Background: The overuse of the emergency department (ED) for non- critical patients has been associated with overcrowding and a rise in healthcare cost. Green Valley Fire Department (GVFD) has created a program, Fire-Based Urgent Medicals Service (FBUMS) with a nurse practitioner (NP). Patients can call 9-1-1 or the ""NP hotline"" and request to be seen by the NP instead of being immediately transported to the hospital via ambulance. Purpose: The purpose of this project is to evaluate the impact of the nurse practitioner led FBUMS, on ED visits and ambulance transports. Methods: A survey was mailed to all persons, age 18 and older, who were seen by the NP with FBUMS between February 2017 and March 2017. The survey asked about the reasons for contacting GVFD, the type of treatment received, and whether they went to ED after treatment. Data analysis: Descriptive statistics including frequencies, percentages, means and standard deviations were used to analyze each of the answered survey questions in Microsoft Excel©. Results: Surveys completed (n=42). The majority, 39 (92.9%) stated they did not receive care at the ED within 72 hours following their appointment with the NP, three (7.1%) stated they did. By dramatically decreasing transport to the hospital and associated ED treatment, it is estimated to have saved approximately $53,425 in ambulance costs and $54,210 in ED treatment for a total savings of $99,632.52. Conclusion: A Fire-Based Urgent Medical Service led by a nurse practitioner decreased emergency room visits and ambulance transports.

Information overload förekommer på alla arbetsplatser där informationsbearbetning är viktigt för arbetsprocesserna. I vissa fall kan information overload medföra allvarliga konsekvenser både för den enskilda medarbetaren och för verksamheten i stort. På akutmottagningen på Centrallasarettet i Växjö har sjuksköterskorna en viktig roll som samordnare av den information som används i patientarbetet. Syftet med denna undersökning är att undersöka vilka faktorer som främst orsakar information overload hos sjuksköterskorna på akutmottagningen CLV, samt att undersöka hur fenomenet IO påverkar vårdkvaliteten. Under mars och april 2007 genomfördes intervjuer med sju sjuksköterskor på den aktuella akutmottagningen utifrån en frågemall som utformats med hjälp av aktuell forskning på information overload. Resultatanalysen skedde utifrån en specifik orsakstabell som tagits från en litteratursammanställning av Eppler och Mengis (2004). Orsakstabellen utgår ifrån fem specifika områden - personliga faktorer, informationens karaktär, arbetsuppgifter och processparametrar, organisatorisk design samt informationsteknologi. Studien har genomförts utifrån en kvalitativ ansats. Undersökningen visar att sjuksköterskorna på akutmottagningen ofta drabbas av information overload, och att riskfaktorer finns i samtliga fem ovanstående kategorier. Flera av deltagarna upplever regelbundet information overload-relaterade symtom och detta riskerar att hota patientsäkerheten på mottagningen. Dessutom leder det till minskad arbetstillfredsställelse hos sjuksköterskorna. Slutligen konstateras att en ordentlig informationsplan behöver upprättas för att rätta till de missförhållanden som orsakar information overload. Det är framför allt viktigt att informationen är relevant och hanterbar för att höja patientsäkerheten och vårdkvaliteten. / Information overload exists in all organisations where information processing is important for the work process. In some cases information overload is a serious threat to both the individual who suffers from it and to the organisation at large. At the emergency department at the Central Hospital in Växjö the nurses have an important function as coordinators of the information used in the patient treatments. The purpose of this study is to find out which factors primarily cause information overload in the emergency department and what implication this has on the quality of care given there. In March and April of 2007 seven nurses were interviewed on the subject of information overload. Through a literary review relevant questions were formed for the interviews. The analysis of the answers were conducted from a table by Eppler and Mengis (2004) illustrating the causes of information overload. The table has five sub categories, personal factors, information characteristics, task and process parameters, organizational design and information technology. The study has a qualitative approach. The result shows that the nurses at the ED are often affected by information overload, and that risk factors exist in all five sub categories mentioned above. Several nurses regularly experience symptoms caused by information overload, and this is a threat to patient safety at the ED. It also causes dissatisfaction in the daily work. Finally we conclude that a proper information plan is needed in order to find solutions to the problem. The information needs to be relevant and manageable to increase patient safety and the quality of care.

