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
1425
Axillary Artery and Vein Cannulation
07-29-2015
1978
Blunt Cardiac Trauma
09-28-2016
837
Hypertension Management
11-25-2015
1286
Noninvasive Hemodynamic Monitoring
09-28-2016
934
Vasopressors and Inotropes in Shock
04-19-2011
14562


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
778
Hyperglycemia Control in the Critically Ill
12-06-2011
1079


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
2763
Fluid Resuscitation
09-11-2014
1154
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
451
Rhabdomyolysis: Prevention and Treatment
07-29-2015
807


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
968
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
1055
Blunt Splenic Injury
09-29-2015
1059
Cirrhotic Management
02-24-2016
588
Clostridium difficile Infection
06-28-2015
858
Diverticulitis
09-29-2015
636
Enteral Feeding Guidelines
04-09-2017
961
Intra-abdominal Pressure Monitoring
03-22-2015
632
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
545
Percutaneous Endoscopic Gastrostomy
06-03-2014
427
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
635
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1029
Small Bowel Obstruction
06-03-2014
557
Stress Ulcer Prophylaxis
09-15-2011
829


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
462
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1393
Disseminated Intravascular Coagulation
04-09-2017
245
DVT Prophylaxis in Solid Organ Injury
12-04-2013
565
Erythropoietin Use in the Critically Ill
02-05-2008
1060
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
473
Heparin Induced Thrombocytopenia
09-04-2013
593
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
615
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
4214
Non-Vitamin K Anticoagulation Reversal
03-29-2016
776
Thromboelastography (TEG) in Trauma
12-03-2014
976
Venous Thromboprophylaxis in Obesity
02-24-2016
2973
Warfarin Dosing
08-31-2009
584
Warfarin Reversal
01-03-2012
683


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
566
Antibiotic Prophylaxis in Surgery
11-29-2013
2824
Candida Infections in Surgical Patients
04-09-2017
1564
Continuous Antibiotic Infusions
05-15-2007
483
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1646
Presumptive Chest Tube Antibiotics
03-06-2013
852


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1047
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3697
Blunt Cerebrovascular Injury
09-29-2015
1009
Brain Death Determination / Apnea Test Procedure
09-29-2015
1083
Cervical Spine Clearance
10-24-2009
519
Delirium Management in the ICU
01-04-2011
628
Hypertonic Saline Solution Instructions
05-06-2008
738
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2925
Pain Management in Surgery
09-29-2015
785
Sedation and Agitation Management in the ICU
10-24-2009
677
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
6955
Severe Traumatic Brain Injury Management
05-04-2017
1362
Syncope Evaluation in the Trauma Patient
09-28-2016
497
Therapeutic Hypothermia
02-24-2016
635


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
653
Chest Tube Management
09-28-2016
780
Extubation and the Open Abdomen
01-25-2017
425
High frequency oscillatory ventilation in the surgical patient
03-03-2009
489
Independent Lung Ventilation
12-03-2014
450
Multi-modality Rib Fracture Management
11-30-2010
841
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1119
Peri-Procedural Tracheostomy Complications
01-03-2013
469
Post-Extubation Stridor
05-01-2012
2631
Post-Tracheostomy Hemorrhage
07-29-2015
662
Retained Hemothorax
04-27-2016
1227
Surgical Fixation of Rib Fractures
02-06-2013
4875
Timing of Tracheostomy
09-29-2015
954
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
455
Ventilator-Associated Pneumonia
02-24-2016
679


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
616
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
529
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1066
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
598
Snakebite/crotalid Antivenoms
11-30-2010
541


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
673
Central Venous Catheterization
12-03-2009
1656
Fever Assessment
01-30-2013
1041
Gabapentin in Post-operative Pain Management
09-28-2016
855
Laparoscopy in Trauma
02-24-2016
579
Mangled Extremity
04-27-2016
599
Muscle Relaxants in Multimodal Pain Management
01-25-2017
378
Necrotizing Soft Tissues Infections
06-03-2014
518
Negative Pressure Wound Therapy
02-05-2014
450
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1163



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