Surgicalcriticalcare.net

Evidence Based-Medicine Guidelines

The following is a collection of best practice guidelines currently in use by the Surgical Critical Care service 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.

The Evidence-Based Medicine Guidelines Committee is pleased to share these guidelines for clinical use in your intensive care unit. If you choose to do so, the Committee requests that the time and effort involved in developing these guidelines be appropriately recognized. All guidelines contained on this site are copyrighted by Surgicalcriticalcare.net unless otherwise indicated.

Guidelines should be referenced in the following manner: Rojas K, Birrer K, Cheatham M, Smith C. Seizure Prophylaxis following Traumatic Brain Injury. http://www.surgicalcriticalcare.net/Guidelines/Seizure prophylaxis in TBI 2017.pdf. Updated July 26, 2017. Accessed January 13, 2021.


Cardiovascular

EBM Guideline
Revision Date
Times Accessed
Acute Atrial Fibrillation in the Surgical Patient
12-13-2017
12110
Axillary Artery and Vein Cannulation
07-30-2015
15249
Blunt Cardiac Trauma
09-29-2016
6999
Free Flap Management
02-21-2020
9644
Hypertension Management
11-26-2015
13265
Noninvasive Hemodynamic Monitoring
09-29-2016
6502
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
5117
Vasopressors and Inotropes in Shock
09-12-2019
38968

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
6286
Hyperglycemia Control in the Critically Ill
12-07-2011
9368
Thyroid Management in the ICU
06-18-2019
6060

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
23556
Fluid Resuscitation
11-03-2017
13169
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
9143
Rhabdomyolysis: Prevention and Treatment
08-12-2018
12349

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
7998
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
12393
Blunt Splenic Injury
09-30-2015
6819
Cirrhotic Management
02-25-2016
5749
Clostridium difficile Infection
06-29-2015
6253
Diverticulitis
09-30-2015
5693
Enteral Feeding Guidelines
04-10-2017
16130
Intra-abdominal Pressure Monitoring
03-23-2015
5449
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
22037
Percutaneous Endoscopic Gastrostomy
06-11-2020
5489
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
10356
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
9018
Small Bowel Obstruction
06-04-2014
5090
Stress Ulcer Prophylaxis
11-03-2017
8862

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
5958
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
9837
Disseminated Intravascular Coagulation
04-10-2017
4488
DVT Prophylaxis in Solid Organ Injury
12-05-2013
6137
Erythropoietin Use in the Critically Ill
02-06-2008
6868
Heparin Induced Thrombocytopenia
09-14-2019
6567
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
5125
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
41439
Non-Vitamin K Anticoagulation Reversal
08-12-2018
6186
Thromboelastography (TEG) in Trauma
12-04-2014
7828
Ultrasound Guided Peripheral IV Insertion
05-27-2020
3082
Venous Thromboprophylaxis in Obesity
02-25-2016
16321
Warfarin Dosing
09-01-2009
5355
Warfarin Reversal
11-30-2017
6824

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
4876
Antibiotic Prophylaxis in Surgery
11-30-2013
14330
Candida Infections in Surgical Patients
04-10-2017
6373
Continuous Antibiotic Infusions
05-16-2007
4358
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
7484
Facial Fracture Antibiotics
04-29-2020
8255
Presumptive Chest Tube Antibiotics
03-07-2013
4737

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
10469
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
26873
Blunt Cerebrovascular Injury
09-30-2015
5776
Brain Death Determination / Apnea Test Procedure
09-10-2019
13925
Cervical Spine Clearance
12-13-2017
5500
Delirium Management in the ICU
08-12-2018
13463
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
14098
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
8496
Pain Management in Surgery
09-30-2015
5356
Sedation and Agitation Management in the ICU
10-25-2009
5612
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
35331
Severe Traumatic Brain Injury Management
09-11-2019
13245
Syncope Evaluation in the Trauma Patient
09-29-2016
4658
Therapeutic Hypothermia
09-01-2020
5888

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
4962
Chest Tube Management
09-29-2016
6986
Diaphragm Pacing
07-18-2019
4077
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
6786
High frequency oscillatory ventilation in the surgical patient
03-04-2009
4323
Independent Lung Ventilation
12-04-2014
4172
Multi-modality Rib Fracture Management
03-05-2020
11088
Peri-Procedural Tracheostomy Complications
01-04-2013
4035
Post-Extubation Stridor
08-01-2017
7459
Post-Tracheostomy Hemorrhage
07-30-2015
6416
Rescue Ventilation
08-22-2018
5695
Retained Hemothorax
04-28-2016
11553
Surgical Fixation of Rib Fractures
09-04-2020
12056
Timing of Tracheostomy
04-29-2020
8859
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
7221
Ventilator-Associated Pneumonia
02-25-2016
5175

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
9394
Burn Resuscitation
11-26-2019
11350
Ketamine for Analgesia
12-27-2019
7687
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
11959
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
8158
Snakebite/crotalid Antivenoms
09-28-2018
5648

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
5665
Central Venous Catheterization
12-04-2009
8835
Fever Assessment
06-27-2019
11492
Gabapentin in Post-operative Pain Management
09-29-2016
7246
Ketamine for Analgesia
12-13-2017
10471
Laparoscopy in Trauma
02-25-2016
4664
Mangled Extremity
04-28-2016
6814
Muscle Relaxants in Multimodal Pain Management
01-26-2017
11535
Necrotizing Soft Tissues Infections
09-28-2018
6898
Negative Pressure Wound Therapy
02-06-2014
4072
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
10212