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
12-13-2017
9278
Axillary Artery and Vein Cannulation
07-30-2015
10934
Blunt Cardiac Trauma
09-29-2016
4893
Free Flap Management
02-21-2020
5806
Hypertension Management
11-26-2015
10342
Noninvasive Hemodynamic Monitoring
09-29-2016
4676
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
3271
Vasopressors and Inotropes in Shock
09-12-2019
34731


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
4435
Hyperglycemia Control in the Critically Ill
12-07-2011
6832
Thyroid Management in the ICU
06-18-2019
2906


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-12-2018
18470
Fluid Resuscitation
11-03-2017
10992
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
6378
Rhabdomyolysis: Prevention and Treatment
08-12-2018
10025


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-08-2015
5657
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
8121
Blunt Splenic Injury
09-30-2015
4943
Cirrhotic Management
02-25-2016
3651
Clostridium difficile Infection
06-29-2015
4424
Diverticulitis
09-30-2015
3719
Enteral Feeding Guidelines
04-10-2017
11445
Intra-abdominal Pressure Monitoring
03-23-2015
3774
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
17730
Percutaneous Endoscopic Gastrostomy
06-11-2020
3402
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
8294
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
6167
Small Bowel Obstruction
06-04-2014
3404
Stress Ulcer Prophylaxis
11-03-2017
6001


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
4084
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
7584
Disseminated Intravascular Coagulation
04-10-2017
2870
DVT Prophylaxis in Solid Organ Injury
12-05-2013
3276
Erythropoietin Use in the Critically Ill
02-06-2008
5111
Heparin Induced Thrombocytopenia
09-14-2019
4474
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
3281
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
32735
Non-Vitamin K Anticoagulation Reversal
08-12-2018
4491
Thromboelastography (TEG) in Trauma
12-04-2014
5828
Ultrasound Guided Peripheral IV Insertion
05-27-2020
967
Venous Thromboprophylaxis in Obesity
02-25-2016
13937
Warfarin Dosing
09-01-2009
3803
Warfarin Reversal
11-30-2017
5104


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
3079
Antibiotic Prophylaxis in Surgery
11-30-2013
12248
Candida Infections in Surgical Patients
04-10-2017
4963
Continuous Antibiotic Infusions
05-16-2007
2807
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
5849
Facial Fracture Antibiotics
04-29-2020
3943
Presumptive Chest Tube Antibiotics
03-07-2013
3215


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-11-2018
8673
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
24289
Blunt Cerebrovascular Injury
09-30-2015
4252
Brain Death Determination / Apnea Test Procedure
09-10-2019
7140
Cervical Spine Clearance
12-13-2017
3982
Delirium Management in the ICU
08-12-2018
7281
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
4884
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
6992
Pain Management in Surgery
09-30-2015
3726
Sedation and Agitation Management in the ICU
10-25-2009
3910
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
33044
Severe Traumatic Brain Injury Management
09-11-2019
10721
Syncope Evaluation in the Trauma Patient
09-29-2016
3003
Therapeutic Hypothermia
09-01-2020
3531


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-20-2015
3392
Chest Tube Management
09-29-2016
4860
Diaphragm Pacing
07-18-2019
1959
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
2661
High frequency oscillatory ventilation in the surgical patient
03-04-2009
2877
Independent Lung Ventilation
12-04-2014
2697
Multi-modality Rib Fracture Management
03-05-2020
6351
Peri-Procedural Tracheostomy Complications
01-04-2013
2602
Post-Extubation Stridor
08-01-2017
5893
Post-Tracheostomy Hemorrhage
07-30-2015
4174
Rescue Ventilation
08-22-2018
3408
Retained Hemothorax
04-28-2016
8630
Surgical Fixation of Rib Fractures
09-04-2020
9966
Timing of Tracheostomy
04-29-2020
5978
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
4352
Ventilator-Associated Pneumonia
02-25-2016
3477


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Burn Inhalation injury
06-18-2019
2922
Burn Resuscitation
11-26-2019
7476
Ketamine for Analgesia
12-27-2019
5509
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
7579
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
3284
Snakebite/crotalid Antivenoms
09-28-2018
4109


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-30-2015
3933
Central Venous Catheterization
12-04-2009
6833
Fever Assessment
06-27-2019
7596
Gabapentin in Post-operative Pain Management
09-29-2016
5517
Ketamine for Analgesia
12-13-2017
7379
Laparoscopy in Trauma
02-25-2016
3082
Mangled Extremity
04-28-2016
4924
Muscle Relaxants in Multimodal Pain Management
01-26-2017
5698
Necrotizing Soft Tissues Infections
09-28-2018
5035
Negative Pressure Wound Therapy
02-06-2014
2650
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
8109



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