Background Acute drug poisoning is a medical emergency that represents a major health problem all over the world and affects people of all age groups. It significantly contributes to morbidity and mortality, therefore requiring immediate assessment and management. Aim To assess the outcomes of acute drug poisoning among patients at one of the university hospitals in Cairo. Research design A descriptive exploratory research design was utilized in the current study. Research question What are the outcomes of critically ill patients admitted to the toxicology department with acute drug poisoning? Sample A purposive sample of 150 adult male and female patients who were admitted with acute drug poisoning. Tools of data collection Three tools were utilized to collect data pertinent to the current study: demographic and medical data tool, Sequential Organ Failure Assessment scores tool, and Acute Physiology and Chronic Health Evaluation II score. Results More than three-quarters of patients in the present study were females and had single-drug poisoning in percentages of 81.3 and 76.7%, respectively. Most of the studied sample was in the age group 18–20 with a mean age of 28±9.33 and stayed for 2 days in the ICU in percentages of 41.3 and 48%, respectively. Almost all (99.3%) of the studied sample had mild organ failure, more than two- thirds (64.7%) had Acute Physiology and Chronic Health Evaluation II scores ranging from 0 to 4, indicating a 4% predicted mortality. Conclusion Single acute drug poisoning was markedly noticed among patients in the present study and most frequently was related to consumption of psychotropic medications with a greater proportion among the females who had in common mild organ dysfunction and low predicted mortality. Recommendations Increasing young-adult awareness about drug overdose to prevent poisoning. Furthermore, psychiatric consultation for patients admitted with acute drug poisoning before discharge is needed. For future studies, replication of this study on a larger-probability sample selected from different geographical areas in Egypt is recommended to obtain more generalizable results.

Background Antithrombotic agents are widely used for thrombotic disorder management among critically ill patients. Subcutaneous administration of heparin is a repeated clinical practice done by nurses, which may cause adverse outcomes. Aim To investigate critical care nurses’ knowledge and practices regarding subcutaneous antithrombotic drugs and associated patients’ outcomes at Cairo University Hospitals. Research questions What do critical care nurses know regarding subcutaneous antithrombotic administration? What are critical care nurses’ practices regarding subcutaneous antithrombotic administration? What are the outcomes associated with subcutaneous antithrombotic drug administration among critically ill patients? Research design A descriptive exploratory research design. Setting Selected ICU affiliated to Cairo University Hospitals. Sample A convenience sample of 30 nurses and purposive sample of 60 adult male and female critically ill patients. Tools of data collection Four tools were utilized. Tool 1: critically ill patients’ personal characteristics and medical data sheet, tool 2: nurses’ knowledge-assessment questionnaire regarding subcutaneous antithrombotic drugs, tool 3: nurses’ practice observational checklist regarding subcutaneous antithrombotic drug administration, and tool 4: subcutaneous antithrombotic drug administration observational sheet of critically ill patients’ outcomes. Results About 60% of the studied nurses were females, 53.3% of the sample’s age ranged from 20 to less than 30 years. As well, 51.7% of critically ill patients were females, 38.3% of the sample’s age ranged from 60 to less than 70 years. The studied nurses were having unsatisfactory general knowledge level about subcutaneous anticoagulants, subcutaneous anticoagulants’ adverse effects, and nurses’ responsibilities concerning subcutaneous anticoagulants in percentages of 96.7, 96.7, and 90%, respectively. Also, unsatisfactory practice level as regards preinjection, during, and postinjection of subcutaneous anticoagulants in percentage of 100%. The most frequent adverse outcomes were localized pain, bruising, itching, and hematoma in percentages of 93, 85, 70, and 58%, respectively, where less frequent adverse outcomes were systemic thrombocytopenia, hematuria, and epistaxis in percentages of 6, 4, and 3.3%, respectively. Conclusion All critical care nurses had unsatisfactory knowledge and practice regarding antithrombotic therapy, inspite of their vital role in assessment, drug administration, care of critically ill patients, and monitoring drug-adverse effects. Also, the most frequent adverse outcomes among critically ill patients were pain, bruising, itching, and hematoma. Recommendations Updating ICU nurses’ knowledge and practice about antithrombotic drugs and maintaining close observation and record for both local and general patient’s response to antithrombotics by staff nurses during and after drug administration are highly recommended to safeguard critically ill patients against such complications.

Background Critically ill patients receiving positive inotropes are at risk for developing many complications, of these is peripheral limb ischemia. Therefore, they require assessment, prevention, early detection, and management that might shorten hospital stay and improve patient outcomes. Aim To assess factors predisposing to limb ischemia among critically ill patients receiving positive inotropes. Research design A descriptive exploratory research design was utilized in this study. Results Severe peripheral/limb ischemia affected 70.6% of the studied participants. It was most frequently found in the right and left lower limbs at a percentage of 81.6 and 79.4%, respectively. Limb ischemia was most frequently noticed among male patients in the age group of 50–60 years old, who had comorbid diseases such as diabetes and hypertension. Many factors predisposes the patient to limb ischemia such as intravenous administration of both epinephrine and norepinephrine at a percentage of 81.6%, with a significant statistical relationship between limb ischemia and positive inotrope administration (χ 2=31.52, P≤0.000), epinephrine doses (χ 2=43.53, P≤0.000), and norepinephrine doses (χ 2=69.55, P≤0.000): smoking (χ 2=12.46, P≤0.002), family history (χ 2=24.01, P≤0.000), total cholesterol level (χ 2=7.64, P≤0.022), BMI (χ 2=55.02, P≤0.000), and comorbidities (χ 2=20.55, P≤0.002). Conclusion Based on the findings of this study, it can be concluded that limb ischemia is a common problem among critically ill patients receiving positive inotropes. Therefore, continuous and strict assessment could play an important role in its prevention and early detection. Recommendations Closed observation for patients receiving inotrope infusions, especially for those at risk for developing limb ischemia, and replication of this study on a larger probability sample selected from different geographical areas in Egypt.