Surgicalcriticalcare.net

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 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 January 13, 2021.

Cardiovascular

EBM Guideline
Revised
Acute Atrial Fibrillation in the Surgical Patient
12/12/2017
Axillary Artery and Vein Cannulation
11/18/2022
Blunt Cardiac Injury
3/23/2021
Blunt Thoracic Aortic Injury
3/24/2021
Free Flap Management
3/4/2018
Hypertension Management
10/25/2023
Noninvasive Hemodynamic Monitoring
9/28/2016
Resuscitative Balloon Occlusion of the Aorta (REBOA)
05/29/2023
Resuscitative Thoracotomy
1/10/2024
Ultrasound Guided Peripheral IV Insertion
5/27/2020
Vasopressors and Inotropes in Shock
9/11/2019


Endocrine

EBM Guideline
Revised
Critical Illness-Related Corticosteroid Insufficiency
6/21/2022
Hyperglycemia Control in the Critically Ill
3/8/2024
Thyroid Management in the ICU
4/1/2019


Fluids, Electrolytes, Nutrition

EBM Guideline
Revised
Burn Nutrition
07/02/2023
Electrolyte Replacement
9/27/2019
Fluid Resuscitation
11/2/2017
Hypertonic Saline Bolus & Infusion
5/27/2020
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
1/25/2017
Rhabdomyolysis: Prevention and Treatment
7/2/2023


Gastrointestinal

EBM Guideline
Revised
Acute Cholecystitis
1/7/2015
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12/12/2017
Acute Liver Failure Management
10/30/2024
Blunt Splenic Injury
9/30/2015
Cirrhotic Management
2/24/2016
Clostridium difficile Infection
9/7/2022
Diverticulitis
9/30/2015
Enteral Feeding Guidelines
4/9/2017
Intra-abdominal Pressure Monitoring
10/24/2023
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11/2/2017
Percutaneous Endoscopic Gastrostomy
6/8/2020
Post-Splenectomy Vaccine Prophylaxis
12/27/2022
Premature Gastrostomy / Jejunostomy Removal
10/20/2009
Small Bowel Obstruction
6/3/2014
Stress Ulcer Prophylaxis
2/22/2023


Hematologic

EBM Guideline
Revised
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
6/26/2019
Deep Venous Thrombosis Prophylaxis in Surgery and Trauma Patients
9/24/2023
Disseminated Intravascular Coagulation
4/9/2017
Erythropoietin Use in the Critically Ill
2/5/2008
Heparin Induced Thrombocytopenia
9/13/2019
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10/30/2024
Massive Transfusion Protocol for Hemorrhagic Shock
5/7/2020
Non-Vitamin K Anticoagulation Reversal
7/25/2018
Thromboelastography (TEG) in Trauma
2/23/2024
Warfarin Dosing
8/31/2009
Warfarin Reversal
11/29/2017


Infectious Disease

EBM Guideline
Revised
Aerosolized Antibiotic Therapy in the ICU
3/29/2016
Antibiotic Administration in Facial and Skull Fractures
2/24/2021
Antibiotic Prophylaxis in Surgery
11/29/2013
Candida Infections in Surgical Patients
4/9/2017
Continuous Antibiotic Infusions
7/2/2023
Empiric Antibiotic Use in Critically Ill Patients
5/8/2007
Presumptive Chest Tube Antibiotics
3/6/2013


Miscellaneous

EBM Guideline
Revised
Alcohol Withdrawal
4/25/2023
Central Venous Catheterization
12/3/2009
Fever Assessment
1/30/2013
Gabapentin in Post-operative Pain Management
7/2/2023
Ketamine for Analgesia
3/11/2021
Laparoscopy in Trauma
2/24/2016
Mangled Extremity
4/27/2016
Muscle Relaxants in Multimodal Pain Management
1/25/2017
Necrotizing Soft Tissues Infections
9/27/2018
Negative Pressure Wound Therapy
2/5/2014
Neuromuscular Blocking Agents in the Adult ICU
8/1/2018


Neurologic

EBM Guideline
Revised
Acute Spinal Cord Injury Guideline
10/25/2023
Analgosedation Management in the Adult Critically Ill
5/12/2024
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
4/9/2017
Blunt Cerebrovascular Injury
3/31/2021
Brain Death Determination / Apnea Test Procedure
9/30/2015
Cervical Spine Clearance
12/12/2017
Delirium Management in the ICU
7/2/2023
Management of Status Epilepticus in Adults
7/27/2022
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
8/1/2014
Pain Management in Surgery
9/30/2015
Seizure Prophylaxis in Traumatic Brain Injury
7/2/2023
Syncope Evaluation in the Trauma Patient
9/28/2016
Therapeutic Hypothermia Following Cardiac Arrest
9/2/2020
Traumatic Brain Injury Management
1/16/2023


Pulmonary

EBM Guideline
Revised
Burn Inhalation Injury
6/10/2019
Pulmonary Blast Injury
9/28/2016
Thrombolytics for Pulmonary Embolism
9/28/2016
Air Travel Following Traumatic Pneumothorax
11/18/2022
Chest Tube Management
9/28/2016
Extubating the Trauma Patient with an Open Abdomen
6/21/2022
Independent Lung Ventilation
12/3/2014
Management of Hemothorax (This describes the process of chest tube irrigation for hemothorax; an updated guideline is under way)
5/2/2024
Multi-modality Rib Fracture Management
3/5/2020
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
4/20/2010
Peri-Procedural Tracheostomy Complications
1/3/2013
Post-Extubation Stridor
6/28/2017
Post-Tracheostomy Hemorrhage
1/3/2013
Rescue Ventilation
8/21/2018
Retained Hemothorax
4/27/2016
Surgical Fixation of Rib Fractures
9/4/2020
Timing of Tracheostomy
9/30/2015
Tissue Plasminogen Activator in Traumatic Hemothorax
3/31/2018
Tracheostomy Dislodgement
2/20/2020
Ventilator-Associated Pneumonia
2/24/2016


Skin

EBM Guideline
Revised
Acute Adult Burn Resuscitation
9/11/2023
Perioperative Hypothermia Prevention in Burn Patients
3/29/2018
Skin Biopsy for Stevens-Johnson & Toxic Epidermal Necrolysis
10/30/2024
Snakebite/Crotalid Envenomation
7/2/2023