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


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 November 13, 2017.



Cardiovascular

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Atrial Fibrillation in the Surgical Patient
12-12-2017
2244
Axillary Artery and Vein Cannulation
07-29-2015
3073
Blunt Cardiac Trauma
09-28-2016
1306
Hypertension Management
11-25-2015
2304
Noninvasive Hemodynamic Monitoring
09-28-2016
1398
Vasopressors and Inotropes in Shock
04-19-2011
21264


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
1247
Hyperglycemia Control in the Critically Ill
12-06-2011
1673


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
4501
Fluid Resuscitation
11-02-2017
1808
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
764
Rhabdomyolysis: Prevention and Treatment
07-29-2015
1276


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1576
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
1471
Blunt Splenic Injury
09-29-2015
1634
Cirrhotic Management
02-24-2016
917
Clostridium difficile Infection
06-28-2015
1332
Diverticulitis
09-29-2015
987
Enteral Feeding Guidelines
04-09-2017
1512
Intra-abdominal Pressure Monitoring
03-22-2015
1013
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
887
Percutaneous Endoscopic Gastrostomy
06-03-2014
700
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1024
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1649
Small Bowel Obstruction
06-03-2014
889
Stress Ulcer Prophylaxis
11-02-2017
1379


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
761
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
2383
Disseminated Intravascular Coagulation
04-09-2017
620
DVT Prophylaxis in Solid Organ Injury
12-04-2013
930
Erythropoietin Use in the Critically Ill
02-05-2008
1738
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1007
Heparin Induced Thrombocytopenia
09-04-2013
950
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
918
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
6056
Non-Vitamin K Anticoagulation Reversal
03-29-2016
1161
Thromboelastography (TEG) in Trauma
12-03-2014
1502
Venous Thromboprophylaxis in Obesity
02-24-2016
4698
Warfarin Dosing
08-31-2009
1518
Warfarin Reversal
11-29-2017
1335


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
891
Antibiotic Prophylaxis in Surgery
11-29-2013
4692
Candida Infections in Surgical Patients
04-09-2017
1936
Continuous Antibiotic Infusions
05-15-2007
798
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
2443
Presumptive Chest Tube Antibiotics
03-06-2013
1163


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1651
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
4311
Blunt Cerebrovascular Injury
09-29-2015
1591
Brain Death Determination / Apnea Test Procedure
09-29-2015
1777
Cervical Spine Clearance
12-12-2017
895
Delirium Management in the ICU
01-04-2011
1017
Hypertonic Saline Solution Instructions
05-06-2008
1225
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
3963
Pain Management in Surgery
09-29-2015
1275
Sedation and Agitation Management in the ICU
10-24-2009
1087
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
7940
Severe Traumatic Brain Injury Management
05-04-2017
2146
Syncope Evaluation in the Trauma Patient
09-28-2016
814
Therapeutic Hypothermia
02-24-2016
991


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1026
Chest Tube Management
09-28-2016
1231
Extubation and the Open Abdomen
01-25-2017
725
High frequency oscillatory ventilation in the surgical patient
03-03-2009
805
Independent Lung Ventilation
12-03-2014
734
Multi-modality Rib Fracture Management
11-30-2010
1445
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1670
Peri-Procedural Tracheostomy Complications
01-03-2013
741
Post-Extubation Stridor
07-31-2017
3305
Post-Tracheostomy Hemorrhage
07-29-2015
1073
Retained Hemothorax
04-27-2016
2331
Surgical Fixation of Rib Fractures
02-06-2013
6872
Timing of Tracheostomy
09-29-2015
1552
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
736
Ventilator-Associated Pneumonia
02-24-2016
1115


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
989
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
870
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1746
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
938
Snakebite/crotalid Antivenoms
11-30-2010
887


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1071
Central Venous Catheterization
12-03-2009
2648
Fever Assessment
01-30-2013
1498
Gabapentin in Post-operative Pain Management
09-28-2016
1964
Ketamine for Analgesia
12-12-2017
12
Laparoscopy in Trauma
02-24-2016
926
Mangled Extremity
04-27-2016
1111
Muscle Relaxants in Multimodal Pain Management
01-25-2017
733
Necrotizing Soft Tissues Infections
06-03-2014
831
Negative Pressure Wound Therapy
02-05-2014
730
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1787



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