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
12-13-2017
7623
Axillary Artery and Vein Cannulation
07-30-2015
8983
Blunt Cardiac Trauma
09-29-2016
3967
Free Flap Management
03-05-2018
3182
Hypertension Management
11-26-2015
8580
Noninvasive Hemodynamic Monitoring
09-29-2016
3920
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
2536
Vasopressors and Inotropes in Shock
09-12-2019
29119


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
3564
Hyperglycemia Control in the Critically Ill
12-07-2011
5517
Thyroid Management in the ICU
06-18-2019
1848


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-12-2018
14877
Fluid Resuscitation
11-03-2017
8756
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
4724
Rhabdomyolysis: Prevention and Treatment
08-12-2018
7715


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-08-2015
4673
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
5832
Blunt Splenic Injury
09-30-2015
4273
Cirrhotic Management
02-25-2016
2908
Clostridium difficile Infection
06-29-2015
3736
Diverticulitis
09-30-2015
2934
Enteral Feeding Guidelines
04-10-2017
8230
Intra-abdominal Pressure Monitoring
03-23-2015
2990
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
10526
Percutaneous Endoscopic Gastrostomy
06-04-2014
2242
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
7054
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
5004
Small Bowel Obstruction
06-04-2014
2762
Stress Ulcer Prophylaxis
11-03-2017
4833


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
3392
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
6492
Disseminated Intravascular Coagulation
04-10-2017
2269
DVT Prophylaxis in Solid Organ Injury
12-05-2013
2659
Erythropoietin Use in the Critically Ill
02-06-2008
4406
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-03-2008
2808
Heparin Induced Thrombocytopenia
09-14-2019
3238
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
2685
Massive Transfusion Protocol for Hemorrhagic Shock
11-03-2017
26332
Non-Vitamin K Anticoagulation Reversal
08-12-2018
3789
Thromboelastography (TEG) in Trauma
12-04-2014
4701
Venous Thromboprophylaxis in Obesity
02-25-2016
12043
Warfarin Dosing
09-01-2009
3272
Warfarin Reversal
11-30-2017
4309


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
2564
Antibiotic Prophylaxis in Surgery
11-30-2013
11051
Candida Infections in Surgical Patients
04-10-2017
4369
Continuous Antibiotic Infusions
05-16-2007
2286
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
5105
Facial Fracture Antibiotics
06-27-2019
1544
Presumptive Chest Tube Antibiotics
03-07-2013
2685


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-11-2018
7682
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
23289
Blunt Cerebrovascular Injury
09-30-2015
3649
Brain Death Determination / Apnea Test Procedure
09-10-2019
5844
Cervical Spine Clearance
12-13-2017
3322
Delirium Management in the ICU
08-12-2018
5308
Hypertonic Saline Solution Instructions
05-07-2008
3156
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
6447
Pain Management in Surgery
09-30-2015
3134
Sedation and Agitation Management in the ICU
10-25-2009
3183
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
27800
Severe Traumatic Brain Injury Management
09-11-2019
8556
Syncope Evaluation in the Trauma Patient
09-29-2016
2419
Therapeutic Hypothermia
02-25-2016
2756


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-20-2015
2775
Chest Tube Management
09-29-2016
3871
Diaphragm Pacing
07-18-2019
1376
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
1946
High frequency oscillatory ventilation in the surgical patient
03-04-2009
2407
Independent Lung Ventilation
12-04-2014
2187
Multi-modality Rib Fracture Management
12-01-2010
4105
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-21-2010
4252
Peri-Procedural Tracheostomy Complications
01-04-2013
2123
Post-Extubation Stridor
08-01-2017
5343
Post-Tracheostomy Hemorrhage
07-30-2015
3320
Rescue Ventilation
08-22-2018
2495
Retained Hemothorax
04-28-2016
7078
Surgical Fixation of Rib Fractures
02-07-2013
9260
Timing of Tracheostomy
09-30-2015
4235
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
3367
Ventilator-Associated Pneumonia
02-25-2016
2810


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Burn Inhalation injury
06-18-2019
1659
Burn Resuscitation
11-26-2019
4619
Ketamine for Analgesia
12-27-2019
3853
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
4775
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
2704
Snakebite/crotalid Antivenoms
09-28-2018
3334


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-30-2015
3183
Central Venous Catheterization
12-04-2009
6046
Fever Assessment
06-27-2019
6028
Gabapentin in Post-operative Pain Management
09-29-2016
4932
Ketamine for Analgesia
12-13-2017
4999
Laparoscopy in Trauma
02-25-2016
2505
Mangled Extremity
04-28-2016
3994
Muscle Relaxants in Multimodal Pain Management
01-26-2017
4565
Necrotizing Soft Tissues Infections
09-28-2018
3790
Negative Pressure Wound Therapy
02-06-2014
2179
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
6489



Need Adobe Acrobat Reader?