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
893
Axillary Artery and Vein Cannulation
07-29-2015
1188
Blunt Cardiac Trauma
09-28-2016
559
Hypertension Management
11-25-2015
783
Noninvasive Hemodynamic Monitoring
09-28-2016
635
Vasopressors and Inotropes in Shock
04-19-2011
9355


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
495
Hyperglycemia Control in the Critically Ill
12-06-2011
672


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
1662
Fluid Resuscitation
09-11-2014
717
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
194
Rhabdomyolysis: Prevention and Treatment
07-29-2015
498


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
599
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
432
Blunt Splenic Injury
09-29-2015
653
Cirrhotic Management
02-24-2016
362
Clostridium difficile Infection
06-28-2015
535
Diverticulitis
09-29-2015
381
Enteral Feeding Guidelines
03-25-2012
562
Intra-abdominal Pressure Monitoring
03-22-2015
377
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
337
Percutaneous Endoscopic Gastrostomy
06-03-2014
255
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
406
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
636
Small Bowel Obstruction
06-03-2014
342
Stress Ulcer Prophylaxis
09-15-2011
491


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
289
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
855
DVT Prophylaxis in Solid Organ Injury
12-04-2013
329
Erythropoietin Use in the Critically Ill
02-05-2008
644
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
277
Heparin Induced Thrombocytopenia
09-04-2013
363
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
356
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
2702
Non-Vitamin K Anticoagulation Reversal
03-29-2016
509
Thromboelastography (TEG) in Trauma
12-03-2014
595
Venous Thromboprophylaxis in Obesity
02-24-2016
1745
Warfarin Dosing
08-31-2009
364
Warfarin Reversal
01-03-2012
415


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
323
Antibiotic Prophylaxis in Surgery
11-29-2013
1745
Candida Infections in Surgical Patients
05-06-2008
1172
Continuous Antibiotic Infusions
05-15-2007
292
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1199
Presumptive Chest Tube Antibiotics
03-06-2013
670


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
716
Antiplatlet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
09-01-2012
3116
Blunt Cerebrovascular Injury
09-29-2015
632
Brain Death Determination / Apnea Test Procedure
09-29-2015
633
Cervical Spine Clearance
10-24-2009
313
Delirium Management in the ICU
01-04-2011
368
Hypertonic Saline Solution Instructions
05-06-2008
443
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2066
Pain Management in Surgery
09-29-2015
458
Sedation and Agitation Management in the ICU
10-24-2009
418
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
4524
Severe Traumatic Brain Injury Management
03-29-2016
780
Syncope Evaluation in the Trauma Patient
09-28-2016
324
Therapeutic Hypothermia
02-24-2016
374


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
397
Chest Tube Management
09-28-2016
506
Extubation and the Open Abdomen
01-25-2017
174
High frequency oscillatory ventilation in the surgical patient
03-03-2009
298
Independent Lung Ventilation
12-03-2014
269
Multi-modality Rib Fracture Management
11-30-2010
621
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
620
Peri-Procedural Tracheostomy Complications
01-03-2013
275
Post-Extubation Stridor
05-01-2012
1616
Post-Tracheostomy Hemorrhage
07-29-2015
436
Retained Hemothorax
04-27-2016
544
Surgical Fixation of Rib Fractures
02-06-2013
3085
Timing of Tracheostomy
09-29-2015
554
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
277
Ventilator-Associated Pneumonia
02-24-2016
421


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
363
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
301
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
636
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
357
Snakebite/crotalid Antivenoms
11-30-2010
315


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
406
Central Venous Catheterization
12-03-2009
936
Fever Assessment
01-30-2013
665
Gabapentin in Post-operative Pain Management
09-28-2016
471
Laparoscopy in Trauma
02-24-2016
366
Mangled Extremity
04-27-2016
287
Muscle Relaxants in Multimodal Pain Management
01-25-2017
140
Necrotizing Soft Tissues Infections
06-03-2014
309
Negative Pressure Wound Therapy
02-05-2014
262
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
778



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