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


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 November 13, 2017.



Cardiovascular

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Atrial Fibrillation in the Surgical Patient
12-12-2017
4413
Axillary Artery and Vein Cannulation
07-29-2015
5004
Blunt Cardiac Trauma
09-28-2016
2183
Free Flap Management
03-04-2018
768
Hypertension Management
11-25-2015
4151
Noninvasive Hemodynamic Monitoring
09-28-2016
2221
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
42
Vasopressors and Inotropes in Shock
04-19-2011
24132


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
1942
Hyperglycemia Control in the Critically Ill
12-06-2011
2752


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
6995
Fluid Resuscitation
11-02-2017
3675
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
1742
Rhabdomyolysis: Prevention and Treatment
08-11-2018
2088


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
2425
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
2896
Blunt Splenic Injury
09-29-2015
2527
Cirrhotic Management
02-24-2016
1495
Clostridium difficile Infection
06-28-2015
2103
Diverticulitis
09-29-2015
1557
Enteral Feeding Guidelines
04-09-2017
3320
Intra-abdominal Pressure Monitoring
03-22-2015
1605
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
3222
Percutaneous Endoscopic Gastrostomy
06-03-2014
1203
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1602
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
2763
Small Bowel Obstruction
06-03-2014
1447
Stress Ulcer Prophylaxis
11-02-2017
2588


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1270
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
3750
Disseminated Intravascular Coagulation
04-09-2017
1145
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1469
Erythropoietin Use in the Critically Ill
02-05-2008
2624
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1758
Heparin Induced Thrombocytopenia
09-04-2013
1464
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1463
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
13462
Non-Vitamin K Anticoagulation Reversal
08-11-2018
1858
Thromboelastography (TEG) in Trauma
12-03-2014
2413
Venous Thromboprophylaxis in Obesity
02-24-2016
7273
Warfarin Dosing
08-31-2009
2107
Warfarin Reversal
11-29-2017
2474


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1440
Antibiotic Prophylaxis in Surgery
11-29-2013
6863
Ascorbic Acid in Sepsis
03-31-2018
670
Candida Infections in Surgical Patients
04-09-2017
3246
Continuous Antibiotic Infusions
05-15-2007
1258
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3551
Presumptive Chest Tube Antibiotics
03-06-2013
1631


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
2591
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
11360
Blunt Cerebrovascular Injury
09-29-2015
2307
Brain Death Determination / Apnea Test Procedure
09-29-2015
2887
Cervical Spine Clearance
12-12-2017
1793
Delirium Management in the ICU
08-11-2018
1711
Hypertonic Saline Solution Instructions
05-06-2008
1828
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5076
Pain Management in Surgery
09-29-2015
1960
Sedation and Agitation Management in the ICU
10-24-2009
1739
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
15005
Severe Traumatic Brain Injury Management
05-04-2017
4146
Syncope Evaluation in the Trauma Patient
09-28-2016
1306
Therapeutic Hypothermia
02-24-2016
1545


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1596
Chest Tube Management
09-28-2016
1961
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
223
Extubation and the Open Abdomen
01-25-2017
1388
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1357
Independent Lung Ventilation
12-03-2014
1177
Multi-modality Rib Fracture Management
11-30-2010
2413
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
2621
Peri-Procedural Tracheostomy Complications
01-03-2013
1192
Post-Extubation Stridor
07-31-2017
4168
Post-Tracheostomy Hemorrhage
07-29-2015
1806
Retained Hemothorax
04-27-2016
3760
Surgical Fixation of Rib Fractures
02-06-2013
7860
Timing of Tracheostomy
09-29-2015
2526
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
1496
Ventilator-Associated Pneumonia
02-24-2016
1681


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1631
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
1414
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
2715
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
290
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1570
Snakebite/crotalid Antivenoms
11-30-2010
1442


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1713
Central Venous Catheterization
12-03-2009
3910
Fever Assessment
01-30-2013
2367
Gabapentin in Post-operative Pain Management
09-28-2016
3565
Ketamine for Analgesia
12-12-2017
1493
Laparoscopy in Trauma
02-24-2016
1458
Mangled Extremity
04-27-2016
1954
Muscle Relaxants in Multimodal Pain Management
01-25-2017
1761
Necrotizing Soft Tissues Infections
06-03-2014
1324
Negative Pressure Wound Therapy
02-05-2014
1169
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
2608



Need Adobe Acrobat Reader?