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
4985
Axillary Artery and Vein Cannulation
07-29-2015
5739
Blunt Cardiac Trauma
09-28-2016
2498
Free Flap Management
03-04-2018
1101
Hypertension Management
11-25-2015
5083
Noninvasive Hemodynamic Monitoring
09-28-2016
2511
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
540
Vasopressors and Inotropes in Shock
04-19-2011
24594


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2181
Hyperglycemia Control in the Critically Ill
12-06-2011
3290


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
8547
Fluid Resuscitation
11-02-2017
4291
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
2283
Rhabdomyolysis: Prevention and Treatment
08-11-2018
2859


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
2850
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3384
Blunt Splenic Injury
09-29-2015
2862
Cirrhotic Management
02-24-2016
1726
Clostridium difficile Infection
06-28-2015
2379
Diverticulitis
09-29-2015
1798
Enteral Feeding Guidelines
04-09-2017
4155
Intra-abdominal Pressure Monitoring
03-22-2015
1821
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
4554
Percutaneous Endoscopic Gastrostomy
06-03-2014
1370
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1823
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
3214
Small Bowel Obstruction
06-03-2014
1662
Stress Ulcer Prophylaxis
11-02-2017
2998


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1425
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
4317
Disseminated Intravascular Coagulation
04-09-2017
1340
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1670
Erythropoietin Use in the Critically Ill
02-05-2008
3005
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1926
Heparin Induced Thrombocytopenia
09-04-2013
1652
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1694
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
16829
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2351
Thromboelastography (TEG) in Trauma
12-03-2014
2754
Venous Thromboprophylaxis in Obesity
02-24-2016
8271
Warfarin Dosing
08-31-2009
2308
Warfarin Reversal
11-29-2017
2804


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1650
Antibiotic Prophylaxis in Surgery
11-29-2013
7844
Ascorbic Acid in Sepsis
03-31-2018
2630
Candida Infections in Surgical Patients
04-09-2017
3459
Continuous Antibiotic Infusions
05-15-2007
1433
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3842
Presumptive Chest Tube Antibiotics
03-06-2013
1823


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
09-10-2018
3344
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
15096
Blunt Cerebrovascular Injury
09-29-2015
2531
Brain Death Determination / Apnea Test Procedure
09-29-2015
3258
Cervical Spine Clearance
12-12-2017
2040
Delirium Management in the ICU
08-11-2018
2329
Hypertonic Saline Solution Instructions
05-06-2008
2035
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5430
Pain Management in Surgery
09-29-2015
2179
Sedation and Agitation Management in the ICU
10-24-2009
2034
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
18829
Severe Traumatic Brain Injury Management
05-04-2017
4727
Syncope Evaluation in the Trauma Patient
09-28-2016
1498
Therapeutic Hypothermia
02-24-2016
1760


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1781
Chest Tube Management
09-28-2016
2306
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
655
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1526
Independent Lung Ventilation
12-03-2014
1326
Multi-modality Rib Fracture Management
11-30-2010
2802
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
2954
Peri-Procedural Tracheostomy Complications
01-03-2013
1333
Post-Extubation Stridor
07-31-2017
4344
Post-Tracheostomy Hemorrhage
07-29-2015
2097
Rescue Ventilation
08-21-2018
543
Retained Hemothorax
04-27-2016
4415
Surgical Fixation of Rib Fractures
02-06-2013
8110
Timing of Tracheostomy
09-29-2015
2877
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
1920
Ventilator-Associated Pneumonia
02-24-2016
1880


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1901
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
1578
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
2945
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
1005
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1771
Snakebite/crotalid Antivenoms
09-27-2018
1796


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1953
Central Venous Catheterization
12-03-2009
4343
Fever Assessment
01-30-2013
2773
Gabapentin in Post-operative Pain Management
09-28-2016
3818
Ketamine for Analgesia
12-12-2017
1958
Laparoscopy in Trauma
02-24-2016
1658
Mangled Extremity
04-27-2016
2357
Muscle Relaxants in Multimodal Pain Management
01-25-2017
2391
Necrotizing Soft Tissues Infections
09-27-2018
1667
Negative Pressure Wound Therapy
02-05-2014
1353
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
3286



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