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
14928
Axillary Artery and Vein Cannulation
07-30-2015
18002
Blunt Cardiac Trauma
09-29-2016
9903
Free Flap Management
02-21-2020
12996
Hypertension Management
11-26-2015
16084
Noninvasive Hemodynamic Monitoring
09-29-2016
9235
Resuscitative Balloon Occlusion of the Aorta (REBOA)
08-12-2018
7797
Vasopressors and Inotropes in Shock
09-12-2019
42050

Endocrine

EBM Guideline
Revision Date
Times Accessed
Critical Illness-Related Corticosteroid Insufficiency
03-03-2015
8988
Hyperglycemia Control in the Critically Ill
12-07-2011
12153
Thyroid Management in the ICU
06-18-2019
9280

Fluids/Electrolytes/Nutrition

EBM Guideline
Revision Date
Times Accessed
Electrolyte Replacement
08-12-2018
26829
Fluid Resuscitation
11-03-2017
16826
Nasogastric/Nasoenteric Tube Placement in Traumatic Craniofacial Fractures
01-26-2017
12116
Rhabdomyolysis: Prevention and Treatment
08-12-2018
15112

Gastrointestinal

EBM Guideline
Revision Date
Times Accessed
Acute Cholecystitis
01-08-2015
10794
Acute Gastrointestinal Hemorrhage: Pharmacologic Management
12-13-2017
15433
Blunt Splenic Injury
09-30-2015
9552
Cirrhotic Management
02-25-2016
8501
Clostridium difficile Infection
06-29-2015
8908
Diverticulitis
09-30-2015
8400
Enteral Feeding Guidelines
04-10-2017
18943
Intra-abdominal Pressure Monitoring
03-23-2015
8257
Octreotide in the Prevention and Treatment of Gastrointestinal and Pancreatic Fistulas
11-03-2017
24709
Percutaneous Endoscopic Gastrostomy
06-11-2020
8133
Post-Splenectomy Vaccine Prophylaxis
01-27-2019
12988
Premature Gastrostomy / Jejunostomy Removal
10-21-2009
11793
Small Bowel Obstruction
06-04-2014
7768
Stress Ulcer Prophylaxis
11-03-2017
11650

Hematologic

EBM Guideline
Revision Date
Times Accessed
Blood Conservation and Transfusion Avoidance Strategies in the Surgical Patient
06-27-2019
8581
Deep Venous Thrombosis Prophylaxis in the Critically Ill
01-30-2014
12493
Disseminated Intravascular Coagulation
04-10-2017
7112
DVT Prophylaxis in Solid Organ Injury
12-05-2013
8803
Erythropoietin Use in the Critically Ill
02-06-2008
9501
Heparin Induced Thrombocytopenia
09-14-2019
9101
Inferior Vena Caval Filter Use in Patients at High Risk for Pulmonary Embolism
10-28-2009
7746
Massive Transfusion Protocol for Hemorrhagic Shock
05-27-2020
44275
Non-Vitamin K Anticoagulation Reversal
08-12-2018
8719
Thromboelastography (TEG) in Trauma
12-04-2014
10573
Ultrasound Guided Peripheral IV Insertion
05-27-2020
5759
Venous Thromboprophylaxis in Obesity
02-25-2016
18865
Warfarin Dosing
09-01-2009
7986
Warfarin Reversal
11-30-2017
9414

Infectious Disease

EBM Guideline
Revision Date
Times Accessed
Aerosolized Antibiotic Therapy in the ICU
03-30-2016
7564
Antibiotic Prophylaxis in Surgery
11-30-2013
17136
Candida Infections in Surgical Patients
04-10-2017
8955
Continuous Antibiotic Infusions
05-16-2007
7018
Empiric Antibiotic Use in Critically Ill Patients
05-09-2007
10162
Facial Fracture Antibiotics
04-29-2020
11375
Presumptive Chest Tube Antibiotics
03-07-2013
7355

Neurologic

EBM Guideline
Revision Date
Times Accessed
Acute Spinal Cord Injury Guideline
09-11-2018
13135
Antiplatelet Agent Reversal in Adults With Traumatic Intracranial Hemorrhage
04-10-2017
29762
Blunt Cerebrovascular Injury
09-30-2015
8419
Brain Death Determination / Apnea Test Procedure
09-10-2019
18153
Cervical Spine Clearance
12-13-2017
8084
Delirium Management in the ICU
08-12-2018
16155
Hypertonic Saline Bolus & Infusion Instructions
05-27-2020
17552
Methylprednisolone (Solumedrol) in Acute Spinal Cord Injury
08-02-2014
11109
Pain Management in Surgery
09-30-2015
7999
Sedation and Agitation Management in the ICU
10-25-2009
8261
Seizure Prophylaxis in Traumatic Brain Injury
08-01-2017
38007
Severe Traumatic Brain Injury Management
09-11-2019
16136
Syncope Evaluation in the Trauma Patient
09-29-2016
7313
Therapeutic Hypothermia
09-01-2020
8631

Respiratory

EBM Guideline
Revision Date
Times Accessed
Air Travel Following Traumatic Pneumothorax
03-20-2015
8148
Chest Tube Management
09-29-2016
9860
Diaphragm Pacing
07-18-2019
6872
Extubating the Trauma Patient with an Open Abdomen
06-24-2018
9523
High frequency oscillatory ventilation in the surgical patient
03-04-2009
7059
Independent Lung Ventilation
12-04-2014
6881
Multi-modality Rib Fracture Management
03-05-2020
14560
Peri-Procedural Tracheostomy Complications
01-04-2013
6749
Post-Extubation Stridor
08-01-2017
10302
Post-Tracheostomy Hemorrhage
07-30-2015
9219
Rescue Ventilation
08-22-2018
8838
Retained Hemothorax
04-28-2016
14525
Surgical Fixation of Rib Fractures
09-04-2020
14899
Timing of Tracheostomy
04-29-2020
12844
Tissue Plasminogen Activator in Traumatic Hemothorax
04-01-2018
10139
Ventilator-Associated Pneumonia
02-25-2016
7963

Skin

EBM Guideline
Revision Date
Times Accessed
Burn Inhalation injury
06-18-2019
12758
Burn Resuscitation
11-26-2019
14275
Ketamine for Analgesia
12-27-2019
14542
Perioperative Hypothermia Prevention in Burn Patients
04-01-2018
15404
Remifentanil Infusion for Adult Burn Dressing Changes
10-29-2009
10794
Snakebite/crotalid Antivenoms
09-28-2018
8358

Miscellaneous

EBM Guideline
Revision Date
Times Accessed
Alcohol Withdrawal
07-30-2015
8448
Central Venous Catheterization
12-04-2009
11669
Fever Assessment
06-27-2019
15488
Gabapentin in Post-operative Pain Management
09-29-2016
10076
Ketamine for Analgesia
12-13-2017
13947
Laparoscopy in Trauma
02-25-2016
7398
Mangled Extremity
04-28-2016
9613
Muscle Relaxants in Multimodal Pain Management
01-26-2017
14501
Necrotizing Soft Tissues Infections
09-28-2018
9654
Negative Pressure Wound Therapy
02-06-2014
6888
Neuromuscular Blocking Agents in the Adult ICU
08-02-2018
12931