Background: Spinal cord compression is a common oncological emergency that requires early detection and prompt treatment as it can result in permanent neurological deficit. Nurses are often involved in supporting patients living with cancer. They may be the first healthcare professional to recognize the "red flag" symptoms of MSCC. Early recognition by the nurses will prompt timely investigation, treatment and potentially reduce the risks of patient's having a permanent disability. Aim: To determine the effect of educational program for nurses on clinical outcomes of cancer patients with Metastatic Spinal Cord Compression. Method: Design, A quasi-experimental research design was utilized in this study .Setting, the study was conducted at Clinical Oncology and Nuclear Medicine Department at Tanta University Hospital.. Subjects: convenience sample of 40 nurses and 30 cancer patients. Tools: Tool I: Structured Interview Schedule. Tool II: Nursing Care Observational Checklist. Tool III: Patient's Assessment Structured Interview Schedule. Tool (IV): Patient's Outcomes sheet. Results : a highly significant difference was noticed related to the total level of knowledge and practice of studied nurses through periods of study (pre-immediate and post one month assessment periods) with P value= 0.0001.A highly significant difference was found related to the total level of knowledge for the studied patients thought the periods of the study as P value =0.0001.Conclusion:The oncology nurse's knowledge and practice improved significantly after attendance of program sessions. Recommendation: Conduct periodical training programs, workshops and seminars for oncology nurses to refresh their knowledge, and practice about metastatic spinal cord compression and its early detection and management.

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Background: Continuous changes in central venous pressure monitoring among critically ill patients was allied to fluid response. External jugular venous pressure may be a reliable estimation method to central venous pressure and have the advantages of being less invasive. Setting: This study was conducted at the anesthesia Intensive Care Unit at Emergency Hospital affiliated to Tanta University Hospitals, Egypt. The aim of the study was to estimate external jugular venous pressure versus central venous pressure measurement as a clinical predictor among critically ill mechanically ventilated patients Method: A prospective comparative study design was utilized in the current study. A purposive sample of 30 adults mechanically ventilated patients was included in this study. Two tools were utilized to collect data: Tool (I): Mechanically ventilated patient assessment and Tool II: Central venous pressure and External jugular venous pressure assessment. Results: It was observed that there was a highly positive and significant correlation between central venous pressure and external jugular venous pressure reading r= 0.813 and p=0,000. Conclusions: External jugular venous pressure measurement represented a real value of central venous pressure. A positive statistical correlation between central venous pressure and external jugular venous pressure measurements seems to be a reliable method to differentiate mechanically ventilated patients with high or low central venous pressure monitoring. Recommendations: Measurement of external jugular venous pressure should be integrated within the critically ill patient's routine care Measurement. Also Measuring central venous pressure may be replaced with external jugularvenous pressure (EJVP) when indicated. Further studies will be needed to confirm reliability of the EJVP on a larger probability sample.

Background: Major trauma is a life-threatening emergency condition that requires immediate intervention. Resuscitation of low volume fluid or decreasing maintenance fluids maintains tissue perfusion and decreases the negative consequences of early vigorous resuscitation. Aim of the study was to evaluate the effect of normovolemic versus decreasing maintenance fluids on ICU multiple trauma patient's clinical outcomes. Method: A quasi experimental comparative research design was utilized in this study, purposive sample of 40 adult critically ill patients with multiple traumas would be enrolled sequentially into two groups, each group consists of ( 20) patients. This study was carried out in trauma intensive care unit at Emergency Hospital affiliated to Tanta University Hospitals, Egypt .Three tools were used to conduct the study. Tool I: socialdemographic and clinical data sheet, Tool II: injury severity score, Tool III: patients' outcome sheet. Results: There were sixty percent of patients in control group had age more than 30 years compared to 45% of patients in the study group. The male patient represents the highest percentage in this both groups. It was observed 90.0% of the study groups had injury severity score between (17-25) score. While 80.0% of the control groups has < 25 injury severity score level. a significant improvement regarding mean scores of pulse rate, respiratory rate, and Fio2 on discharge. The mean score of sodium, urea and creatinine was improved significantly among study groups compared with control groups on discharge where P= 0.022 and 0.00 respectively. Seventy percent of patients in control group had long duration of stay in ICU more than 20 days compared to (55.0%) of patients in the study group. Conclusion: It can be concluded that trauma patients in the ICU who received decreasing maintenance fluids at 30 mL/h in normotensive trauma patients had improved physiological parameters, decreased ICU stay and days on ventilator. Recommendations: Emergency hospital should include decreasing maintenance fluids for trauma patients admitted to the ICU if not contraindicated. Nursing and medical staff should be informed with the updated protocols of fluid resuscitation therapy and its application in clinical practice for emergency and critically ill patients.