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
1931
Axillary Artery and Vein Cannulation
07-29-2015
2663
Blunt Cardiac Trauma
09-28-2016
1156
Hypertension Management
11-25-2015
1894
Noninvasive Hemodynamic Monitoring
09-28-2016
1233
Vasopressors and Inotropes in Shock
04-19-2011
18637


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
1089
Hyperglycemia Control in the Critically Ill
12-06-2011
1435


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
3935
Fluid Resuscitation
09-11-2014
1518
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
656
Rhabdomyolysis: Prevention and Treatment
07-29-2015
1104


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1381
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
1319
Blunt Splenic Injury
09-29-2015
1416
Cirrhotic Management
02-24-2016
790
Clostridium difficile Infection
06-28-2015
1162
Diverticulitis
09-29-2015
860
Enteral Feeding Guidelines
04-09-2017
1331
Intra-abdominal Pressure Monitoring
03-22-2015
882
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
760
Percutaneous Endoscopic Gastrostomy
06-03-2014
596
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
880
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1405
Small Bowel Obstruction
06-03-2014
780
Stress Ulcer Prophylaxis
09-15-2011
1159


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
641
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
2015
Disseminated Intravascular Coagulation
04-09-2017
501
DVT Prophylaxis in Solid Organ Injury
12-04-2013
801
Erythropoietin Use in the Critically Ill
02-05-2008
1494
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
799
Heparin Induced Thrombocytopenia
09-04-2013
828
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
812
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
5622
Non-Vitamin K Anticoagulation Reversal
03-29-2016
1028
Thromboelastography (TEG) in Trauma
12-03-2014
1300
Venous Thromboprophylaxis in Obesity
02-24-2016
4098
Warfarin Dosing
08-31-2009
802
Warfarin Reversal
01-03-2012
968


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
771
Antibiotic Prophylaxis in Surgery
11-29-2013
4054
Candida Infections in Surgical Patients
04-09-2017
1775
Continuous Antibiotic Infusions
05-15-2007
688
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
2139
Presumptive Chest Tube Antibiotics
03-06-2013
1047


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1430
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3955
Blunt Cerebrovascular Injury
09-29-2015
1380
Brain Death Determination / Apnea Test Procedure
09-29-2015
1524
Cervical Spine Clearance
10-24-2009
752
Delirium Management in the ICU
01-04-2011
871
Hypertonic Saline Solution Instructions
05-06-2008
1051
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
3618
Pain Management in Surgery
09-29-2015
1139
Sedation and Agitation Management in the ICU
10-24-2009
944
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
7739
Severe Traumatic Brain Injury Management
05-04-2017
1870
Syncope Evaluation in the Trauma Patient
09-28-2016
701
Therapeutic Hypothermia
02-24-2016
872


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
905
Chest Tube Management
09-28-2016
1085
Extubation and the Open Abdomen
01-25-2017
610
High frequency oscillatory ventilation in the surgical patient
03-03-2009
677
Independent Lung Ventilation
12-03-2014
625
Multi-modality Rib Fracture Management
11-30-2010
1151
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1475
Peri-Procedural Tracheostomy Complications
01-03-2013
639
Post-Extubation Stridor
07-31-2017
3154
Post-Tracheostomy Hemorrhage
07-29-2015
924
Retained Hemothorax
04-27-2016
2031
Surgical Fixation of Rib Fractures
02-06-2013
6235
Timing of Tracheostomy
09-29-2015
1330
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
637
Ventilator-Associated Pneumonia
02-24-2016
979


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
847
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
751
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1456
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
811
Snakebite/crotalid Antivenoms
11-30-2010
780


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
927
Central Venous Catheterization
12-03-2009
2250
Fever Assessment
01-30-2013
1324
Gabapentin in Post-operative Pain Management
09-28-2016
1525
Laparoscopy in Trauma
02-24-2016
793
Mangled Extremity
04-27-2016
910
Muscle Relaxants in Multimodal Pain Management
01-25-2017
603
Necrotizing Soft Tissues Infections
06-03-2014
721
Negative Pressure Wound Therapy
02-05-2014
625
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1571



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