Evidence Based-Medicine Guidelines

The following is a collection of best practice guidelines currently in use by the Surgical Critical Care service at Orlando Regional Medical Center (ORMC). They are based upon the most recent medical literature and are reviewed and updated on a regular basis. 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.

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 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. prophylaxis in TBI 2017.pdf. Updated July 26, 2017. Accessed January 13, 2021.


EBM Guideline
Acute Atrial Fibrillation in the Surgical Patient
Axillary Artery and Vein Cannulation
Blunt Cardiac Injury
Blunt Thoracic Aortic injury
Free Flap Management
Hypertension Management
Noninvasive Hemodynamic Monitoring
Resuscitative Balloon Occlusion of the Aorta (REBOA)
Ultrasound Guided Peripheral IV Insertion
Vasopressors and Inotropes in Shock


EBM Guideline
Critical Illness-Related Corticosteroid Insufficiency
Hyperglycemia Control in the Critically Ill
Thyroid Management in the ICU

Fluids, Electrolytes, Nutrition

EBM Guideline
Electrolyte Replacement
Fluid Resuscitation
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
Rhabdomyolysis: Prevention and Treatment


EBM Guideline
Acute Cholecystitis
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
Blunt Splenic Injury
Cirrhotic Management
Clostridium difficile Infection
Enteral Feeding Guidelines
Intra-abdominal Pressure Monitoring
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
Percutaneous Endoscopic Gastrostomy
Post-Splenectomy Vaccine Prophylaxis
Premature Gastrostomy / Jejunostomy Removal
Small Bowel Obstruction
Stress Ulcer Prophylaxis


EBM Guideline
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
Deep Venous Thrombosis Prophylaxis in the Critically Ill
Disseminated Intravascular Coagulation
DVT Prophylaxis in Solid Organ Injury
Erythropoietin Use in the Critically Ill
Heparin Induced Thrombocytopenia
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
Massive Transfusion Protocol for Hemorrhagic Shock
Non-Vitamin K Anticoagulation Reversal
Thromboelastography (TEG) in Trauma
Venous Thromboprophylaxis in Obesity
Warfarin Dosing
Warfarin Reversal

Infectious Disease

EBM Guideline
Aerosolized Antibiotic Therapy in the ICU
Antibiotic Administration in Facial and Skull Fractures
Antibiotic Prophylaxis in Surgery
Candida Infections in Surgical Patients
Continuous Antibiotic Infusions
Empiric Antibiotic Use in Critically Ill Patients
Presumptive Chest Tube Antibiotics


EBM Guideline
Alcohol Withdrawal
Central Venous Catheterization
Fever Assessment
Gabapentin in Post-operative Pain Management
Ketamine for Analgesia
Laparoscopy in Trauma
Mangled Extremity
Muscle Relaxants in Multimodal Pain Management
Necrotizing Soft Tissues Infections
Negative Pressure Wound Therapy
Neuromuscular Blocking Agents in the Adult ICU


EBM Guideline
Acute Spinal Cord Injury Guideline
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
Blunt Cerebrovascular Injury
Brain Death Determination / Apnea Test Procedure
Cervical Spine Clearance
Delirium Management in the ICU
Hypertonic Saline Solution Instructions
Management of Status Epilepticus in Adults
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
Pain Management in Surgery
Sedation and Agitation Management in the ICU
Seizure Prophylaxis in Traumatic Brain Injury
Syncope Evaluation in the Trauma Patient
Therapeutic Hypothermia Following Cardiac Arrest
Traumatic Brain Injury Management


EBM Guideline
Pulmonary Blast Injury
Thrombolytics for Pulmonary Embolism
Air Travel Following Traumatic Pneumothorax
Chest Tube Management
Extubating the Trauma Patient with an Open Abdomen
High frequency oscillatory ventilation in the surgical patient
Independent Lung Ventilation
Multi-modality Rib Fracture Management
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
Peri-Procedural Tracheostomy Complications
Post-Extubation Stridor
Post-Tracheostomy Hemorrhage
Rescue Ventilation
Retained Hemothorax
Surgical Fixation of Rib Fractures
Timing of Tracheostomy
Tissue Plasminogen Activator in Traumatic Hemothorax
Tracheostomy Dislodgement
Ventilator-Associated Pneumonia


EBM Guideline
Acute Burn Resuscitation
Perioperative Hypothermia Prevention in Burn Patients
Remifentanil Infusion for Adult Burn Dressing Changes
Snakebite/crotalid Antivenoms