Bakgrund: Palliativ vård bygger på ett förhållningssätt med syfte att lindra lidande och öka livskvaliteten under den sista tiden i livet. Sjuksköterskans uppgift i den palliativa vården är att utifrån en personcentrerad vård skapa förutsättningar för en god död. Trots att det finns möjlighet för vård i hemmet eller på palliativ vårdenhet händer det att patienter i ett sent palliativt skede ändå söker sig till akutmottagningen. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda patienter i ett sent palliativt skede, på akutmottagning. Metod: En litteraturöversikt har gjorts för att besvara syftet. Elva vetenskapliga orginalartiklar har inkluderats och dessa har granskats, analyserats tematiserats för att urskilja likheter och skillnader. Resultat: Två huvudteman och sex underteman identifierades. Det första huvudtemat var Sjuksköterskans erfarenheter av faktorer som utgör hinder för god palliativ vård, med tillhörande underteman vårdmiljön som ett hinder, avsaknad av nödvändiga resurser, kurativ mentalitet och anhöriga som ett hinder för god palliativ vård. Det andra huvudtemat var sjuksköterskans erfarenheter av faktorer som främjar en god palliativ vård, med tillhörande underteman en underlättande vårdmiljö och resursers betydelse för god palliativ vård. Diskussion: Diskussionen framhäver vårdkulturens betydelse för den palliativa vården på en akutmottagning. Författarna diskuterar tre fenomen, resurser, kurativ mentalitet och akutmottagningens utformning i relation till Katie Erikssons caritativa vårdteori.

Bakgrund: Året runt söker sig människor till akutmottagningen på grund av problem med sin hälsa. Vissa besöker akutmottagningen oftare än andra. Av det totala besöksantalet inom akutsjukvården utgör mångbesökare ca 10 %. Ur ett internationellt perspektiv har personal på akutmottagningen en tendens att ifrågasätta mångbesökarnas behov av akutsjukvård. Syfte: Syftet var att beskriva mångbesökarnas upplevelser av att upprepade gånger återkomma till akutmottagningen samt orsakerna till dessa oplanerade återbesök. Metod: vald metod var systematisk litteraturöversikt, där totalt 15 artiklar inkluderades till resultatpresentationen. Denna magisteruppsats har utgått ifrån de grundläggande begreppen i Katie Erikssons vårdteori; hälsa, människa, vård och lidande. Resultat: Nyckelorden och meningarna kategoriserades i följande huvudteman; relationer, tid och resurser. Orsaker till att människor ofta besökte akutmottagningen var relaterade till deras relationer till primärvården. Det fanns även en rädsla för att dö eftersom symtomen blev så pass allvarliga att patienterna inte kunde vänta på en tid på vårdcentralen. För dem som hade en kronisk sjukdom var exacerbationen alltför svår att hantera i hemmet, vilket ledde till att de besökte akutmottagningen. Slutsats: Mångbesökarnas upplevelser av att återkomma till akutmottagningen skiljde sig. Vissa kände sig nöjda med besöket medan andra hade en negativ erfarenhet, präglad av respektlöshet, diskriminering och maktlöshet. Mångbesökare visar sig ofta ha komplex problematik vilken är svår att få in i akutmottagningens patientflöde. Människor med ett komplext vård- och hälsobehov ska inte mötas enbart utifrån ett medicinskt perspektiv utan också som individer med kropp, själ och ande - även i en hektisk akutsjukvårdsmiljö. / Background: Throughout the year people visit the emergency room because of health issues. Some people visit the emergency room more frequent than others. Frequent attenders stand for 10 % of the total visits to the emergency room. Internationally, emergency department staff tend to question these patients’ need of emergency care. Aim: the aim was to describe frequent attenders’ experiences of repeatedly returning to the emergency room and the causes of these unplanned returns. Method: systematic literature review was chosen as method, where a total of 15 articles were included in the results. This study emanated from the elementary concepts of Katie Eriksson’s theory of caritative caring: health, human being, nursing and suffering. Results: the key components were categorised into the following main themes; relationships, time and resources. The reasons for frequently visiting the emergency room were related to the outpatient clinic. There was also a fear of dying because the symptoms became too severe and patients couldn’t wait for an appointment at the outpatient clinic. For those who were diagnosed with a chronic disease the exacerbation was too difficult to manage at home which lead them to the emergency room. Conclusion: the experiences of being a frequent attender differed. Some were satisfied with the visit, whereas some had a negative experience shaped by disrespect, discrimination and powerlessness. Frequent attenders often show a complex of problems which are difficult to fit into the patient flow in the emergency room. Humans with a complex health and wellbeing need should not be met only from a medical perspective but also as individuals with body, mind and spirit - even in a hectic emergency care environment.

