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
872
Axillary Artery and Vein Cannulation
07-29-2015
1161
Blunt Cardiac Trauma
09-28-2016
541
Hypertension Management
11-25-2015
768
Noninvasive Hemodynamic Monitoring
09-28-2016
627
Vasopressors and Inotropes in Shock
04-19-2011
9095


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
482
Hyperglycemia Control in the Critically Ill
12-06-2011
659


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
1620
Fluid Resuscitation
09-11-2014
703
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
181
Rhabdomyolysis: Prevention and Treatment
07-29-2015
484


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
588
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
410
Blunt Splenic Injury
09-29-2015
628
Cirrhotic Management
02-24-2016
357
Clostridium difficile Infection
06-28-2015
526
Diverticulitis
09-29-2015
371
Enteral Feeding Guidelines
03-25-2012
550
Intra-abdominal Pressure Monitoring
03-22-2015
372
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
327
Percutaneous Endoscopic Gastrostomy
06-03-2014
251
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
393
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
625
Small Bowel Obstruction
06-03-2014
336
Stress Ulcer Prophylaxis
09-15-2011
479


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
285
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
837
DVT Prophylaxis in Solid Organ Injury
12-04-2013
321
Erythropoietin Use in the Critically Ill
02-05-2008
625
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
267
Heparin Induced Thrombocytopenia
09-04-2013
352
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
342
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
2610
Non-Vitamin K Anticoagulation Reversal
03-29-2016
501
Thromboelastography (TEG) in Trauma
12-03-2014
579
Venous Thromboprophylaxis in Obesity
02-24-2016
1707
Warfarin Dosing
08-31-2009
357
Warfarin Reversal
01-03-2012
406


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
315
Antibiotic Prophylaxis in Surgery
11-29-2013
1702
Candida Infections in Surgical Patients
05-06-2008
1150
Continuous Antibiotic Infusions
05-15-2007
286
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1181
Presumptive Chest Tube Antibiotics
03-06-2013
659


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
695
Antiplatlet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
09-01-2012
3052
Blunt Cerebrovascular Injury
09-29-2015
619
Brain Death Determination / Apnea Test Procedure
09-29-2015
618
Cervical Spine Clearance
10-24-2009
306
Delirium Management in the ICU
01-04-2011
361
Hypertonic Saline Solution Instructions
05-06-2008
436
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2037
Pain Management in Surgery
09-29-2015
451
Sedation and Agitation Management in the ICU
10-24-2009
408
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
4411
Severe Traumatic Brain Injury Management
03-29-2016
756
Syncope Evaluation in the Trauma Patient
09-28-2016
316
Therapeutic Hypothermia
02-24-2016
366


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
388
Chest Tube Management
09-28-2016
499
Extubation and the Open Abdomen
01-25-2017
162
High frequency oscillatory ventilation in the surgical patient
03-03-2009
290
Independent Lung Ventilation
12-03-2014
264
Multi-modality Rib Fracture Management
11-30-2010
613
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
602
Peri-Procedural Tracheostomy Complications
01-03-2013
269
Post-Extubation Stridor
05-01-2012
1570
Post-Tracheostomy Hemorrhage
07-29-2015
427
Retained Hemothorax
04-27-2016
518
Surgical Fixation of Rib Fractures
02-06-2013
2997
Timing of Tracheostomy
09-29-2015
535
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
269
Ventilator-Associated Pneumonia
02-24-2016
407


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
353
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
293
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
622
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
340
Snakebite/crotalid Antivenoms
11-30-2010
310


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
397
Central Venous Catheterization
12-03-2009
913
Fever Assessment
01-30-2013
656
Gabapentin in Post-operative Pain Management
09-28-2016
462
Laparoscopy in Trauma
02-24-2016
351
Mangled Extremity
04-27-2016
277
Muscle Relaxants in Multimodal Pain Management
01-25-2017
132
Necrotizing Soft Tissues Infections
06-03-2014
301
Negative Pressure Wound Therapy
02-05-2014
259
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
766



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