The nonverbal critically ill patients have a considerable need for information and support, so verbal communication can provide orientation and meaningful sensory input to these patients, Information received by the nonverbal critically ill patients may assist in reducing stress, helping patients preserve self-identity. Aim: This study was carried out to investigate effect of implementing communication strategies on nonverbal critically ill patient's outcomes (level of consciousness, pain and duration of mechanical ventilation). Design: a quasi-experimental design. Setting: In (Trauma, General and Critical care ICUS) at Assiut University Hospital. Subjects: A convenience sampling of 60 adults patients. Sample was assigned to two equal groups (study and control). Tools: Three tools were utilized to collect data of study, Tool I: Patient assessment tool. Tool II: Level of consciousness assessment tool (FOUR scale). Tool III: Pain assessment tool (Critical care pain observation (CPOT) scale. Method: The researcher used preparatory, implementation and evaluation phases to implement this study. Results: Finding of present study revealed that there was significant statistical difference between both study and control groups regarding to level of consciousness (P value = 0.005**& <0.001**). Conclusion: implementing communication strategies had effects on promotion of level of consciousness, improve pain sensation and decrease duration of mechanical ventilation of the study group. Recommendation: Communication strategies should standardize as a basic part of care provided to all nonverbal critically ill patients in intensive care units.

Background: Respiratory acid-base disorders are commonly seen in the critical care setting and can occur independently or coexist with metabolic acid-base disorders. Aim of the study: To explore the pattern of respiratory acid-base disorders and related risk factors in critically ill patients. Design: the descriptive design was utilized in this study. Setting: This study was carried out in the Trauma and general Intensive Care Unit at Assiut university hospital. Sample: fifty patients admitted to trauma and general Intensive Care Unit. Tools: Four tools were used in this study, patient assessment tool, APACHE II tool, Acid-base parameters assessment tool, and Risk factors assessment tool. Result: A total of 50 patients most of them were male with a mean age of 40.37 ± 13.86 in the survivors versus 47.75 ± 11.86 in non-survivor. APACHE II score was significant in non-survivor group confirmed by (P = 0.000), (P = 0.003) respectively.The incidences of respiratory alkalosis (52%), respiratory acidosis (24%) were higher in the survivor group. The significant risk factor was iatrogenic(drugs, mechanical ventillation). Conclusion:Respiratory acid-base disorders are common in critically ill patients mainly respiratory alkalosis and the major related risk factor was an iatrogenic.