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. 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.

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
Revision Date
Times Accessed
Acute Atrial Fibrillation in the Surgical Patient
12-13-2017
14996
Axillary Artery and Vein Cannulation
07-30-2015
18074
Blunt Cardiac Trauma
09-29-2016
9981
Free Flap Management
02-21-2020
13092
Hypertension Management
11-26-2015
16145
Noninvasive Hemodynamic Monitoring
09-29-2016
9290
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
7861
Vasopressors and Inotropes in Shock
09-12-2019
42131

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
9046
Hyperglycemia Control in the Critically Ill
12-07-2011
12217
Thyroid Management in the ICU
06-18-2019
9383

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
26899
Fluid Resuscitation
11-03-2017
16887
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
12181
Rhabdomyolysis: Prevention and Treatment
08-12-2018
15174

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
10861
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
15513
Blunt Splenic Injury
09-30-2015
9614
Cirrhotic Management
02-25-2016
8566
Clostridium difficile Infection
06-29-2015
8968
Diverticulitis
09-30-2015
8459
Enteral Feeding Guidelines
04-10-2017
19006
Intra-abdominal Pressure Monitoring
03-23-2015
8322
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
24777
Percutaneous Endoscopic Gastrostomy
06-11-2020
8188
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
13039
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
11852
Small Bowel Obstruction
06-04-2014
7825
Stress Ulcer Prophylaxis
11-03-2017
11712

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
8648
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
12548
Disseminated Intravascular Coagulation
04-10-2017
7168
DVT Prophylaxis in Solid Organ Injury
12-05-2013
8863
Erythropoietin Use in the Critically Ill
02-06-2008
9558
Heparin Induced Thrombocytopenia
09-14-2019
9164
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
7802
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
44350
Non-Vitamin K Anticoagulation Reversal
08-12-2018
8773
Thromboelastography (TEG) in Trauma
12-04-2014
10640
Ultrasound Guided Peripheral IV Insertion
05-27-2020
5824
Venous Thromboprophylaxis in Obesity
02-25-2016
18918
Warfarin Dosing
09-01-2009
8043
Warfarin Reversal
11-30-2017
9470

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
7629
Antibiotic Prophylaxis in Surgery
11-30-2013
17204
Candida Infections in Surgical Patients
04-10-2017
9015
Continuous Antibiotic Infusions
05-16-2007
7074
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
10224
Facial Fracture Antibiotics
04-29-2020
11466
Presumptive Chest Tube Antibiotics
03-07-2013
7416

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
13207
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
29834
Blunt Cerebrovascular Injury
09-30-2015
8481
Brain Death Determination / Apnea Test Procedure
09-10-2019
18373
Cervical Spine Clearance
12-13-2017
8143
Delirium Management in the ICU
08-12-2018
16220
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
17622
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
11168
Pain Management in Surgery
09-30-2015
8061
Sedation and Agitation Management in the ICU
10-25-2009
8327
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
38074
Severe Traumatic Brain Injury Management
09-11-2019
16209
Syncope Evaluation in the Trauma Patient
09-29-2016
7378
Therapeutic Hypothermia
09-01-2020
8689

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
8352
Chest Tube Management
09-29-2016
9929
Diaphragm Pacing
07-18-2019
6949
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
9579
High frequency oscillatory ventilation in the surgical patient
03-04-2009
7122
Independent Lung Ventilation
12-04-2014
6943
Multi-modality Rib Fracture Management
03-05-2020
14627
Peri-Procedural Tracheostomy Complications
01-04-2013
6809
Post-Extubation Stridor
08-01-2017
10370
Post-Tracheostomy Hemorrhage
07-30-2015
9280
Rescue Ventilation
08-22-2018
8937
Retained Hemothorax
04-28-2016
14605
Surgical Fixation of Rib Fractures
09-04-2020
14970
Timing of Tracheostomy
04-29-2020
12961
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
10207
Ventilator-Associated Pneumonia
02-25-2016
8034

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
12827
Burn Resuscitation
11-26-2019
14351
Ketamine for Analgesia
12-27-2019
14629
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
15469
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
10853
Snakebite/crotalid Antivenoms
09-28-2018
8423

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
8515
Central Venous Catheterization
12-04-2009
11732
Fever Assessment
06-27-2019
15647
Gabapentin in Post-operative Pain Management
09-29-2016
10136
Ketamine for Analgesia
12-13-2017
14051
Laparoscopy in Trauma
02-25-2016
7457
Mangled Extremity
04-28-2016
9676
Muscle Relaxants in Multimodal Pain Management
01-26-2017
14566
Necrotizing Soft Tissues Infections
09-28-2018
9721
Negative Pressure Wound Therapy
02-06-2014
6952
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
13004