ANAHEIM, Calif.—A study of accidental firearm injuries in children found that the shootings most often occurred in the homes of the patient, friends, or family members, and that in most instances, one child unintentionally shot another or a child shot themselves.
“Retrospective Analysis of Unintentional Firearm Injuries in Children Presenting to a Pediatric Emergency Department,” conducted through the Pediatric Research Program at Fort Worth and Cook Children’s Health Care System, analyzed accidental firearm injuries in pediatric patients under 19 years old at the Cook Children’s Emergency Department in Fort Worth, Texas. The aim of the study was to identify trends and potential factors that place children at higher risk for unintentional firearm injuries. The researchers compared the outcomes and differences between powder guns (shotguns, rifles, handguns) and air-power guns (BB guns, pellet guns, air soft guns and nerf guns).
The study was conducted using medical records at Cook Children’s Health Care Center from January 2015 to June 2021. A total of 204 patients met the inclusion criteria. Cases in which the intention could not be determined or the shooting was deemed intentional or it was a suicide attempt were excluded from the study. The researchers recorded data on the type of gun, location and scenario of the shooting, and the location of the injury.
The study found that 29% of the firearm injuries occurred with powder guns and 71% with air-powder guns, with BB guns causing the most injuries. Most of the injuries were due to guns that may not seem dangerous, such as BB guns, but can cause serious injuries and death.
The study also found that the shootings most commonly occurred in the homes of the patient (76%), friends, or family members and that most of the time the accident occurred when one child accidentally shot another, or the child shot themselves.
Dr. Daniel D Guzman from Cook Children’s in Fort Worth, who led the study, said: “Firearm storage and supervision are key factors in reducing the number of unintentional gun injuries in our youth, given many of these injuries occur in the home. It is important that all firearms, powdered and air-powered, be stored safely in a lock box or safe. Our Aim for Safety program was developed at Cook Children’s Health Care System in Fort Worth, Texas. This research provides targeted education to school-aged children and parents about the dangers of unsupervised play with BB/pellet guns, as well as the importance of storing all firearms in the home unloaded and in a locked safe.”
The authors also recommend that parents have conversations with the parents of their children’s friends to find out if they have guns in their homes and how they are stored.
Firearm injury is one of the leading causes of death in children and adolescents, with about 1,300 children dying annually from gun-related injuries. It is estimated that there are more than 22 million children living in homes with guns. Children are at a higher risk for unintentional death or injury because of their natural curiosity. Research also has indicated that the main danger to children does not come from accidental injury by adults, but from the accessibility of firearms to children, their siblings, and friends, the study notes.
Student Doctor Abigail Rodgers is scheduled to present an abstract of the study, available below, during the Section on Child Death Review and Prevention presentation on Monday, Oct. 10, 2022, at 11:15 a.m. PT. at Anaheim Convention Center, Room 259. The third-year medical student at the University of North Texas Health Science Center at Fort Worth’s Texas College of Osteopathic Medicine used medical records from Cook Children’s for her research. To request an interview with Student Doctor Rodgers or another abstract author, journalists may contact Libby Maness at libby.maness@unthsc.edu or Kim Brown at kim.brown3@cookchildrens.org.
Please note: Only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/
Program Name: 2022 AAP National Conference & Exhibition
Abstract Title: Retrospective Analysis of Unintentional Firearm Injuries in Children Presenting to a Pediatric Emergency Department
Abigail Rodgers
Fort Worth, TX, United States
In the US, firearm injury has been documented as the second leading cause of death in children and adolescents - causing 15.4% of deaths in 2016. Research has indicated that the main danger comes from the accessibility of firearms to children, their siblings, and friends. The aim of this study is to identify trends and potential factors that place children at higher risk for unintentional firearm injuries. We specifically compared the outcomes and differences between powder guns and air-power guns. This information will be helpful in developing curriculums for injury prevention.
A retrospective cohort study was conducted using medical records from Cook Children’s Health Care System (CCHCS). To be included, patients had to be less than 19 years of age and have presented at the CCHCS emergency department (ED) with an unintentional firearm injury between January 1, 2015 and June 30, 2021. For each patient, we recorded data on type of gun, location and scenario of the shooting, and location of injury on patient’s body.
Two hundred four patients met inclusion criteria. There were 59 (28.9%) shootings by powder guns, including handguns (24.0%), shotguns (2.9%), rifles (1.0%), and unreported (1.0%). The other 145 (71.1%) shootings were by air-power guns, including BB (48.5%), pellet (14.7%), air (4.9%), nerf (2.5%), and paintball (0.5%) guns. Shootings most commonly occurred in the patient’s home (76.5%), a friend’s home (12.3%), or a family member’s home (3.9%). Compared with air-power-gun shootings, powder-gun shootings were statistically significantly more likely to take place outside the patient’s home (35.6% vs. 18.6%, p< 0.0001, OR=2.61). The most common locations of gunshot wounds were extremities (44.1%), the face (37.3%), and head or brain (15.2%). Compared with those shot with air-power-gun shootings, powder-gun shootings were significantly less likely to injure the face (22.0% vs. 43.4%, p=0.004, OR=0.37). Upon discharge, 131 patients (64.2%) went home, 65 (31.9%) went to the floor, 2 (1.0%) were transferred to another facility, and 6 (2.9%) decreased. Compared to those shot with air-power guns, patients shot with powder guns were significantly less likely to be discharged home (32.2% vs. 77.2%, p< 0.0001, OR=7.15).
Most shootings were by air-power guns. Although most of these were minor injuries, we suggest that children should have proper supervision while these guns are in use. Shootings most commonly occurred in the homes of the patient, friends, or family members. We suggest that many of these unintentional gun injuries could be prevented by use of proper storage and safety measures. The majority of incidents were caused by injury to the face, head, or brain. We suggest that safety equipment such as protective eyewear should be worn when handling firearms to decrease these unintentional injuries.
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Article Title
Retrospective Analysis of Unintentional Firearm Injuries in Children Presenting to a Pediatric Emergency Department
Article Publication Date
7-Oct-2022