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
02-13-2012
1314
Axillary Artery and Vein Cannulation
07-29-2015
1823
Blunt Cardiac Trauma
09-28-2016
775
Hypertension Management
11-25-2015
1167
Noninvasive Hemodynamic Monitoring
09-28-2016
875
Vasopressors and Inotropes in Shock
04-19-2011
13728


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
717
Hyperglycemia Control in the Critically Ill
12-06-2011
991


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
2396
Fluid Resuscitation
09-11-2014
1036
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
403
Rhabdomyolysis: Prevention and Treatment
07-29-2015
742


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
880
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
931
Blunt Splenic Injury
09-29-2015
972
Cirrhotic Management
02-24-2016
537
Clostridium difficile Infection
06-28-2015
774
Diverticulitis
09-29-2015
577
Enteral Feeding Guidelines
04-09-2017
881
Intra-abdominal Pressure Monitoring
03-22-2015
575
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
495
Percutaneous Endoscopic Gastrostomy
06-03-2014
389
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
585
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
921
Small Bowel Obstruction
06-03-2014
507
Stress Ulcer Prophylaxis
09-15-2011
706


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
417
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1278
Disseminated Intravascular Coagulation
04-09-2017
185
DVT Prophylaxis in Solid Organ Injury
12-04-2013
510
Erythropoietin Use in the Critically Ill
02-05-2008
983
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
433
Heparin Induced Thrombocytopenia
09-04-2013
535
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
555
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
3927
Non-Vitamin K Anticoagulation Reversal
03-29-2016
728
Thromboelastography (TEG) in Trauma
12-03-2014
888
Venous Thromboprophylaxis in Obesity
02-24-2016
2701
Warfarin Dosing
08-31-2009
536
Warfarin Reversal
01-03-2012
620


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
516
Antibiotic Prophylaxis in Surgery
11-29-2013
2574
Candida Infections in Surgical Patients
04-09-2017
1514
Continuous Antibiotic Infusions
05-15-2007
442
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1569
Presumptive Chest Tube Antibiotics
03-06-2013
819


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
975
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3641
Blunt Cerebrovascular Injury
09-29-2015
921
Brain Death Determination / Apnea Test Procedure
09-29-2015
982
Cervical Spine Clearance
10-24-2009
471
Delirium Management in the ICU
01-04-2011
561
Hypertonic Saline Solution Instructions
05-06-2008
681
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2759
Pain Management in Surgery
09-29-2015
717
Sedation and Agitation Management in the ICU
10-24-2009
610
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
6494
Severe Traumatic Brain Injury Management
05-04-2017
1256
Syncope Evaluation in the Trauma Patient
09-28-2016
460
Therapeutic Hypothermia
02-24-2016
584


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
605
Chest Tube Management
09-28-2016
719
Extubation and the Open Abdomen
01-25-2017
373
High frequency oscillatory ventilation in the surgical patient
03-03-2009
449
Independent Lung Ventilation
12-03-2014
412
Multi-modality Rib Fracture Management
11-30-2010
783
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1011
Peri-Procedural Tracheostomy Complications
01-03-2013
422
Post-Extubation Stridor
05-01-2012
2419
Post-Tracheostomy Hemorrhage
07-29-2015
615
Retained Hemothorax
04-27-2016
1082
Surgical Fixation of Rib Fractures
02-06-2013
4529
Timing of Tracheostomy
09-29-2015
874
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
419
Ventilator-Associated Pneumonia
02-24-2016
603


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
551
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
476
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
961
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
544
Snakebite/crotalid Antivenoms
11-30-2010
493


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
611
Central Venous Catheterization
12-03-2009
1506
Fever Assessment
01-30-2013
954
Gabapentin in Post-operative Pain Management
09-28-2016
708
Laparoscopy in Trauma
02-24-2016
531
Mangled Extremity
04-27-2016
528
Muscle Relaxants in Multimodal Pain Management
01-25-2017
331
Necrotizing Soft Tissues Infections
06-03-2014
466
Negative Pressure Wound Therapy
02-05-2014
411
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1098



Need Adobe Acrobat Reader?