Background: People are living longer and more people suffer from age-related illnesses. Multiple illness is when a person have more than one disease. It is a high flow of patients on the emergency departments. The nurses work conditions are stressful and this causes less time for the nurses to take care of patients. Purpose: Describe older people with multiple illnessess experience of seeking care in emergency departments. Method: A systematic literature study with descriptive synthesis with a qualitative approach based on Evans (2002). Results: The results is based on two different main themes. One main theme was “left to ones own destiny” with two related subthemes “feel forgotten” and “feel uncertain”. Another identified main theme was “give over the responsibility to staff” with two related subthemes “feel safe” and “feel seen”.   Conclusion: Older people with multiple illness are a vulnerable group of patients and they have a desire for contact of staff and to feel safe. When staff are safe in their profession, the older people with multiple illness feel seen from the staff. Then the older people also feel that their self-consciousness is strengthened. Keywords: Elderly patients, emergency department, multiple illness, patient experiences and qualitative study.

Bakgrund: På akutmottagningen prioriteras patienten efter somatiska tecken och symtom. Patienten behandlas för att skickas hem eller för inläggning. Sjuksköterskans huvudsakliga kompetensområde är omvårdnaden och det är viktigt att patienten behandlas med respekt och värdighet. Högt patienttryck och långa väntetider gör att det är många patienter som ligger på akutmottagningen och väntar. Detta leder till stress och anses negativt för omvårdnaden. Syfte: Syftet är att beskriva vad sjuksköterskor upplever påverkar omvårdnaden av patienter på en akutmottagning. Metod: En litteraturöversikt utfördes som inkluderade 10 kvalitativa artiklar, en induktiv analysmetod utfördes. Resultat: Fem teman identifierades och är baserade på beskrivna påverkansfaktorer och är: Organisationens prioriteringar som handlar om hur organisationen är prioriterad; Miljön på akutmottagnigen som tar upp arbetsmiljön; Kunskap kring omvårdnad som behandlar sjuksköterskors kunskaper kring praktisk omvårdnad och sjuksköterskors attityder till omvårdnad samt förväntningar på omvårdnaden; Kommunikation relaterat till språk och kulturella skillnader samt mellan personal och vårdinstanser och Tid relaterat till tid till patienten och till personalbrist. Konklusion: Den somatiska vården tar fokus från omvårdnadsinsatser; attityden till och kunskapen om omvårdnad prioriteras ned; kommunikation påverkar hos många patientgrupper och blir svår; slutligen är tiden en faktor som är genomgående i alla teman och härleds till patienttryck och personalbrist. / Bakground: The emergency department priorities patients after somatic signs and symptoms. Patients are treated to be sent home or be admitted. Nurses’ main area of competency is nursing care and it’s important the patients are treated with respect and dignity. Overcrowding and long wait times leads to many patients lying there just waiting. This leads to stress and is viewed as negative for the nursing care. Objective: To describe what nurses’ experience influences the nursing care of the patient at the emergency department Method: A literature overview was conducted and included 10 studies that were analyzed by inductive analysis. Result: Five themes were identified and were based on described influences; The organizations priorities that includes what the organizational prioritieses; The Environment at the Emergency Department that includes how the environment effects nursing care; Knowledge about nursing care that includes nurses’ practical skill and attitude towards nursing care; Communication related to language and cultural differences and communication between staff and organizations; Time related to time for the patient and to lack of staff. Conclusions: The focus on somatic care distracts from nursing care; the knowledge and attitude about nursing care are down prioritized; the communication is affected for different groups of patient and becomes difficult; finally time is a factor that goes through all the themes and is related to overcrowding and lack of personal.

