ABSTRACTS
Trends in EMS Encounters for Children and Teenagers with Firearm Injuries from 2018 to 2022Author: Alison Treichel, MPH | | Associate Authors: Remle P. Crowe, PhD, NREMT, Antonio R. Fernandez, PhD, NRP, Scott S. Bourn, PhD, RN, Brent Myers, MD, MPH
Introduction Firearm injury is a leading preventable cause of death for children in the United States, which may have changed during the pandemic. Objective To describe changes in patient and encounter characteristics among EMS encounters for children with firearm injuries prior to and during the COVID-19 pandemic. Methods We used data from the 2018–2022 ESO Data Collaborative for this retrospective analysis. We only included EMS agencies that were part of the Collaborative throughout the 5-year study period. All 9-1-1 records for patients ages 0–19 years with documented injuries from firearms were included. We calculated annual percent changes stratified by patient age, gender, race/ethnicity, socioeconomic status, and EMS encounter characteristics. Results Among 7,913 total encounters, the median age ranged from 16–17 years; most encounters were among male patients (80–83%). Between 9–10% of children with firearm injuries died on scene each year. Among transported patients with hospital outcome data (n = 2,049), 7% died. Firearm injuries increased 79% over the study period, peaking in 2021 (n = 2,036). In all study years, assault (96% total percent increase) was the most documented injury intent category, followed by unknown (137% total percent change), accidental (9% total percent change), and self-harm (37% total percent change). Black children represented 61–69% of total encounters annually. Moreover, Black and Hispanic children experienced the largest total percent increase in firearm injuries from 2018 to 2022 (86%; 110%). Over half of encounters occurred in communities of greatest socioeconomic vulnerability, ranging between 59–54% annually. Conclusion In this large national evaluation, we observed an upward trend in EMS encounters for firearm injuries from 2018 to 2022 among pediatric patients, with nearly 1 in 10 children dying in the field and another 7% dying after arrival at the emergency department. Injuries resulting from assault increased at the fastest rate. This injury burden disproportionately impacts minorities and socioeconomically vulnerable communities, presenting an area of focus for future prevention initiatives. Limitations include use of a convenience sample and missing data related to the injury intent.
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