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ABSTRACTS

 

Changes in EMS Encounters for Patients with Firearm-Related Injuries during the COVID-19 Pandemic

Author: Remle P. Crowe, PhD, NREMT | |

Associate Authors:

Background

Media reports have described increasing gun violence during the COVID-19 pandemic; however, limited data exist describing changes in EMS encounters related to firearm injuries. Our objective was to compare EMS encounters for patients with firearm injuries prior to and during the COVID-19 pandemic.

Methods

This retrospective analysis used prehospital patient care records from the ESO Data Collaborative. We limited the analysis sample to EMS agencies that were part of the collaborative in CY 2019 and CY 2021 All 9-1-1 records for patients with documented injuries from firearms were included. We excluded interfacility transports. As expected, mortality differs for injuries resulting from assault or accidental discharges compared to intended self-harm, we excluded encounters with self-harm or unknown intent from the mortality analysis. Percent change was calculated for 2021 compared to 2019.

Results

We analyzed records from 1194 EMS agencies. The total number of 9-1-1 responses increased by 6% from 5,438,898 in 2019 to 5,751,108 in 2021. Meanwhile, the number of EMS encounters involving firearm injuries increased by 30% from 13,958 to 18,184. Assault was the most common intent documented in 2019 (55%, 7720) and 2021 (53%, 8610).
Encounters with unknown intent increased by 61% from 2019 (2423) to 2021 (3893), while encounters related to self-harm and those related to accidental injuries remained similar. The median age was similar in 2019 (31 years; IQR:23-46) compared to 2021 (30 years; IQR: 22-43); however, the number of encounters for children < 18 years increased by 70% from 957 in 2019 to 1626 in 2021. After excluding encounters involving self-harm or unknown intent, on scene mortality for injuries from assault or accidental discharges was 9% (768) in 2019 and 10% (1103) in 2021.

Conclusion

EMS encounters for firearm injuries in 2021 increased by 30% compared to 2019, substantially exceeding the 6% increase in overall call volume. A disproportionate increase in firearm injury encounters was observed among children, suggesting an important focus for EMS readiness. Limitations include use of a convenience sample and missing data related to the intent of the injury.