La toxicité des antidépresseurs inhibiteurs de recapture de la sérotonine (IRS) dont le citalopram est le représentant le plus sélectif, est réputée faible. Or les IRS ont été rendus responsables de syndromes sérotoninergiques, de convulsions, d’anomalies électrocardiographiques, voire de troubles respiratoires et de décès. L’implication de cette classe pharmacologique au cours des intoxications médicamenteuses volontaires (IMV) apparait peu documentée par des données récentes en France. Ainsi, la morbidité des IMV impliquant un IRS aux urgences (SAU) et les symptômes les plus fréquemment observés à la suite d’une exposition toxique aux IRS sont peu décrits. De même, les mécanismes toxiques impliqués dans les décès ne sont clairs. Objectifs : Nous avons mené ces travaux dans le but de : 1- mieux connaitre l’épidémiologie des IMV dans un SAU et y préciser l’implication des IRS ; 2- explorer une éventuelle sur-morbidité liée aux IRS dans les IMV polymédicamenteuses ; 3-comprendre les mécanismes de décès induits par de fortes doses de citalopram et les moyens de les prévenir. Méthodes: Nous avons conduit une étude observationnelle des IMV admises au SAU durant 4 ans, avec appariement des patients ayant ingéré un IRS versus des patients intoxiqués non exposés à un IRS. Nous avons également mené une étude expérimentale chez le rat Sprague-Dawley pour connaitre la dose létale médiane (MLD) du citalopram et explorer la toxicité neurologique, respiratoire et systémique impliquée dans le décès consécutif à l’administration de citalopram. Des dosages de sérotonine plasmatiques et plaquettaires ont été effectués afin de caractériser le rôle de la toxicité sérotoninergique. Résultats : Les IRS étaient impliqués dans 16% des IMV au SAU, soit en 2e position après les benzodiazépines. L’attribution des symptômes observés aux effets sérotoninergiques était rarement faite (dans environ un cas sur cinq) par les médecins urgentistes en charge des patients. La survenue d’un syndrome sérotoninergique et de convulsions était plus fréquente dans le groupe de patients intoxiqués par IRS que chez les témoins appariés. Un allongement du QT a été noté chez un patient et aucune toxicité respiratoire n’a été décelée. Le recours à la ventilation mécanique était plus important du fait de troubles de la conscience, sans augmentation pour autant du nombre d’admission en réanimation en comparaison aux témoins. L’étude expérimentale nous a permis de montrer que les décès induits par le citalopram étaient toujours précédés de convulsions, et que la prévalence des convulsions étaient dose-dépendante, significativement plus fréquente pour les fortes doses de citalopram (80 et 120% de la MLD) comparativement aux autres groupes (60% de la MLD et témoins). De même, le citalopram induisait une baisse dose-dépendante de la sérotonine plaquettaire et une élévation dose-dépendante de la sérotonine plasmatique. L’incidence du syndrome sérotoninergique était, par contre, comparable. Le citalopram n’induisait ni hypoxémie, ni hypercapnie, ni hyperlactatémie ; mais il était responsable d’un allongement du temps inspiratoire et d’un « braking expiratoire » mimant un phénomène adaptatif à l’hypoxémie. Par ailleurs, le prétraitement par diazépam ou cyproheptadine des rats intoxiqués avec une dose létale de citalopram prévenait les convulsions et le décès. Conclusions : La toxicité des IRS et du citalopram en particulier, semble essentiellement neurologique, tant chez l’homme que chez l’animal. Le syndrome sérotoninergique et les convulsions devraient être rassemblés en marqueurs de la toxicité sérotoninergique. Il est nécessaire de sensibiliser les médecins urgentistes à cette toxicité, en utilisant les critères de Hunter, plus simples et probablement plus spécifique. La place des antidotes restent à définir, mais, selon notre modèle expérimental, ils pourraient être efficaces pour réduire cette toxicité spécifique. / Toxicity of the serotonin-reuptake inhibitors (SRI) including citalopram, the most selective one, is considered as relatively low. However SRI may be responsible for serotonin syndrome, seizures, electrocardiographic abnormalities, respiratory failure, and even death. Implication of SRI in deliberate drug poisonings has not been assessed by recent data in France. Morbidity of SRI-related poisonings as well as the most common resulting presentations in the emergency department (ED) remains poorly described. Moreover, mechanisms of SRI-attributed death remain unclear. Objectives: We conducted these clinical and experimental