Evidence Based-Medicine Guidelines

The following is a collection of best practice guidelines currently in use by the Surgical Critical Care and Acute Care Surgery teams 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.

Are you rotating on the ORMC Surgical Critical Care team? If so, watch this brief video describing your involvement with the Evidence-Based Medicine Guideline Committee


Cardiovascular

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Atrial Fibrillation in the Surgical Patient
12-12-2017
6083
Axillary Artery and Vein Cannulation
07-29-2015
7468
Blunt Cardiac Trauma
09-28-2016
3092
Free Flap Management
03-04-2018
1902
Hypertension Management
11-25-2015
6875
Noninvasive Hemodynamic Monitoring
09-28-2016
3061
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
1607
Vasopressors and Inotropes in Shock
04-19-2011
25569


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2665
Hyperglycemia Control in the Critically Ill
12-06-2011
4351


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
11025
Fluid Resuscitation
11-02-2017
5374
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
3237
Rhabdomyolysis: Prevention and Treatment
08-11-2018
4592


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
3590
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
4412
Blunt Splenic Injury
09-29-2015
3420
Cirrhotic Management
02-24-2016
2143
Clostridium difficile Infection
06-28-2015
2919
Diverticulitis
09-29-2015
2205
Enteral Feeding Guidelines
04-09-2017
6134
Intra-abdominal Pressure Monitoring
03-22-2015
2240
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
7216
Percutaneous Endoscopic Gastrostomy
06-03-2014
1659
Post-Splenectomy Vaccine Prophylaxis
01-26-2019
2793
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3970
Small Bowel Obstruction
06-03-2014
2037
Stress Ulcer Prophylaxis
11-02-2017
3814


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1740
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
5268
Disseminated Intravascular Coagulation
04-09-2017
1647
DVT Prophylaxis in Solid Organ Injury
12-04-2013
2008
Erythropoietin Use in the Critically Ill
02-05-2008
3614
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
2212
Heparin Induced Thrombocytopenia
09-04-2013
2001
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
2068
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
21858
Non-Vitamin K Anticoagulation Reversal
08-11-2018
3053
Thromboelastography (TEG) in Trauma
12-03-2014
3506
Venous Thromboprophylaxis in Obesity
02-24-2016
9891
Warfarin Dosing
08-31-2009
2659
Warfarin Reversal
11-29-2017
3444


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
2069
Antibiotic Prophylaxis in Surgery
11-29-2013
9163
Candida Infections in Surgical Patients
04-09-2017
3817
Continuous Antibiotic Infusions
05-15-2007
1743
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
4337
Presumptive Chest Tube Antibiotics
03-06-2013
2140


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
6373
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
21221
Blunt Cerebrovascular Injury
09-29-2015
3021
Brain Death Determination / Apnea Test Procedure
09-29-2015
4089
Cervical Spine Clearance
12-12-2017
2487
Delirium Management in the ICU
08-11-2018
3763
Hypertonic Saline Solution Instructions
05-06-2008
2489
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5812
Pain Management in Surgery
09-29-2015
2554
Sedation and Agitation Management in the ICU
10-24-2009
2511
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
24581
Severe Traumatic Brain Injury Management
05-04-2017
5674
Syncope Evaluation in the Trauma Patient
09-28-2016
1845
Therapeutic Hypothermia
02-24-2016
2141


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
2172
Chest Tube Management
09-28-2016
2976
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
1226
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1873
Independent Lung Ventilation
12-03-2014
1688
Multi-modality Rib Fracture Management
11-30-2010
3361
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3490
Peri-Procedural Tracheostomy Complications
01-03-2013
1624
Post-Extubation Stridor
07-31-2017
4745
Post-Tracheostomy Hemorrhage
07-29-2015
2599
Rescue Ventilation
08-21-2018
1663
Retained Hemothorax
04-27-2016
5542
Surgical Fixation of Rib Fractures
02-06-2013
8556
Timing of Tracheostomy
09-29-2015
3479
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
2532
Ventilator-Associated Pneumonia
02-24-2016
2208


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
2398
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
3225
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
2387
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
2173
Snakebite/crotalid Antivenoms
09-27-2018
2665


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2407
Central Venous Catheterization
12-03-2009
5137
Fever Assessment
01-30-2013
3658
Gabapentin in Post-operative Pain Management
09-28-2016
4265
Ketamine for Analgesia
12-12-2017
3186
Laparoscopy in Trauma
02-24-2016
1947
Mangled Extremity
04-27-2016
3079
Muscle Relaxants in Multimodal Pain Management
01-25-2017
3369
Necrotizing Soft Tissues Infections
09-27-2018
2681
Negative Pressure Wound Therapy
02-05-2014
1652
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
5048



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