
06-27-2019
8749
Gabapentin in Post-operative Pain Management
09-29-2016
5896
Ketamine for Analgesia
12-13-2017
8275
Laparoscopy in Trauma
02-25-2016
3426
Mangled Extremity
04-28-2016
5377
Muscle Relaxants in Multimodal Pain Management
01-26-2017
6499
Necrotizing Soft Tissues Infections
09-28-2018
5671
Negative Pressure Wound Therapy
02-06-2014
2921
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
8827