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
1013
Axillary Artery and Vein Cannulation
07-29-2015
1354
Blunt Cardiac Trauma
09-28-2016
611
Hypertension Management
11-25-2015
874
Noninvasive Hemodynamic Monitoring
09-28-2016
698
Vasopressors and Inotropes in Shock
04-19-2011
10688


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
557
Hyperglycemia Control in the Critically Ill
12-06-2011
761


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
1856
Fluid Resuscitation
09-11-2014
801
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
251
Rhabdomyolysis: Prevention and Treatment
07-29-2015
563


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
650
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
578
Blunt Splenic Injury
09-29-2015
742
Cirrhotic Management
02-24-2016
409
Clostridium difficile Infection
06-28-2015
589
Diverticulitis
09-29-2015
435
Enteral Feeding Guidelines
04-09-2017
651
Intra-abdominal Pressure Monitoring
03-22-2015
426
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
374
Percutaneous Endoscopic Gastrostomy
06-03-2014
288
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
450
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
712
Small Bowel Obstruction
06-03-2014
385
Stress Ulcer Prophylaxis
09-15-2011
553


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
317
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
966
Disseminated Intravascular Coagulation
04-09-2017
31
DVT Prophylaxis in Solid Organ Injury
12-04-2013
366
Erythropoietin Use in the Critically Ill
02-05-2008
726
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
305
Heparin Induced Thrombocytopenia
09-04-2013
400
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
409
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
2998
Non-Vitamin K Anticoagulation Reversal
03-29-2016
561
Thromboelastography (TEG) in Trauma
12-03-2014
667
Venous Thromboprophylaxis in Obesity
02-24-2016
2002
Warfarin Dosing
08-31-2009
407
Warfarin Reversal
01-03-2012
457


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
367
Antibiotic Prophylaxis in Surgery
11-29-2013
1964
Candida Infections in Surgical Patients
04-09-2017
1361
Continuous Antibiotic Infusions
05-15-2007
323
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1361
Presumptive Chest Tube Antibiotics
03-06-2013
705


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
782
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3465
Blunt Cerebrovascular Injury
09-29-2015
707
Brain Death Determination / Apnea Test Procedure
09-29-2015
721
Cervical Spine Clearance
10-24-2009
355
Delirium Management in the ICU
01-04-2011
411
Hypertonic Saline Solution Instructions
05-06-2008
500
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
2247
Pain Management in Surgery
09-29-2015
526
Sedation and Agitation Management in the ICU
10-24-2009
471
Seizure Prophylaxis in Traumatic Brain Injury
08-27-2012
5051
Severe Traumatic Brain Injury Management
03-29-2016
920
Syncope Evaluation in the Trauma Patient
09-28-2016
359
Therapeutic Hypothermia
02-24-2016
414


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
464
Chest Tube Management
09-28-2016
562
Extubation and the Open Abdomen
01-25-2017
223
High frequency oscillatory ventilation in the surgical patient
03-03-2009
334
Independent Lung Ventilation
12-03-2014
302
Multi-modality Rib Fracture Management
11-30-2010
661
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
722
Peri-Procedural Tracheostomy Complications
01-03-2013
311
Post-Extubation Stridor
05-01-2012
1790
Post-Tracheostomy Hemorrhage
07-29-2015
482
Retained Hemothorax
04-27-2016
667
Surgical Fixation of Rib Fractures
02-06-2013
3468
Timing of Tracheostomy
09-29-2015
629
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
319
Ventilator-Associated Pneumonia
02-24-2016
468


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
409
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
346
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
716
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
399
Snakebite/crotalid Antivenoms
11-30-2010
352


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
448
Central Venous Catheterization
12-03-2009
1098
Fever Assessment
01-30-2013
738
Gabapentin in Post-operative Pain Management
09-28-2016
504
Laparoscopy in Trauma
02-24-2016
407
Mangled Extremity
04-27-2016
341
Muscle Relaxants in Multimodal Pain Management
01-25-2017
192
Necrotizing Soft Tissues Infections
06-03-2014
340
Negative Pressure Wound Therapy
02-05-2014
294
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
856



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