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Trends in Prehospital Firearm Incidents and Intentionality for the Pediatric Population

Author: Morgan Anderson | |

Associate Authors: Douglas G. Butler, Jr.

Introduction

While firearm-related injuries are among the five leading causes of death for individuals under the age of 65 years, they surpassed traffic-related incidents and took the top leading cause of death for pediatrics in 2020. The purpose of this study was to evaluate the rate and intentionality of firearm-related prehospital incidents in the pediatric population. Understanding the intentionality of firearm incidents amongst pediatrics can help target public health efforts in preventing
mortality and injury due to firearms.

Methods

From the ImageTrend Collaborate database, retrospective prehospital 9-1-1 response firearm-related incidents from January 2018 to December 2021 were analyzed. National EMS Information System Version 3.4 Cause of Injury (eInjury.01), Provider Primary Impression (eSituation.11), and Provider Secondary Impression (eSitutation.12) fields were searched for terms “gun” or “firearm.” ICD-10 codes were grouped to establish suspected intentionality of accidental, violent (assault), self-harm, and undetermined. Pediatric patients including anyone with an age under 17 years. Chi-square analysis was performed to measure changes in trends over time. Rates were compared among different age groups.

Results
Of the 362,930 prehospital pediatric incidents, 5602 (1.5%) were firearm-related incidents; 77% of incidents were treated and transported, and 9% were field death pronouncements. Males accounted for 80% of the incidents and over 75% were in the 14- to 17-year-old age group, followed by 10% in the 11- to 13-year-old group. For intentionality, violence (assaults) accounted for 41%, 31% was unknown, 18% was accidental, and 6% were self-harm related. Overall pediatric firearm incidents have increased by 94% from 2018 to 2021. In comparison, adult firearm incidents increased by 51% during this timeframe. Violent (assault-related) firearm incidents among pediatrics increased by 32% within this timeframe. From 2018 to 2021, there was a 52% increase in self-harm incidents and 58% increase in violence-related among 11-year-olds to 13-year-olds.

Conclusion
Firearm injuries have drastically increased amongst the pediatric population within the prehospital setting, specifically for 14-year-olds to 17-year-olds and violence-related incidents. Further collaboration is needed with public
health organizations in prevention efforts to help curb these pediatric incidents.