Friday, February 12, 2016

Children and firearm injuries: What are the consequences?

Children who survive firearm injuries often require extensive follow-up treatment once released from the hospital, including rehabilitation, home health care, and mental health or social services. A new study says pediatricians and other health care providers can play an important role in preventing these injuries through counseling about firearm safety, including safe storage.

Children and firearm injuries: What are the consequences?


We know that firearm injuries are the second leading cause of death among American children and a major contributor to injury and long term medical costs for survivors, but little information exists about children and teens who are hospitalized for firearm injuries.

A study released online today in Pediatrics reviewed national data on deaths and injuries in children from 2009, and found that there were 7,391 hospitalizations for firearm-related injuries in US children.

The overwhelming majority, 89 percent of hospitalizations, occurred in males. Hospitalization rates were highest for 15- to 19-year-olds and for black males. The rate in African American boys was 10 times the rate for other groups. Deaths in the hospital occurred in 6.1 percent of children and adolescents. About 35 percent of children died who were hospitalized after suicide attempts, an extremely high death rate for any hospitalized condition. 

Previous estimates of nonfatal injuries have relied on small samples of emergency department visits and did not give a full view of the scope of the problem

For those who are hospitalized, there is usually a long course of surgeries, medical treatment and mental health treatment that extends for years and permanently damages lives. The shame is that these are all preventable deaths and injuries.  

At Newtown, 20 children died along with 6 adults. The new study indicates that about 20 children are shot each day in the United States, and while most do not die, their lives are forever changed. The tragedy is that these are preventable injuries and deaths. Many of these shootings are due to guns being handled by other children or adults inexperienced or untrained in safe use of firearms. Often these shootings are due to loaded guns being left around a home for ‘protection.’ Along with shootings, we now have our children exposed to ‘lock down’ drills at schools so they can prepare to survive a school shooting. Children used to feel safe at school, but that sense of security is being taken from them.

The proliferation of unsecured mishandled guns is resulting in deaths, hospitalizations, long term disability and disruption of school for thousands of children across the country. 

In the year since the horror of Newtown, gun laws have changed.  Paradoxically, the laws have generally become looser and less strict. For those selling assault rifles, it has been a banner year, gun companies are making a fortune on the dead children of Newtown.  Each mass shooting results in more sales and profit. 

More people are being shot, including children shot by adults and children shot by other children. Recent reviews have shown that adults involved in accidental shootings are rarely charged with a crime, it is often described as an accident. In most states, if you get distracted, crash your car and kill a child, you will probably be charged with vehicular homicide. If you get distracted and shoot and kill a child, it’s possible you won’t be charged. 

In Lancaster County, a man pulled a trigger and shot a 2 month old to death on Christmas morning.  It took the District Attorney almost two weeks to file charges, only after a lot of negative national publicity. In other states, often no charges are filed. There are more deaths and far more injuries.  We are starting to become de-sensitized to shootings and I feel starting to accept it as something that happens and cannot be stopped. 

Gun advocates no longer discuss safety.  They want armed guards in schools and open carrying everywhere. Those who want no limits on guns, say that it is needed to protect citizens from tyranny, and to protect their homes from criminals.  

In regards to tyranny, Thomas Jefferson, writing about the Constitution, is often quoted “The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants. It is a natural manure.” Jefferson was talking about rebellious patriots and the conflict with royal tyrants. He never said that the tree of liberty needed to be refreshed with the blood of children.  By the time he died, he understood that in America you vote tyrants out of office, you don’t need a gun.   

Unfortunately in this country, we are shedding the blood of children, innocent bystanders, moviegoers, students and those at worship.  Blood is not being shed by adult patriots or perceived tyrants. I don’t quite see how killing and maiming our own citizens, including our children protects and strengthens us.

The study’s authors underscore the important role that pediatricians and other health care providers who care for children can play in the prevention of firearm injuries in children and adolescents. Beyond the health care community, we all can play a role in educating children and other adults about firearm safety and storage. We need to put an end to these needless injuries and deaths.

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About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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