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Safety in Numbers? Refuting the Urban Legend of Water and Bullets in Pediatric Trauma
Pamela M. Choi, MD, Michael Wallendorf, PhD, Martin S. Keller, MD, Adam M. Vogel, MD. Washington University School of Medicine, St. Louis, MO, USA.

Background: Opponents of gun-control measures have often made the argument that "swimming pools are more dangerous than guns." We sought to provide data describing the demographics and outcomes of children who sustain firearm and drowning/submersion injuries.

Methods: The National Trauma Database (NTDB) was queried for all patients <18 years who were injured by firearms or suffered a water submersion mechanism from 2013-2014.

Results: Demographic and clinical data is summarized in Table 1. There were 6244 firearm injuries. Firearm patients were older (13.80.05 years). 1643 (26.3%) patients required operations and 977 (15.6%) required intensive care. 328 patients died in the emergency department, while 376 additional patients ultimately expired during their hospitalization. Most patients were assaulted (3859, 61.8%), while 1738(27.8%) were accidental, and 378(6.1%) were self-inflicted. In contrast, 228 patients had water submersion. The average age was 8.1 0.4 years; 33% of patients were less than 3 years and 30.2% were greater than 14 years. 46.9% were admitted to the ICU, and 50 (21.9%) died. 25 patients (11.0%) drowned in a bathtub, while 36 patients (15.8%) had incidents involving water transport crafts.

Conclusions: Firearm and water safety are important pediatric public health concerns. However, morbidity from firearm injuries far exceed that of drowning or submersion. The comparison of any risk severity between these mechanisms is not supported and is not appropriate in public discourse.

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