Pediatric Trauma Society

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Barely Benign: Non-Powder Gun Injuries in Pediatric Patients
Jonathan Hyak1; Hannah Todd2; Eric Rosenfeld, MD1; Bindi Naik-Mathuria, MD3
1Baylor College of Medicine, Houston, TX; 2Rice University, Houston, TX; 3Texas Children's Hospital Department of Surgery, Houston, TX

Purpose: To characterize the spectrum of injuries, management, and outcomes of non-powder gun incidents at an American College of Surgeons Verified Level-I pediatric trauma center.

Methods: Retrospective review of children ≤18 years of age who presented with BB or pellet gun injuries between 2013-2017. Demographics, injury characteristics, treatments, and outcomes were reviewed and analyzed using descriptive statistics.

Results: Forty-six cases were identified; of these, 78% were male and the median age was 10 years (IQR 7-13). Eighty-five percent sustained penetrating injuries. The most common location was the head and neck (28%), followed by the anterior torso (26%) and eye (24%). Major injuries were: intracranial penetration causing subarachnoid hemorrhage, lung, liver, and kidney laceration, pericardial and pulmonary artery injury with tamponade, and tracheal injury. Twenty patients (43%) patients were admitted and 17 (37%) required surgery: 5 head and neck and 4 extremity or truncal pellet removals, 2 ocular procedures, 2 exploratory laparotomies, 1 thoracoscopy, 1 sternotomy, 1 scrotal exploration, and 1 metacarpal fracture fixation. Four patients (9%) were admitted to the intensive care unit. There were no deaths.

Conclusions: Injuries from recreational non-powder guns can cause severe injuries, and a thorough penetrating trauma workup should always be undertaken. Additionally, young children should be restricted from accessing these guns.

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