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
11081
Axillary Artery and Vein Cannulation
07-30-2015
13860
Blunt Cardiac Trauma
09-29-2016
6125
Free Flap Management
02-21-2020
8165
Hypertension Management
11-26-2015
12359
Noninvasive Hemodynamic Monitoring
09-29-2016
5690
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
4243
Vasopressors and Inotropes in Shock
09-12-2019
37600

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
5467
Hyperglycemia Control in the Critically Ill
12-07-2011
8417
Thyroid Management in the ICU
06-18-2019
4501

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
21765
Fluid Resuscitation
11-03-2017
12367
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
8184
Rhabdomyolysis: Prevention and Treatment
08-12-2018
11482

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
7070
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
11216
Blunt Splenic Injury
09-30-2015
5999
Cirrhotic Management
02-25-2016
4785
Clostridium difficile Infection
06-29-2015
5485
Diverticulitis
09-30-2015
5009
Enteral Feeding Guidelines
04-10-2017
15029
Intra-abdominal Pressure Monitoring
03-23-2015
4751
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
21193
Percutaneous Endoscopic Gastrostomy
06-11-2020
4702
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
9679
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
8084
Small Bowel Obstruction
06-04-2014
4336
Stress Ulcer Prophylaxis
11-03-2017
7893

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
5117
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
8795
Disseminated Intravascular Coagulation
04-10-2017
3743
DVT Prophylaxis in Solid Organ Injury
12-05-2013
5349
Erythropoietin Use in the Critically Ill
02-06-2008
6085
Heparin Induced Thrombocytopenia
09-14-2019
5752
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
4303
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
39830
Non-Vitamin K Anticoagulation Reversal
08-12-2018
5442
Thromboelastography (TEG) in Trauma
12-04-2014
7071
Ultrasound Guided Peripheral IV Insertion
05-27-2020
2272
Venous Thromboprophylaxis in Obesity
02-25-2016
15387
Warfarin Dosing
09-01-2009
4649
Warfarin Reversal
11-30-2017
6111

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
4030
Antibiotic Prophylaxis in Surgery
11-30-2013
13497
Candida Infections in Surgical Patients
04-10-2017
5774
Continuous Antibiotic Infusions
05-16-2007
3623
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
6809
Facial Fracture Antibiotics
04-29-2020
6774
Presumptive Chest Tube Antibiotics
03-07-2013
4060

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
9743
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
25848
Blunt Cerebrovascular Injury
09-30-2015
5128
Brain Death Determination / Apnea Test Procedure
09-10-2019
12320
Cervical Spine Clearance
12-13-2017
4835
Delirium Management in the ICU
08-12-2018
12160
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
9953
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
7840
Pain Management in Surgery
09-30-2015
4620
Sedation and Agitation Management in the ICU
10-25-2009
4975
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
34525
Severe Traumatic Brain Injury Management
09-11-2019
12366
Syncope Evaluation in the Trauma Patient
09-29-2016
3890
Therapeutic Hypothermia
09-01-2020
5095

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
4282
Chest Tube Management
09-29-2016
6068
Diaphragm Pacing
07-18-2019
3148
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
5045
High frequency oscillatory ventilation in the surgical patient
03-04-2009
3649
Independent Lung Ventilation
12-04-2014
3508
Multi-modality Rib Fracture Management
03-05-2020
9630
Peri-Procedural Tracheostomy Complications
01-04-2013
3355
Post-Extubation Stridor
08-01-2017
6709
Post-Tracheostomy Hemorrhage
07-30-2015
5499
Rescue Ventilation
08-22-2018
4631
Retained Hemothorax
04-28-2016
10314
Surgical Fixation of Rib Fractures
09-04-2020
11181
Timing of Tracheostomy
04-29-2020
7925
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
6043
Ventilator-Associated Pneumonia
02-25-2016
4408

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
6616
Burn Resuscitation
11-26-2019
10179
Ketamine for Analgesia
12-27-2019
6659
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
9628
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
7493
Snakebite/crotalid Antivenoms
09-28-2018
5001

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
4821
Central Venous Catheterization
12-04-2009
7988
Fever Assessment
06-27-2019
9713
Gabapentin in Post-operative Pain Management
09-29-2016
6523
Ketamine for Analgesia
12-13-2017
9064
Laparoscopy in Trauma
02-25-2016
3930
Mangled Extremity
04-28-2016
5957
Muscle Relaxants in Multimodal Pain Management
01-26-2017
10656
Necrotizing Soft Tissues Infections
09-28-2018
6159
Negative Pressure Wound Therapy
02-06-2014
3369
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
9506