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
5310
Axillary Artery and Vein Cannulation
07-29-2015
6369
Blunt Cardiac Trauma
09-28-2016
2691
Free Flap Management
03-04-2018
1373
Hypertension Management
11-25-2015
5703
Noninvasive Hemodynamic Monitoring
09-28-2016
2686
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
927
Vasopressors and Inotropes in Shock
04-19-2011
24878


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2330
Hyperglycemia Control in the Critically Ill
12-06-2011
3645


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
9454
Fluid Resuscitation
11-02-2017
4670
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2590
Rhabdomyolysis: Prevention and Treatment
08-11-2018
3467


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
3080
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3725
Blunt Splenic Injury
09-29-2015
3035
Cirrhotic Management
02-24-2016
1865
Clostridium difficile Infection
06-28-2015
2567
Diverticulitis
09-29-2015
1939
Enteral Feeding Guidelines
04-09-2017
4824
Intra-abdominal Pressure Monitoring
03-22-2015
1943
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
5551
Percutaneous Endoscopic Gastrostomy
06-03-2014
1461
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1975
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3479
Small Bowel Obstruction
06-03-2014
1795
Stress Ulcer Prophylaxis
11-02-2017
3315


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1512
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
4642
Disseminated Intravascular Coagulation
04-09-2017
1441
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1790
Erythropoietin Use in the Critically Ill
02-05-2008
3232
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
2019
Heparin Induced Thrombocytopenia
09-04-2013
1764
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1813
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
18901
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2635
Thromboelastography (TEG) in Trauma
12-03-2014
2966
Venous Thromboprophylaxis in Obesity
02-24-2016
8846
Warfarin Dosing
08-31-2009
2418
Warfarin Reversal
11-29-2017
3022


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1783
Antibiotic Prophylaxis in Surgery
11-29-2013
8335
Candida Infections in Surgical Patients
04-09-2017
3566
Continuous Antibiotic Infusions
05-15-2007
1542
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3994
Presumptive Chest Tube Antibiotics
03-06-2013
1928


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
4307
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
17292
Blunt Cerebrovascular Injury
09-29-2015
2663
Brain Death Determination / Apnea Test Procedure
09-29-2015
3546
Cervical Spine Clearance
12-12-2017
2179
Delirium Management in the ICU
08-11-2018
2879
Hypertonic Saline Solution Instructions
05-06-2008
2182
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5550
Pain Management in Surgery
09-29-2015
2300
Sedation and Agitation Management in the ICU
10-24-2009
2186
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
20934
Severe Traumatic Brain Injury Management
05-04-2017
5007
Syncope Evaluation in the Trauma Patient
09-28-2016
1615
Therapeutic Hypothermia
02-24-2016
1892


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1910
Chest Tube Management
09-28-2016
2531
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
872
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1663
Independent Lung Ventilation
12-03-2014
1454
Multi-modality Rib Fracture Management
11-30-2010
2967
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
3123
Peri-Procedural Tracheostomy Complications
01-03-2013
1428
Post-Extubation Stridor
07-31-2017
4487
Post-Tracheostomy Hemorrhage
07-29-2015
2274
Rescue Ventilation
08-21-2018
1012
Retained Hemothorax
04-27-2016
4794
Surgical Fixation of Rib Fractures
02-06-2013
8252
Timing of Tracheostomy
09-29-2015
3085
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
2116
Ventilator-Associated Pneumonia
02-24-2016
1983


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
2049
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
3030
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
1489
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1926
Snakebite/crotalid Antivenoms
09-27-2018
2037


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
2098
Central Venous Catheterization
12-03-2009
4627
Fever Assessment
01-30-2013
3028
Gabapentin in Post-operative Pain Management
09-28-2016
3969
Ketamine for Analgesia
12-12-2017
2353
Laparoscopy in Trauma
02-24-2016
1766
Mangled Extremity
04-27-2016
2622
Muscle Relaxants in Multimodal Pain Management
01-25-2017
2726
Necrotizing Soft Tissues Infections
09-27-2018
1964
Negative Pressure Wound Therapy
02-05-2014
1461
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
3900



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