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
1164
Axillary Artery and Vein Cannulation
07-29-2015
1594
Blunt Cardiac Trauma
09-28-2016
690
Hypertension Management
11-25-2015
1013
Noninvasive Hemodynamic Monitoring
09-28-2016
780
Vasopressors and Inotropes in Shock
04-19-2011
12403


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
637
Hyperglycemia Control in the Critically Ill
12-06-2011
856


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
2103
Fluid Resuscitation
09-11-2014
905
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
331
Rhabdomyolysis: Prevention and Treatment
07-29-2015
653


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
767
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
726
Blunt Splenic Injury
09-29-2015
844
Cirrhotic Management
02-24-2016
466
Clostridium difficile Infection
06-28-2015
674
Diverticulitis
09-29-2015
508
Enteral Feeding Guidelines
04-09-2017
763
Intra-abdominal Pressure Monitoring
03-22-2015
490
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
434
Percutaneous Endoscopic Gastrostomy
06-03-2014
336
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
513
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
826
Small Bowel Obstruction
06-03-2014
438
Stress Ulcer Prophylaxis
09-15-2011
625


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
368
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1120
Disseminated Intravascular Coagulation
04-09-2017
104
DVT Prophylaxis in Solid Organ Injury
12-04-2013
441
Erythropoietin Use in the Critically Ill
02-05-2008
859
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
370
Heparin Induced Thrombocytopenia
09-04-2013
459
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
481
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
3480
Non-Vitamin K Anticoagulation Reversal
03-29-2016
641
Thromboelastography (TEG) in Trauma
12-03-2014
768
Venous Thromboprophylaxis in Obesity
02-24-2016
2344
Warfarin Dosing
08-31-2009
468
Warfarin Reversal
01-03-2012
538


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
437
Antibiotic Prophylaxis in Surgery
11-29-2013
2279
Candida Infections in Surgical Patients
04-09-2017
1435
Continuous Antibiotic Infusions
05-15-2007
382
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1463
Presumptive Chest Tube Antibiotics
03-06-2013
758


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
880
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3542
Blunt Cerebrovascular Injury
09-29-2015
813
Brain Death Determination / Apnea Test Procedure
09-29-2015
845
Cervical Spine Clearance
10-24-2009
412
Delirium Management in the ICU
01-04-2011
483
Hypertonic Saline Solution Instructions
05-06-2008
598
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2492
Pain Management in Surgery
09-29-2015
625
Sedation and Agitation Management in the ICU
10-24-2009
539
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
5811
Severe Traumatic Brain Injury Management
05-04-2017
1097
Syncope Evaluation in the Trauma Patient
09-28-2016
411
Therapeutic Hypothermia
02-24-2016
493


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
530
Chest Tube Management
09-28-2016
631
Extubation and the Open Abdomen
01-25-2017
300
High frequency oscillatory ventilation in the surgical patient
03-03-2009
389
Independent Lung Ventilation
12-03-2014
358
Multi-modality Rib Fracture Management
11-30-2010
726
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
865
Peri-Procedural Tracheostomy Complications
01-03-2013
363
Post-Extubation Stridor
05-01-2012
2121
Post-Tracheostomy Hemorrhage
07-29-2015
549
Retained Hemothorax
04-27-2016
878
Surgical Fixation of Rib Fractures
02-06-2013
3997
Timing of Tracheostomy
09-29-2015
779
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
367
Ventilator-Associated Pneumonia
02-24-2016
532


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
480
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
417
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
838
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
478
Snakebite/crotalid Antivenoms
11-30-2010
418


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
533
Central Venous Catheterization
12-03-2009
1303
Fever Assessment
01-30-2013
863
Gabapentin in Post-operative Pain Management
09-28-2016
565
Laparoscopy in Trauma
02-24-2016
474
Mangled Extremity
04-27-2016
454
Muscle Relaxants in Multimodal Pain Management
01-25-2017
261
Necrotizing Soft Tissues Infections
06-03-2014
404
Negative Pressure Wound Therapy
02-05-2014
354
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
967



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