Nonpowder Firearms Research Articles

72 Injuries Related to Non-Powder Firearms: A National Database Study

72 Injuries Related to Non-Powder Firearms: A National Database Study

Fractures in Children Due to Firearm Activity.

The purpose of this study was to investigate fracture patterns due to pediatric firearm injuries. The data used was from the US Firearm Injury Surveillance Study 1993-2019. Over these 27 years, there were 19,033 children with fractures due to firearm activity with an average age of 12.2 years; 85.2% were boys and the firearm was a powder type in 64.7%. The finger was the most common fracture location, while the tibia/fibula was the most common location for those admitted to the hospital. Children ≤ 5 years of age sustained more skull/face fractures; most spine fractures occurred in the 11-15-year age group. The injury was self-inflicted in 65.2% of the non-powder and 30.6% of the powder group. The injury intent was an assault in 50.0% of the powder and 3.7% of the non-powder firearm group. Powder firearms accounted for the majority of the fractures in the ≤5 and 11-15 year-olds, non-powder firearms accounted for the majority of the fractures in the 6-10 year-olds. Injuries occurring at home decreased with increasing age; there was an increase in hospital admissions over time. In conclusion, our findings support the need for safe storage of firearms in the home away from children. This data will be helpful to assess any changes in prevalence or demographics with future firearm legislation or other prevention programs. The increasing acuity of firearm-associated injuries seen in this study is detrimental to the child, impacts familial wellbeing, and results in significant financial costs to society.

Consumer Product-Related Pediatric Eye Injuries Treated in United States Emergency Departments

ABSTRACT Purpose This study investigates characteristics and trends of children <18 years old treated in United States emergency departments (EDs) for consumer product-related eye injuries. Methods Data from the National Electronic Injury Surveillance System for January 1, 1997 through December 31, 2019 were analyzed. Results During the 23-year study period, an estimated 1,453,283 children were treated for consumer product-related eye injuries, averaging 63,186 children annually. Overall, the eye injury rate per 100,000 children <18 years old increased initially from 82.64 in 1997 to 104.53 in 2001 (p = .0492) and then decreased by 32.1% to 70.95 in 2019 (p < .0001). Almost two-thirds (64.5%) were boys and 32.1% were <5 years old. Overall, 2.6% of patients were admitted, but injuries involving non-powder firearms and golf had the highest admission rates (18.8% and 14.7%, respectively). Compared with other product categories, children were more frequently admitted if they had an eye injury associated with non-powder firearms (18.8% admitted; OR: 10.92, 95% CI: 8.67–13.76) or golf (14.7% admitted; OR: 6.59, 95% CI: 3.51–12.34). Contact with a non-chemical product was the leading mechanism of eye injury in all age groups, except children <5 years old, in which the leading mechanism was contact with a chemical product (34.2%). Corneal abrasion (36.5% overall) was the most frequent diagnosis across all age groups. Conclusions Although the rate of consumer product-related pediatric eye injuries treated in US EDs has decreased since 2001, these injuries remain common among children. Therefore, increased prevention efforts are needed.

Nonpowder Firearm Injuries to Children Treated in Emergency Departments.

To investigate nonpowder firearm injuries treated in US emergency departments among children <18 years old. National Electronic Injury Surveillance System data from 1990 through 2016 were analyzed. An estimated 364 133 (95% confidence interval 314 540-413 727) children <18 years old were treated in US emergency departments for injuries related to nonpowder firearms from 1990 to 2016, averaging 13 486 children annually. From 1990 to 2016, the number and rate of nonpowder firearm injuries decreased by 47.8% (P < .001) and 54.5% (P < .001), respectively. Most injuries occurred among 6- to 12-year-olds (47.4%) and 13- to 17-year-olds (47.0%). Boys accounted for 87.1% of injured children, the most common diagnosis was foreign body (46.3%), and 7.1% of children were admitted. BB guns accounted for 80.8% of injuries, followed by pellet guns (15.5%), paintball guns (3.0%), and airsoft guns (0.6%). The rate of eye injuries increased by 30.3% during the study period. Eye injuries accounted for 14.8% of all injuries and the most common diagnoses were corneal abrasion (35.1%), hyphema (12.5%), globe rupture (10.4%), and foreign body (8.6%). Although the number and rate of nonpowder firearm injuries declined during the study period, nonpowder firearms remain a frequent and important source of preventable and often serious injury to children. The severity and increasing rate of eye injuries related to nonpowder firearms is especially concerning. Increased prevention efforts are needed in the form of stricter and more consistent safety legislation at the state level, as well as child and parental education regarding proper supervision, firearm handling, and use of protective eyewear.

Pediatric Injuries from BB Guns, Pellet Guns, and Other Nonpowder Firearms

To better understand pediatric injuries from nonpowder firearms (BB, pellet, paintball, and airsoft guns), researchers analyzed data from the National

Neurosurgical Care of Nonpowder Firearm Injuries: A Narrative Review of the Literature.

