Introduction: Pediatric firearm injury became the leading cause of death among U.S. children in 2020. Studies evaluating wounding patterns in military and mass casualty shootings have provided insights into treatment and potential salvageability in adults, however, similar studies in the pediatric population do not exist. Hence, our study aimed to analyze wounding patterns of pediatric firearm fatalities and associated demographics and characteristics, such as place of death, to better understand pediatric firearm injuries, potential salvageability, and opportunities to reduce firearm deaths among vulnerable pediatric populations.
Methods: A retrospective review of the National Violent Death Reporting System from 2005-2017 was performed on patients 18 and younger. Mortalities were stratified by patient age: <12 years and 13-18 years and by intent- homicide, suicide, and unintentional. Comparative and exploratory analyses of demographics, location of death and anatomic location of wounds were performed.
Results: Of 8,527 pediatric firearm mortalities identified, 4,728 were homicides, 3,180 were suicides and 619 were unintentional injuries. Suicide victims were most likely to be dead on scene and >90% of suicide victims suffered head/neck injuries. For victims of homicide, younger children were more likely to die on scene (61% vs 44% p < 0.001). The pattern of injury in homicides differed for younger children compared to adolescents, with younger children with more head/neck injuries and older children more thoracic, thoracoabdominal, abdominal, and junctional injuries. In both age groups, children with extremity, abdominal and thoracoabdominal injuries were more likely to die later in the emergency department or inpatient setting.
Conclusions: Wounding patterns across pediatric firearm mortalities in the U.S. vary by age and intent. The majority of pediatric firearm deaths were due to head/neck injuries. Children with homicide and unintentional deaths had more wounding pattern variation, including more injuries to the thorax and abdomen, and a much lower rate of dead-on scene than suicide victims. Our study of wounding patterns among U.S. children killed by firearms highlights the complexity of these injuries and offers opportunities for tailored public health strategies across varying vulnerable pediatric populations.
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http://dx.doi.org/10.1016/j.injury.2022.11.072 | DOI Listing |
Clin Pediatr (Phila)
December 2024
Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
We conducted a quality improvement (QI) study to increase rates of firearm screening/safety counseling by 25% over 10 months for children (4-18 years) at preventive visits in an academic continuity clinic. Plan-Do-Study-Act (PDSA) cycles consisted of 1) (January 2023) educating providers about best practices for screening, safe storage counseling, and use of cable firearm locks; 2) (May 2023) revising the preventive visit note template to prompt providers on best practices; and 3) (September 2023) providing caregiver educational resources to support safe storage practices. The baseline firearm screening rate was 38%.
View Article and Find Full Text PDFAm Surg
December 2024
Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Objectives: In 2020, the public health crises of gun violence and novel coronavirus (COVID-19) collided and interventions to decrease COVID-19 transmission displaced millions of Americans from normal activity. We analyzed the effects of COVID-19 and its resultant shutdowns on gun violence in Buffalo, NY.
Methods: We queried the Gun Violence Archive (GVA) and the hospital databases from the 2 level 1 trauma centers which serve Buffalo firearm victims between March 15th and June 24th, 2020 ("COVID") and the same time period for years 2013 (hospital data)/2014 (GVA data) through 2019 ("pre-COVID") and 2021 through 2022 ("post-COVID").
JAMA Pediatr
December 2024
Department of Research, American Academy of Pediatrics, Itasca, Illinois.
Importance: Injuries from firearms and motor vehicle crashes (MVCs) are the leading causes of death among US children and youths aged 0 to 19 years. Examining the intersections of age group, sex, race, and ethnicity is essential to focus prevention efforts.
Objective: To examine firearm and motor vehicle fatality rates by population subgroups and analyze changes over time.
J Grad Med Educ
December 2024
is Assistant Professor of Pediatrics, Department of Pediatrics, University of Cincinnati College of Medicine, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Firearm-related injury is the leading cause of death among US children and adolescents. Residents across specialties report low preparedness to provide firearm safety counseling. Virtual reality (VR) may offer a modality to support residents' skills through deliberate practice in a simulated setting.
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