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
4610
Axillary Artery and Vein Cannulation
07-29-2015
5217
Blunt Cardiac Trauma
09-28-2016
2291
Free Flap Management
03-04-2018
893
Hypertension Management
11-25-2015
4406
Noninvasive Hemodynamic Monitoring
09-28-2016
2322
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-11-2018
183
Vasopressors and Inotropes in Shock
04-19-2011
24261


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
2032
Hyperglycemia Control in the Critically Ill
12-06-2011
2925


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
08-11-2018
7505
Fluid Resuscitation
11-02-2017
3877
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
1900
Rhabdomyolysis: Prevention and Treatment
08-11-2018
2294


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
2544
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-12-2017
3057
Blunt Splenic Injury
09-29-2015
2614
Cirrhotic Management
02-24-2016
1566
Clostridium difficile Infection
06-28-2015
2199
Diverticulitis
09-29-2015
1638
Enteral Feeding Guidelines
04-09-2017
3533
Intra-abdominal Pressure Monitoring
03-22-2015
1682
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-02-2017
3574
Percutaneous Endoscopic Gastrostomy
06-03-2014
1260
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
1666
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
2903
Small Bowel Obstruction
06-03-2014
1525
Stress Ulcer Prophylaxis
11-02-2017
2719


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
1322
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
3937
Disseminated Intravascular Coagulation
04-09-2017
1224
DVT Prophylaxis in Solid Organ Injury
12-04-2013
1548
Erythropoietin Use in the Critically Ill
02-05-2008
2753
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
1814
Heparin Induced Thrombocytopenia
09-04-2013
1526
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
1525
Massive Transfusion Protocol for Hemorrhagic Shock
11-02-2017
14472
Non-Vitamin K Anticoagulation Reversal
08-11-2018
2004
Thromboelastography (TEG) in Trauma
12-03-2014
2545
Venous Thromboprophylaxis in Obesity
02-24-2016
7541
Warfarin Dosing
08-31-2009
2193
Warfarin Reversal
11-29-2017
2582


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
1513
Antibiotic Prophylaxis in Surgery
11-29-2013
7146
Ascorbic Acid in Sepsis
03-31-2018
1234
Candida Infections in Surgical Patients
04-09-2017
3353
Continuous Antibiotic Infusions
05-15-2007
1319
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
3657
Presumptive Chest Tube Antibiotics
03-06-2013
1715


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
2729
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
12484
Blunt Cerebrovascular Injury
09-29-2015
2377
Brain Death Determination / Apnea Test Procedure
09-29-2015
3001
Cervical Spine Clearance
12-12-2017
1893
Delirium Management in the ICU
08-11-2018
1897
Hypertonic Saline Solution Instructions
05-06-2008
1904
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
5244
Pain Management in Surgery
09-29-2015
2043
Sedation and Agitation Management in the ICU
10-24-2009
1862
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
16141
Severe Traumatic Brain Injury Management
05-04-2017
4404
Syncope Evaluation in the Trauma Patient
09-28-2016
1369
Therapeutic Hypothermia
02-24-2016
1632


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
1664
Chest Tube Management
09-28-2016
2062
Extubating the Trauma Patient with an Open Abdomen
06-23-2018
367
High frequency oscillatory ventilation in the surgical patient
03-03-2009
1414
Independent Lung Ventilation
12-03-2014
1233
Multi-modality Rib Fracture Management
11-30-2010
2539
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
2743
Peri-Procedural Tracheostomy Complications
01-03-2013
1238
Post-Extubation Stridor
07-31-2017
4231
Post-Tracheostomy Hemorrhage
07-29-2015
1908
Rescue Ventilation
08-21-2018
143
Retained Hemothorax
04-27-2016
3973
Surgical Fixation of Rib Fractures
02-06-2013
7945
Timing of Tracheostomy
09-29-2015
2659
Tissue Plasminogen Activator in Traumatic Hemothorax
03-31-2018
1669
Ventilator-Associated Pneumonia
02-24-2016
1763


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
1724
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
1481
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
2831
Perioperative Hypothermia Prevention in Burn Patients
03-31-2018
519
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
1627
Snakebite/crotalid Antivenoms
11-30-2010
1518


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
1793
Central Venous Catheterization
12-03-2009
4045
Fever Assessment
01-30-2013
2513
Gabapentin in Post-operative Pain Management
09-28-2016
3626
Ketamine for Analgesia
12-12-2017
1640
Laparoscopy in Trauma
02-24-2016
1526
Mangled Extremity
04-27-2016
2078
Muscle Relaxants in Multimodal Pain Management
01-25-2017
1910
Necrotizing Soft Tissues Infections
06-03-2014
1386
Negative Pressure Wound Therapy
02-05-2014
1242
Neuromuscular Blocking Agents in the Adult ICU
08-01-2018
2733



Need Adobe Acrobat Reader?