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
| Acute Atrial Fibrillation in the Surgical Patient | ||
| Axillary Artery and Vein Cannulation | ||
| Blunt Cardiac Trauma | ||
| Free Flap Management | ||
| Hypertension Management | ||
| Noninvasive Hemodynamic Monitoring | ||
| Resuscitative Balloon Occlusion of the Aorta (REBOA) | ||
| Vasopressors and Inotropes in Shock |
Endocrine
| Critical Illness-Related Corticosteroid Insufficiency | ||
| Hyperglycemia Control in the Critically Ill | ||
| Thyroid Management in the ICU |
Fluids/Electrolytes/Nutrition
| Electrolyte Replacement | ||
| Fluid Resuscitation | ||
| Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures | ||
| Rhabdomyolysis: Prevention and Treatment |
Gastrointestinal
| Acute Cholecystitis | ||
| Acute Gastrointestinal Hemorrhage: Pharmacologic Management | ||
| Blunt Splenic Injury | ||
| Cirrhotic Management | ||
| Clostridium difficile Infection | ||
| Diverticulitis | ||
| Enteral Feeding Guidelines | ||
| Intra-abdominal Pressure Monitoring | ||
| Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas | ||
| Percutaneous Endoscopic Gastrostomy | ||
| Post-Splenectomy Vaccine Prophylaxis | ||
| Premature Gastrostomy / Jejunostomy Removal | ||
| Small Bowel Obstruction | ||
| Stress Ulcer Prophylaxis |
Hematologic
| Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient | ||
| Deep Venous Thrombosis Prophylaxis in the Critically Ill | ||
| Disseminated Intravascular Coagulation | ||
| DVT Prophylaxis in Solid Organ Injury | ||
| Erythropoietin Use in the Critically Ill | ||
| Heparin Induced Thrombocytopenia | ||
| Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism | ||
| Massive Transfusion Protocol for Hemorrhagic Shock | ||
| Non-Vitamin K Anticoagulation Reversal | ||
| Thromboelastography (TEG) in Trauma | ||
| Ultrasound Guided Peripheral IV Insertion | ||
| Venous Thromboprophylaxis in Obesity | ||
| Warfarin Dosing | ||
| Warfarin Reversal |
Infectious Disease
| Aerosolized Antibiotic Therapy in the ICU | ||
| Antibiotic Prophylaxis in Surgery | ||
| Candida Infections in Surgical Patients | ||
| Continuous Antibiotic Infusions | ||
| Empiric Antibiotic Use in Critically Ill Patients | ||
| Facial Fracture Antibiotics | ||
| Presumptive Chest Tube Antibiotics |
Neurologic
| Acute Spinal Cord Injury Guideline | ||
| Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage | ||
| Blunt Cerebrovascular Injury | ||
| Brain Death Determination / Apnea Test Procedure | ||
| Cervical Spine Clearance | ||
| Delirium Management in the ICU | ||
| Hypertonic Saline Bolus & Infusion Instructions | ||
| Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury | ||
| Pain Management in Surgery | ||
| Sedation and Agitation Management in the ICU | ||
| Seizure Prophylaxis in Traumatic Brain Injury | ||
| Severe Traumatic Brain Injury Management | ||
| Syncope Evaluation in the Trauma Patient | ||
| Therapeutic Hypothermia |
Respiratory
| Air Travel Following Traumatic Pneumothorax | ||
| Chest Tube Management | ||
| Diaphragm Pacing | ||
| Extubating the Trauma Patient with an Open Abdomen | ||
| High frequency oscillatory ventilation in the surgical patient | ||
| Independent Lung Ventilation | ||
| Multi-modality Rib Fracture Management | ||
| Peri-Procedural Tracheostomy Complications | ||
| Post-Extubation Stridor | ||
| Post-Tracheostomy Hemorrhage | ||
| Rescue Ventilation | ||
| Retained Hemothorax | ||
| Surgical Fixation of Rib Fractures | ||
| Timing of Tracheostomy | ||
| Tissue Plasminogen Activator in Traumatic Hemothorax | ||
| Ventilator-Associated Pneumonia |
Skin
| Burn Inhalation injury | ||
| Burn Resuscitation | ||
| Ketamine for Analgesia | ||
| Perioperative Hypothermia Prevention in Burn Patients | ||
| Remifentanil Infusion for Adult Burn Dressing Changes | ||
| Snakebite/crotalid Antivenoms |
Miscellaneous
| Alcohol Withdrawal | ||
| Central Venous Catheterization | ||
| Fever Assessment | ||
| Gabapentin in Post-operative Pain Management | ||
| Ketamine for Analgesia | ||
| Laparoscopy in Trauma | ||
| Mangled Extremity | ||
| Muscle Relaxants in Multimodal Pain Management | ||
| Necrotizing Soft Tissues Infections | ||
| Negative Pressure Wound Therapy | ||
| Neuromuscular Blocking Agents in the Adult ICU |