studies: 1-to better understand the epidemiology of drug poisonings in one ED in Paris area and analyze SRI involvement; 2- to investigate a possible over-morbidity related to SRI in multidrug poisonings and describe the most common SRI-related complications; 3- to understand mechanisms of death induced by elevated doses of citalopram and its possible prevention. Methods: We conducted an observational study during 4 years in an ED matching patients who ingested at least one IRS with patients who did not. We also conducted an experimental study in the Sprague-Dawley rat to determine the median lethal dose (MLD) of citalopram and investigate citalopram-related neurological, respiratory, and systemic toxicity as well as mechanisms of citalopram-induced death. Platelet and plasma serotonin were measured to ensure the serotoninergic mechanism. Results: SRI were involved in 16% of the drug poisonings admitted to the ED, ranking at the second place after the benzodiazepines. Attribution of the observed signs and symptoms to the serotonin toxicity was rarely performed by the emergency physicians in charge, in only one out of five cases. Onset of serotonin syndrome and seizures were more frequent in SRI-exposed patients than in their matched controls. QT prolongation was observed in one patient while no direct respiratory toxicity was reported. Mechanical ventilation was more frequently used in SRI-exposed patients due to impaired consciousness, despite no resulting increased admission rate to the intensive care unit in comparison to the controls. Based on our rat study, citalopram-induced death always occurred after seizures which were dose-dependent, with a greater prevalence at the two highest doses of citalopram (80 and 120% of the MLD) than in the other groups (60% of control and the MLD). Citalopram-induced decrease in platelet serotonin and increase in plasma serotonin were dose-dependent. However, incidence of serotonin syndrome appears similar in all the groups. Citalopram did not induce hypoxemia, hypercapnia or hyperlactacidemia, but resulted in a slight prolongation in the inspiratory time and an "expiratory braking" that could be attributed to an adaptive phenomenon to hypoxemia. Pretreatment with diazepam and cyproheptadine prevented rats treated with lethal-doses of citalopram from seizures and death. Conclusions: SRI and citalopram in particular are mainly responsible for neurological toxicity, both in humans and rats. Serotonin syndrome and seizures should be grouped as markers of serotonin toxicity. Emergency physicians should become more aware of this specific toxicity. Using the simpler and probably more specific Hunter criteria may be useful in the ED. The exact indications of antidotes remain to be defined, but our experimental model seems to support their effectiveness to prevent IRS-related specific serotonin toxicity.

Class of 2016 Abstract / Objectives: To determine if the uncomplicated cystitis population at Banner - University Medical Center Tucson’s (BUMCT) emergency department (ED) is significantly different from the hospital-wide antibiogram. Methods: A prospective, analytical, observational study was performed in the ED at BUMCT. Electronic health records were used to include or exclude patients in the study. Cultures were then compiled and compared to the hospital-wide, 2014 BUMCT antibiogram using a one sample Chi-square goodness of fit test to determine if there was a significant difference between the two proportions. Results: 159 cultures and susceptibilities were analyzed with E. coli and K. pneumoniae being the most common organisms. For E. coli, it was observed that 46.92% were susceptible to ampicillin while 45% was reported by the hospital’s antibiogram (P=0.772), 93.08% compared to 88% for cefazolin (P=0.185), 94.62% compared to 93% for ceftriaxone (P=0.611), 83.08% compared to 78% for ciprofloxacin (P=0.332), 89.23% compared to 90% for nitrofurantoin (P=0.850), and 63.85% compared to 66% for TMP/SMX (P=0.735). For K. pneumoniae, it was observed that 100% of isolates were susceptible to cefazolin, ceftriaxone, and ciprofloxacin compared to 95%, 96%, and 95%, respectively (P=0.254; P=0.309; P=0.254); 40% compared to 28% for nitrofurantoin (P=0.243); and 88% compared to 91% for TMP/SMX (P=0.649). Conclusions: The observed and predicted susceptibilities were not different for any of the drugs and organisms. Our study indicates that the hospital-wide antibiogram used at BUMCT is adequate in treating patients with uncomplicated cystitis coming into their ED.

