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
10727
Axillary Artery and Vein Cannulation
07-30-2015
13183
Blunt Cardiac Trauma
09-29-2016
5808
Free Flap Management
02-21-2020
7713
Hypertension Management
11-26-2015
12000
Noninvasive Hemodynamic Monitoring
09-29-2016
5426
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
4007
Vasopressors and Inotropes in Shock
09-12-2019
37098

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
5217
Hyperglycemia Control in the Critically Ill
12-07-2011
8073
Thyroid Management in the ICU
06-18-2019
4094

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
21068
Fluid Resuscitation
11-03-2017
12056
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
7848
Rhabdomyolysis: Prevention and Treatment
08-12-2018
11026

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
6765
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
10705
Blunt Splenic Injury
09-30-2015
5746
Cirrhotic Management
02-25-2016
4505
Clostridium difficile Infection
06-29-2015
5233
Diverticulitis
09-30-2015
4768
Enteral Feeding Guidelines
04-10-2017
14418
Intra-abdominal Pressure Monitoring
03-23-2015
4509
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
20939
Percutaneous Endoscopic Gastrostomy
06-11-2020
4452
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
9438
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
7698
Small Bowel Obstruction
06-04-2014
4094
Stress Ulcer Prophylaxis
11-03-2017
7503

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
4841
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
8507
Disseminated Intravascular Coagulation
04-10-2017
3509
DVT Prophylaxis in Solid Organ Injury
12-05-2013
5109
Erythropoietin Use in the Critically Ill
02-06-2008
5843
Heparin Induced Thrombocytopenia
09-14-2019
5502
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
4050
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
39218
Non-Vitamin K Anticoagulation Reversal
08-12-2018
5205
Thromboelastography (TEG) in Trauma
12-04-2014
6804
Ultrasound Guided Peripheral IV Insertion
05-27-2020
2028
Venous Thromboprophylaxis in Obesity
02-25-2016
15071
Warfarin Dosing
09-01-2009
4418
Warfarin Reversal
11-30-2017
5878

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
3763
Antibiotic Prophylaxis in Surgery
11-30-2013
13169
Candida Infections in Surgical Patients
04-10-2017
5564
Continuous Antibiotic Infusions
05-16-2007
3395
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
6568
Facial Fracture Antibiotics
04-29-2020
6318
Presumptive Chest Tube Antibiotics
03-07-2013
3832

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
9493
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
25592
Blunt Cerebrovascular Injury
09-30-2015
4915
Brain Death Determination / Apnea Test Procedure
09-10-2019
11892
Cervical Spine Clearance
12-13-2017
4603
Delirium Management in the ICU
08-12-2018
8679
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
9085
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
7623
Pain Management in Surgery
09-30-2015
4395
Sedation and Agitation Management in the ICU
10-25-2009
4710
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
34266
Severe Traumatic Brain Injury Management
09-11-2019
12074
Syncope Evaluation in the Trauma Patient
09-29-2016
3647
Therapeutic Hypothermia
09-01-2020
4802

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
4056
Chest Tube Management
09-29-2016
5766
Diaphragm Pacing
07-18-2019
2854
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
4651
High frequency oscillatory ventilation in the surgical patient
03-04-2009
3440
Independent Lung Ventilation
12-04-2014
3284
Multi-modality Rib Fracture Management
03-05-2020
9049
Peri-Procedural Tracheostomy Complications
01-04-2013
3150
Post-Extubation Stridor
08-01-2017
6498
Post-Tracheostomy Hemorrhage
07-30-2015
5208
Rescue Ventilation
08-22-2018
4375
Retained Hemothorax
04-28-2016
9899
Surgical Fixation of Rib Fractures
09-04-2020
10955
Timing of Tracheostomy
04-29-2020
7629
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
5580
Ventilator-Associated Pneumonia
02-25-2016
4185

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
5812
Burn Resuscitation
11-26-2019
9753
Ketamine for Analgesia
12-27-2019
6376
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
8681
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
7252
Snakebite/crotalid Antivenoms
09-28-2018
4779

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
4597
Central Venous Catheterization
12-04-2009
7705
Fever Assessment
06-27-2019
9405
Gabapentin in Post-operative Pain Management
09-29-2016
6239
Ketamine for Analgesia
12-13-2017
8697
Laparoscopy in Trauma
02-25-2016
3719
Mangled Extremity
04-28-2016
5684
Muscle Relaxants in Multimodal Pain Management
01-26-2017
10385
Necrotizing Soft Tissues Infections
09-28-2018
5947
Negative Pressure Wound Therapy
02-06-2014
3167
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
9221