Practice Management Guidelines

Our primary mission is to provide excellent, patient-centered care to the acutely ill and injured. This is achieved within a clinical learning environment grounded in the best available evidence from surgical literature, peer-reviewed journals, and professional organizations. These Practice Management Guidelines (PMGs) are designed to support clinical decision-making, reduce unwarranted variation in care, and identify areas for ongoing quality improvement and research.

Methodology

These guidelines are developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Evidence quality is categorized as high, moderate, low, or very low, and the strength of recommendations is classified as strong or weak. Each recommendation is formulated through structured review of the available literature and expert panel consensus. Statements achieving ≥80% agreement are designated as strong recommendations. Final approval of all guideline statements is obtained through consensus among the working group.

These recommendations represent evidence-based approaches to care supported by expert consensus; however, they are not intended to exclude alternative management strategies that fall within the standard of care. Regular review and updates are performed to ensure continued relevance and alignment with evolving evidence. Sound clinical judgment remains essential in applying these guidelines to individual patient scenarios.

Trauma

Head & Neck Injury

• Blunt Cerebrovascular Injury
• Penetrating Neck Injury
• Traumatic Brain Injury
• Acute Spinal Cord Injury

Thoracic

• Blunt Chest Trauma
• Blunt Cardiac Injury
• Thoracic Aortic Injury

Abdominal

• Penetrating Thoracoabdominal Trauma
• Penetrating Abdominal Trauma
• Blunt Abdominal Trauma
• Pancreatic Injury Trauma
• AAST Grading Of Organ Injury

Genitourinary

• Genitourinary Trauma

Extremity Vascular Injury

• Content pending

Musculoskeletal

• Pelvic Fracture Pathway
• Orthopedic Injury

Thermal Injury

Venous Thromboembolism Therapy

• Hematologic/Pharmacologic Therapy

Critical Care

Neurologic

• Trauma and SICU Sedation & Delirium
• Trauma and SICU Analgesia
• Alcohol & Hypnosedative Withdrawal
• Determination Of Brain Death

Cardiovascular

• Management Of Atrial Fibrillation
• Hypertension
• Vasopressors And Inotropes In Shock
• Noninvasive Hemodynamic Monitoring

Pulmonary

• Ventilator-Associated Pneumonia
• Evaluation And Management Of Hypoxia
• Evaluation And Management Of Hypercarbia
• Inhalation Injury
• Tracheostomy
• General Airway Management Guideline
• Emergency Airway Management

Gastrointestinal

• Abdominal Compartment Syndrome
• Gastroinestinal Prophylaxis
• Nutritional Support In The SICU

Renal

• Acute Kidney Injury
• Approach To Non-Gap Metabolic Acidosis
• Electrolyte Replacement

Hematologic

• Heparin Infusion For Therapeutic Anticoagulation
• Anticoagulation Reversal
• Venous thromboembolism therapy

Infectious Disease

• Evaluation Of Fever
• Antimicrobial Use For Acute Care Surgery

Emergency General Surgery

• Small Bowel Obstruction
• Diverticulitis
• Appendicitis
• Cholecystitis
• Large Bowel Obstruction
• Necrotising Soft Tissue Infection