Retrospective Analysis of Unintentional Firearm Injuries Presenting to CCMC

Background: An estimated 110 children die each year in the US due to unintentional firearm accidents. Studies show that current educational strategies are ineffective long-term and have called for more research towards improving children’s safety. Purpose: The purpose of this study was to determine trends among victims of unintentional firearm injuries to identify potential risk factors. Methods: This was a retrospective chart review of Cook Children’s Medical Center (CCMC) electronic medical records. Patients ages 0-18 years presenting with unintentional gunshot injuries to the CCMC Emergency Department between January 1, 2011 and June 27, 2018 were included. We excluded injuries deemed to be intentional and patients over age 18. Data were stored in REDCap. Results: There were 140 patients who met inclusion criteria, and 30 of these were excluded (25 for intentional shooting, 2 for being over age 18, and 3 for intentional shooting in patients over age 18). Of the remaining 110 (84.5% male) patients, percentages by type of gun were as follows: BB gun, 50.0%; handgun, 20.0%; pellet gun, 13.7%; other, 16.3%. We also collected data on who pulled the trigger, which was by a friend in 34.7% of cases, a sibling in 26.9% of cases, and the patient in 24.0% of cases. Most injuries (73.8%) occurred at patient’s home, with the second most common location being a friend’s house (15.0%). Locations of injuries included 39.0% to the face, 35.0% to an extremity, and 11.0% to the abdomen. Only 50.0% of the patients were discharged home from the ED, while the other 50.0% were either admitted to CCMC or transferred for further care. Most injuries (60.9%) were considered minor, followed by moderate (23.6%) and serious or critical (15.5%). Conclusions: In the present study of unintentional gunshot injuries, most were considered to be minor or moderate, but almost half still needed a hospital admission. Most of the injuries occurred at the patients’ homes, so we suggest that many of these accidents could be prevented by proper gun storage when not in use and proper safety equipment when in use. Several other injuries also occurred at friends’ homes, and we suggest that many of these injuries could be avoided by encouraging parents to talk to other parents about guns in the home. The most common location for these injuries was the face, so we encourage wearing eye protection when using guns recreationally. Further research should be done to corroborate these possibilities.