Bakgrund: Arbetsmiljön på akutmottagningen är komplex och ständigt föränderlig. Sjuksköterskan förväntas hantera ett högt inflöde av patienter med varierande omvårdnadsbehov och allvarlighetsgrad. I takt med en allt högre arbetsbelastning, överbelagda sjukhus, långa väntetider och sjuksköterskebrist är det angeläget att tydliggöra hur sjuksköterskans arbetsmiljö på akutmottagningen ser ut och vad det har betydelse för patientsäkerheten. Syfte: Studiens syfte var att sammanställa forskning om sjuksköterskans arbetsmiljö på akutmottagningen med särskilt fokus på patientsäkerhet. Metod: Studien genomfördes som en beskrivande litteraturstudie baserad på 14 vetenskapliga artiklar. Artiklarna söktes i Pubmed och Cinahl samt via sekundär sökning. Resultatet: Genom att identifiera och kategorisera mönster och centrala teman i artiklarna kunde bärande aspekter passande syftet sammanställas. Analysen resulterade i två huvudområden: ”Sjuksköterskans arbetsmiljö på akutmottagningen” och ”Arbetsmiljöns betydelse för patientsäkerheten”. I sjuksköterskans arbetsmiljö framträdde sex faktorer som presenteras med underrubrikerna: arbetsbelastning, erfarenhet/kompetens, teamarbete, kommunikation, avbrott/störningar och ledning/organisation. Slutsats: Flera faktorer i sjuksköterskans arbetsmiljö på akutmottagningen har betydelse för patientsäkerheten. Faktorer som hög arbetsbelastning kan ses som både positivt och negativt beroende på sjuksköterskans kompetens, erfarenhet och personlighet. Vidare är tydlig organisatorisk ansvarsfördelning, ett välfungerande teamarbete med rak och riktad kommunikation av betydelse för arbetsmiljön och patientsäkerheten. När patientsäkerheten äventyras är det ofta brister i en eller flera arbetsmiljöfaktorer. Om nämnda faktorer är välfungerande finns förutsättningar för en god arbetsmiljö vilket gynnar vårdkvaliteten samt personalens arbetsglädje. / Abstract: The working environment within emergency care is complex and constantly changing. The nurse is expected to handle high inflows of patients with variety of severity and care needs. In keeping with increasing workload, overcrowded hospitals, long waiting times and lack of nurses it is important to clarify the nurse´s work environment in emergency care and its influence on patients’ safety. Purpose: The purpose of the study was to compile nurse´s working environment research within the emergency department with a particular focus on patient’s safety. Method: The study was conducted as a descriptive literature study based on 14 scientific articles. The articles referenced were searched in Pubmed and Cinahl, as well as via a secondary search. Results: By identifying and categorizing patterns and key themes in the articles, fundamental aspects could be compiled. The analysis resulted in two main areas: “Nurse´s working environment within emergency departments” and “the work environments influence on patients’ safety”. In the nurses working environment, six different influencing factors are described; workload, experience, teamwork, communication, interruptions and organization. Conclusion: Several factors in the nurse's work environment within emergency care are important for patient safety. Factors like high workload can be both positive and negative depending on the nurse's skills, experience and personality. Furthermore, clear organizational allocation of responsibilities, well-functioning teamwork and objective, direct communication is of importance to the work environment and patient safety. There are often shortcomings in one or more work environments where the patient’s safety is compromised. The presence of well - functioning factors in the work environment provide beneficial conditions for quality of patient care and staff satisfaction.

Class of 2011 Abstract / OBJECTIVES: The overall purpose of this study was to describe comorbidities, charges, and mortality associated with inpatient, adult traumatic brain injury (TBI) cases in the United States (US) for the year 2007. METHODS: This was a retrospective cohort analysis of discharge records located in the National Emergency Department Sample (NEDS) of the Healthcare Cost and Utilization Project (HCUP). Descriptive statistics are provided for comorbidities, charges, and mortality. Logistic regression was performed to find characteristics associated with mortality while multiple regression was used to assess charges. Independent variables included age, injury severity, procedures used, location of TBI, and primary payer. RESULTS: A total of 639,698 TBI cases were found which were associated with 267,061 hospital admissions, over $17 billion in hospital charges, and 20,620 deaths in the year 2007.Most common comorbidities were essential hypertension, sprains and strains of the back, tobacco use, fluid and electrolyte disorders, and alcohol-related disorders. Characteristics associated with increased mortality and charges included New Injury Severity Score (NISS) over 10, involvement of a firearm, falls, motor vehicle traffic, and intubation. CONCLUSION: The current study gives the most current picture of inpatient adult TBI cases throughout the US. Future research is warranted to ensure that optimal outcomes are being attained in this vulnerable patient population.