Background Critically ill patients admitted to ICUs often require physical restraint due to agitation, confusion, sleeplessness, or disruptive behaviors. Aim This study aimed to investigate the effect of physical restraint on the occurrence of neurovascular complications among critically ill patients at Cairo University Hospitals. Design A descriptive exploratory research design was utilized. Sample: a purposive sample of 100 adult patients (male and female) undergoing physical restraint was included. Setting The study was conducted at selected critical care units affiliated with Cairo University Hospitals. Tools Data were collected using a demographic and medical data sheet, physical restraining observational checklists, a neurovascular assessment sheet for restrained limbs, the Behavioral Pain Scale, and the Richmond Agitation-Sedation Scale. Results The study revealed that 51.0% of the sample were females, and 66% were aged between 50 and 60 years (mean±SD=50.5±13.3). More than two-thirds (71%) of the patients suffered from ischemic stroke and cardiac disorders, while 38% received fentanyl as sedation. A significant statistical relationship was found between the type of physical restraint used and the occurrence of redness (≤0.03) and edema (≤0.01). Additionally, a significant correlation was observed between edema and the start time of restraint (≤0.003), as well as between the type of restraint material and the type of edema (≤0.03). A high significant correlation was also found between Behavioral Pain Scale scores and length of stay (≤0.001). Conclusion The current study highlights the critical impact of physical restraint on the neurovascular status of ICU patients, noting a high prevalence of complications linked to restraint practices. Recommendations Critical care units should implement evidence-based physical restraint protocols. Nurses must be trained to monitor neurovascular complications as a core part of their daily routine. Furthermore, research into alternative interventions such as increased staffing, family involvement, or environmental modifications is essential to reduce reliance on restraints. Replication of this study on a larger probability sample from different geographical locations in Egypt is recommended.
Elhakam et al. (Thu,) studied this question.