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
1570
Axillary Artery and Vein Cannulation
07-29-2015
2182
Blunt Cardiac Trauma
09-28-2016
935
Hypertension Management
11-25-2015
1438
Noninvasive Hemodynamic Monitoring
09-28-2016
1021
Vasopressors and Inotropes in Shock
04-19-2011
15538


Endocrine

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Critical Illness-Related Corticosteroid Insufficiency
03-02-2015
858
Hyperglycemia Control in the Critically Ill
12-06-2011
1171


Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Electrolyte Replacement
01-14-2008
3137
Fluid Resuscitation
09-11-2014
1269
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-25-2017
506
Rhabdomyolysis: Prevention and Treatment
07-29-2015
881


Gastrointestinal

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Cholecystitis
01-07-2015
1101
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
06-05-2012
1125
Blunt Splenic Injury
09-29-2015
1164
Cirrhotic Management
02-24-2016
643
Clostridium difficile Infection
06-28-2015
949
Diverticulitis
09-29-2015
694
Enteral Feeding Guidelines
04-09-2017
1072
Intra-abdominal Pressure Monitoring
03-22-2015
688
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
10-06-2009
587
Percutaneous Endoscopic Gastrostomy
06-03-2014
467
Post-Splenectomy Vaccine Prophylaxis
07-29-2015
693
Premature Gastrostomy / Jejunostomy Removal
10-20-2009
1118
Small Bowel Obstruction
06-03-2014
609
Stress Ulcer Prophylaxis
09-15-2011
915


Hematologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
10-24-2009
506
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-29-2014
1601
Disseminated Intravascular Coagulation
04-09-2017
309
DVT Prophylaxis in Solid Organ Injury
12-04-2013
622
Erythropoietin Use in the Critically Ill
02-05-2008
1169
Factor VIIa (Recombinant) (Novoseven®) in Trauma
09-02-2008
552
Heparin Induced Thrombocytopenia
09-04-2013
651
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-27-2009
664
Massive Transfusion Protocol for Hemorrhagic Shock
08-01-2012
4662
Non-Vitamin K Anticoagulation Reversal
03-29-2016
843
Thromboelastography (TEG) in Trauma
12-03-2014
1057
Venous Thromboprophylaxis in Obesity
02-24-2016
3257
Warfarin Dosing
08-31-2009
639
Warfarin Reversal
01-03-2012
768


Infectious Disease

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Aerosolized Antibiotic Therapy in the ICU
03-29-2016
620
Antibiotic Prophylaxis in Surgery
11-29-2013
3165
Candida Infections in Surgical Patients
04-09-2017
1618
Continuous Antibiotic Infusions
05-15-2007
541
Empiric Antibiotic Use in Critically Ill Patients
05-08-2007
1787
Presumptive Chest Tube Antibiotics
03-06-2013
903


Neurologic

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Spinal Cord Injury Guideline
12-10-2015
1130
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-09-2017
3762
Blunt Cerebrovascular Injury
09-29-2015
1099
Brain Death Determination / Apnea Test Procedure
09-29-2015
1195
Cervical Spine Clearance
10-24-2009
579
Delirium Management in the ICU
01-04-2011
683
Hypertonic Saline Solution Instructions
05-06-2008
814
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-01-2014
3095
Pain Management in Surgery
09-29-2015
883
Sedation and Agitation Management in the ICU
10-24-2009
747
Seizure Prophylaxis in Traumatic Brain Injury
07-31-2017
7495
Severe Traumatic Brain Injury Management
05-04-2017
1519
Syncope Evaluation in the Trauma Patient
09-28-2016
546
Therapeutic Hypothermia
02-24-2016
705


Respiratory

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Air Travel Following Traumatic Pneumothorax
03-19-2015
717
Chest Tube Management
09-28-2016
852
Extubation and the Open Abdomen
01-25-2017
475
High frequency oscillatory ventilation in the surgical patient
03-03-2009
539
Independent Lung Ventilation
12-03-2014
497
Multi-modality Rib Fracture Management
11-30-2010
973
Paracostal Infusion of Bupivacaine for Management of Rib Fracture Pain
04-20-2010
1205
Peri-Procedural Tracheostomy Complications
01-03-2013
514
Post-Extubation Stridor
07-31-2017
2902
Post-Tracheostomy Hemorrhage
07-29-2015
746
Retained Hemothorax
04-27-2016
1424
Surgical Fixation of Rib Fractures
02-06-2013
5282
Timing of Tracheostomy
09-29-2015
1054
Tissue Plasminogen Activator in Traumatic Hemothorax
03-04-2008
499
Ventilator-Associated Pneumonia
02-24-2016
763


Skin

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Acute Burn Resuscitation
12-04-2013
687
Ascorbic Acid Infusion (Vitamin C) Infusion in the Resuscitation of Burn Patients
11-29-2013
594
Ketamine Sedation for Adult Burn Dressing Changes
12-06-2013
1185
Remifentanil Infusion for Adult Burn Dressing Changes
10-28-2009
657
Snakebite/crotalid Antivenoms
11-30-2010
605


Miscellaneous

EBM Guideline
Revision Date
Times Accessed (since 10/1/16)
Alcohol Withdrawal
07-29-2015
734
Central Venous Catheterization
12-03-2009
1846
Fever Assessment
01-30-2013
1127
Gabapentin in Post-operative Pain Management
09-28-2016
1011
Laparoscopy in Trauma
02-24-2016
627
Mangled Extremity
04-27-2016
678
Muscle Relaxants in Multimodal Pain Management
01-25-2017
434
Necrotizing Soft Tissues Infections
06-03-2014
577
Negative Pressure Wound Therapy
02-05-2014
491
Neuromuscular Blocking Agents in the Adult ICU
11-08-2013
1264



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