Background: Enhanced recovery after cardiac surgery protocol is an evidence-based interdisciplinary process, which has not previously been systematically applied to cardiac surgery. Objectives: The aim of this study was to evaluate the clinical effectiveness of ERAS protocol compared with routine care on the outcomes of patients undergoing cardiac surgery. Methods: This study was conducted between January 2020 and December 2020. A total of 75 patients who underwent cardiac surgery by one surgical team were evaluated for eligibility. Five patients were excluded after the initial assessment; hence, 70 patients were randomly assigned to the ERAS protocol group and control group. Patients in the ERAS group received all elements of the ERAS protocol while patients in control group receive routine care. Tools: Preoperative assessment tool to form base line data, Intra-operative assessment tool to assess Ischemic time, bypass time, and operation time and postoperative evaluation tool to assess the patients' outcome were used in data collection .Results: The duration of ICU stay and duration of mechanical ventilation were significantly shorter in the ERAS group versus control group3.04 ± 0.74, 2.33 ± 0.8), versus (5.82±0.61, 4.64±2.13), respectively; P < 0.001). Post-operative bleeding and re intubation were less in ERAS group versus control group (10 %, 3.33 %), versus (36.67 %, 16.66 %), respectively; P = 0.03).Conclusions: ERAS protocol reduces the length of ICU and for patients undergoing cardiac surgery.

Nursing assessment for coma patients on admission is the basic step for the care to be effective. Assessment must be done every 15 minute. Comatosed patients are completely dependent on nurses as their abilities and protective are impaired. Nurses are responsible for their basic life needs and to prevent complications associated with coma. Aim: This study aimed to assess early complications for coma patients. Research design: a descriptive research design was used in this study. Setting: This study was conducted in emergency Unit at Assuit University Hospital and intensive care unit. Tools of data collection: (I) Patient assessment sheet (II) Cardio vascular complications assessments sheet. (III) Respiratory complications assessment sheet. (IV)Gastrointestinal tract complications assessment sheet. (VI) Laboratory investigations sheet. Results: the results showed that (77.5%) of Patient had complications of coma. Conclusion this study showed that were complications associated with coma affect on all body systems and nursing assessment help to know and treat these complications. Recommendation: the study recommends conducting in large number of comatosed patients.