Study explores solutions to reduce firearm-related injuries in children

Study documents differences in the types of injuries and how children arrive at the hospital based on age, and illustrates important gaps in data collection

Firearm-related injuries in children and adolescents are an important cause of preventable injury and mortality. Recent national shooting tragedies involving children have resulted in new efforts to study the problem and find solutions to reduce this type of injury. In an abstract presented Monday, Oct. 28, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando, researchers sought to determine the local trends and characteristics of pediatric firearm injuries and deaths, especially those involving children under age 14.

The abstract, "A Six Year Retrospective Review of Pediatric Firearm Injuries," reviewed child and adolescent firearm injury data from an urban Level 1 trauma center between January 2005 and December 2010, including injury site, the method of transportation to the hospital, and patient disposition. For patients ages 14 and younger, researchers reviewed trauma center, hospital, and rescue records for shooting details including gun type and shooter characteristics and treatment information such as procedures, discharge diagnoses, medical and social history.

There were 456 patients age 18 and younger with firearm injuries, including 78 patients younger than age 14. Most patients were male (86 percent) and African-American (80 percent). The death rate was 7 percent.

The most common injury sites for children under age 14 were the extremities (51 percent), trunk (41 percent), head (16 percent) and neck (9 percent). Patients ages 5 to 9 were six times more likely to have multiple injury sites compared to children ages 10 to 14.

"Further analysis of our firearm injury data found that children less than 14 years of age differ from those age 15 to 18 in several key areas," said study author Phyllis Hendry, MD, FAAP. "They are four times more likely to be shot at home and are much more likely to arrive by ambulance than by private car or walk in. Older teens often walk in or are dropped off at emergency department entrances. Over 60 percent of the time, the shooter and the type of firearm were unknown."

Emergency records often lack important details necessary to help develop effective crime and injury- prevention strategies, according to the abstract.

"Future firearm prevention initiatives must explore improved methods of linking Emergency Medical Services, hospital and law enforcement records," said study co-author Andrea Suen, MD, FAAP.