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
5335
Axillary Artery and Vein Cannulation
07-29-2015
6413
Blunt Cardiac Trauma
09-28-2016
2715
Free Flap Management
03-04-2018
1391
Hypertension Management
11-25-2015
5744
Noninvasive Hemodynamic Monitoring
09-28-2016
2702
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
952
Vasopressors and Inotropes in Shock
04-19-2011
24904


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2344
Hyperglycemia Control in the Critically Ill
12-06-2011
3682


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
9530
Fluid Resuscitation
11-02-2017
4705
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2620
Rhabdomyolysis: Prevention and Treatment
08-11-2018
3535


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
3091
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3748
Blunt Splenic Injury
09-29-2015
3048
Cirrhotic Management
02-24-2016
1877
Clostridium difficile Infection
06-28-2015
2587
Diverticulitis
09-29-2015
1948
Enteral Feeding Guidelines
04-09-2017
4875
Intra-abdominal Pressure Monitoring
03-22-2015
1957
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
5631
Percutaneous Endoscopic Gastrostomy
06-03-2014
1469
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1991
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3505
Small Bowel Obstruction
06-03-2014
1806
Stress Ulcer Prophylaxis
11-02-2017
3341


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1520
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
4661
Disseminated Intravascular Coagulation
04-09-2017
1449
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1798
Erythropoietin Use in the Critically Ill
02-05-2008
3249
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
2025
Heparin Induced Thrombocytopenia
09-04-2013
1768
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1823
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
19085
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2660
Thromboelastography (TEG) in Trauma
12-03-2014
2986
Venous Thromboprophylaxis in Obesity
02-24-2016
8912
Warfarin Dosing
08-31-2009
2426
Warfarin Reversal
11-29-2017
3041


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1791
Antibiotic Prophylaxis in Surgery
11-29-2013
8359
Candida Infections in Surgical Patients
04-09-2017
3578
Continuous Antibiotic Infusions
05-15-2007
1548
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
4013
Presumptive Chest Tube Antibiotics
03-06-2013
1936


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
4407
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
17456
Blunt Cerebrovascular Injury
09-29-2015
2671
Brain Death Determination / Apnea Test Procedure
09-29-2015
3562
Cervical Spine Clearance
12-12-2017
2191
Delirium Management in the ICU
08-11-2018
2931
Hypertonic Saline Solution Instructions
05-06-2008
2195
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5556
Pain Management in Surgery
09-29-2015
2308
Sedation and Agitation Management in the ICU
10-24-2009
2202
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
21105
Severe Traumatic Brain Injury Management
05-04-2017
5027
Syncope Evaluation in the Trauma Patient
09-28-2016
1623
Therapeutic Hypothermia
02-24-2016
1907


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1921
Chest Tube Management
09-28-2016
2539
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
887
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1668
Independent Lung Ventilation
12-03-2014
1463
Multi-modality Rib Fracture Management
11-30-2010
2985
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3135
Peri-Procedural Tracheostomy Complications
01-03-2013
1432
Post-Extubation Stridor
07-31-2017
4498
Post-Tracheostomy Hemorrhage
07-29-2015
2284
Rescue Ventilation
08-21-2018
1050
Retained Hemothorax
04-27-2016
4835
Surgical Fixation of Rib Fractures
02-06-2013
8269
Timing of Tracheostomy
09-29-2015
3097
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
2131
Ventilator-Associated Pneumonia
02-24-2016
1990


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
2056
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
3036
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
1511
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1938
Snakebite/crotalid Antivenoms
09-27-2018
2054


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2105
Central Venous Catheterization
12-03-2009
4651
Fever Assessment
01-30-2013
3050
Gabapentin in Post-operative Pain Management
09-28-2016
3983
Ketamine for Analgesia
12-12-2017
2392
Laparoscopy in Trauma
02-24-2016
1772
Mangled Extremity
04-27-2016
2642
Muscle Relaxants in Multimodal Pain Management
01-25-2017
2759
Necrotizing Soft Tissues Infections
09-27-2018
1991
Negative Pressure Wound Therapy
02-05-2014
1468
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
3935



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