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
16445
Axillary Artery and Vein Cannulation
07-30-2015
19198
Blunt Cardiac Trauma
09-29-2016
11721
Free Flap Management
02-21-2020
17624
Hypertension Management
11-26-2015
17332
Noninvasive Hemodynamic Monitoring
09-29-2016
10374
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
9067
Vasopressors and Inotropes in Shock
09-12-2019
44567

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
10300
Hyperglycemia Control in the Critically Ill
12-07-2011
13331
Thyroid Management in the ICU
06-18-2019
11011

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
28350
Fluid Resuscitation
11-03-2017
18047
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
13392
Rhabdomyolysis: Prevention and Treatment
08-12-2018
16564

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
11982
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
16878
Blunt Splenic Injury
09-30-2015
10789
Cirrhotic Management
02-25-2016
9686
Clostridium difficile Infection
06-29-2015
10021
Diverticulitis
09-30-2015
9568
Enteral Feeding Guidelines
04-10-2017
20394
Intra-abdominal Pressure Monitoring
03-23-2015
9569
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
25985
Percutaneous Endoscopic Gastrostomy
06-11-2020
9237
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
14135
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
13000
Small Bowel Obstruction
06-04-2014
10383
Stress Ulcer Prophylaxis
11-03-2017
12877

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
10550
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
13663
Disseminated Intravascular Coagulation
04-10-2017
8202
DVT Prophylaxis in Solid Organ Injury
12-05-2013
9913
Erythropoietin Use in the Critically Ill
02-06-2008
10696
Heparin Induced Thrombocytopenia
09-14-2019
10256
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
8884
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
45647
Non-Vitamin K Anticoagulation Reversal
08-12-2018
9863
Thromboelastography (TEG) in Trauma
12-04-2014
11804
Ultrasound Guided Peripheral IV Insertion
05-27-2020
7062
Venous Thromboprophylaxis in Obesity
02-25-2016
19931
Warfarin Dosing
09-01-2009
9157
Warfarin Reversal
11-30-2017
10622

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
8830
Antibiotic Prophylaxis in Surgery
11-30-2013
18464
Candida Infections in Surgical Patients
04-10-2017
10167
Continuous Antibiotic Infusions
05-16-2007
8219
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
11334
Facial Fracture Antibiotics
04-29-2020
13377
Presumptive Chest Tube Antibiotics
03-07-2013
8510

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
14352
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
31030
Blunt Cerebrovascular Injury
09-30-2015
9683
Brain Death Determination / Apnea Test Procedure
09-10-2019
22477
Cervical Spine Clearance
12-13-2017
9283
Delirium Management in the ICU
08-12-2018
17358
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
18892
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
12330
Pain Management in Surgery
09-30-2015
9330
Sedation and Agitation Management in the ICU
10-25-2009
9486
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
115411
Severe Traumatic Brain Injury Management
09-11-2019
17457
Syncope Evaluation in the Trauma Patient
09-29-2016
8500
Therapeutic Hypothermia
09-01-2020
9743

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
14824
Chest Tube Management
09-29-2016
11224
Diaphragm Pacing
07-18-2019
8142
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
10611
High frequency oscillatory ventilation in the surgical patient
03-04-2009
8307
Independent Lung Ventilation
12-04-2014
8061
Multi-modality Rib Fracture Management
03-05-2020
22551
Peri-Procedural Tracheostomy Complications
01-04-2013
7936
Post-Extubation Stridor
08-01-2017
11566
Post-Tracheostomy Hemorrhage
07-30-2015
10476
Rescue Ventilation
08-22-2018
10124
Retained Hemothorax
04-28-2016
15872
Surgical Fixation of Rib Fractures
09-04-2020
16193
Timing of Tracheostomy
04-29-2020
18616
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
11435
Ventilator-Associated Pneumonia
02-25-2016
9181

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
14004
Burn Resuscitation
11-26-2019
15537
Ketamine for Analgesia
12-27-2019
17791
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
16555
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
11943
Snakebite/crotalid Antivenoms
09-28-2018
9502

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
9661
Central Venous Catheterization
12-04-2009
12870
Fever Assessment
06-27-2019
18496
Gabapentin in Post-operative Pain Management
09-29-2016
11156
Ketamine for Analgesia
12-13-2017
16810
Laparoscopy in Trauma
02-25-2016
8489
Mangled Extremity
04-28-2016
10776
Muscle Relaxants in Multimodal Pain Management
01-26-2017
15703
Necrotizing Soft Tissues Infections
09-28-2018
10770
Negative Pressure Wound Therapy
02-06-2014
8072
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
14202