Background Nonpowder firearms discharge a projectile using compressed gases. Unlike traditional firearms, there is a perception that nonpowder guns do not cause serious injury. However, intracranial injury disproportionally affects children and can cause significant neurological disabilities and mortality. Management of nonpowder firearm injuries has received little attention in the literature and presents unique surgical challenges. Materials and Methods We conducted a narrative review of the literature of the management of nonpowder firearm injuries with particular emphasis on intracranial injury. Results Modern nonpowder firearms have muzzle velocities which are capable of penetrating the skin, eyes, and bone. Direct intracranial injury commonly results from entrance of projectile through thinner portions of the skull. Operative intervention is needed to debride and safely explore the trajectory to remove fragments which can easily cause neurovascular injury. Conclusions Neurosurgeons play a crucial role in managing serious nonpowder firearm injuries. A multidisciplinary team is needed to manage the direct results of penetrating injury and long-term sequalae.

The dangers of non-powder firearms

Non-powder weapons have become a persistent threat in today’s society. They are found outside of competitive sports at an increasing rate, being misused among young individuals, and have emerged in Canadian criminal activity. In some cases, misuse of these weapons has led to death or serious injuries. Individual and community safety are at risk when fake firearms are in the hands of criminals, as they can be altered to look and perform like real firearms. They are a particular challenge for law enforcement, who cannot be expected to distinguish fake firearms from real ones under stress. This research found fake firearms to be easily accessible and the regulations around their security and control sorely lacking and often resisted. Education regarding non-powder firearms was also found to be inadequate, when it exists at all. Awareness, education and further regulation are needed to help focus on these issues. This research concludes that it would be beneficial to treat non-powder weapons like real firearms in every aspect: storage, transportation, and handling.

Firearm-related injuries among Canadian children and youth from 2006 to 2013: A CHIRPP study.

The purpose of this study was to describe Canadian contextual trends in pediatric firearm injuries and death from powder and non-powder firearms. This is a registry study of firearm-related injuries captured by the Canadian Hospitals Injury and Reporting Prevention Program (CHIRPP) for children ages 0 to 18 years presenting to participating CHIRPP emergency departments (EDs) from 2006 to 2013. Data included age, sex, year, setting, circumstance, and disposition for each case. The CHIRPP dataset included 325 non-powder firearm injuries and 80 powder gun injuries. The rate of firearm injuries remained stable from 2006 to 2013 (44 per 100,000 ED visits). Forty-five patients required hospital admission and 2 died in the ED; 8 of 9 intentional self-harm injuries were inflicted with a powder gun. Most injuries occurred unintentionally from non-powder firearms (n=298, 71%) in the context of recreation (n=179) and sport (n=48). Eyes were the most commonly injured body part (n=150), 98% of which resulted from a non-powder firearm. Forty-three percent (n=141) of non-powder firearm injuries required treatment or admission. Eye injuries inflicted by non-powder firearms are a prevalent category of firearm-related injury. Most occurred through recreation and sport, highlighting a potential focus for primary prevention.

Non-powder firearms and air-pellet guns: Toys or weapons? A case of a penetrating pellet gun injury in a child

Non-powder firearms and air-pellet guns: Toys or weapons? A case of a penetrating pellet gun injury in a child

Nonpowder firearms cause significant pediatric injuries.

We hypothesize that nonpowder firearms cause significant injuries in children, often requiring intervention. We have noted a difference in demographics of children presenting with injuries from nonpowder firearms compared with patients injured by powder firearms. We reviewed our institution's experience with patients with nonpowder firearm injuries to evaluate these aspects. A retrospective chart review was completed for all patients with a firearm injury from 2003 through February 2013 to a pediatric urban Level I trauma center. Patients were excluded if they were 18 years of age or older or readmitted. Demographics, injury circumstances, interventions, and outcomes were reviewed for 303 patients. The χ test and analysis of variance were completed with a statistical significance of p < 0.05. There were 57 nonpowder firearm injuries and 246 injuries from other firearms. Injuries occurred from BB, pellet, and paintball guns. Treatment included computed tomography scan in 39 patients, three bedside procedures, one angiography, and operative intervention in 25 patients. The most common injury locations were the eye (n = 37), head (n = 7), and neck (n = 6). Children injured by nonpowder firearms were less likely to be female (p = 0.04), more likely to be white (p < 0.01), and less likely to be injured in a violence-related event (p < 0.01). Nonpowder firearms can cause severe pediatric injuries requiring operative intervention and significant radiographic exposure from computed tomography scans. Prevention and education are important in decreasing this risk in the pediatric population and should be targeted to a different population than powder firearm prevention. Epidemiologic study, level V.

Penetrating injury to the parapharyngeal space caused by a BB gun in a pediatric patient

Non-powder firearm related trauma to the head and neck has the potential for significant morbidity and mortality. This is especially so in children, whose injuries tend to be particularly under reported and trivialized. We present a case of penetrating trauma in a three-year-old boy caused by a BB gun pellet fired in close range to the face, entering the right side of the head and landing within 3 mm of the carotid bifurcation, fortunately, without major neurovascular injury. Due to potential morbidity related to surgical exploration of the parapharyngeal space, a non-surgical approach was observed. The patient suffered no functional deficit from the injury. This case demonstrates the merits of the non-surgical approach to head and neck trauma. The literature pertaining to the epidemiology of this injury is reviewed, including the advantages and disadvantages of surgical and non-surgical management.

Significant Pediatric Morbidity and Mortality from Intracranial Ballistic Injuries Caused by Nonpowder Gunshot Wounds

Nonpowder (ball-bearing and pellet) weapons derive their source of energy from compressed air or carbon dioxide. Such weapons are dangerous toys that cause serious injuries and even death to children and adolescents. A retrospective chart review study was undertaken to describe nonpowder gun injuries at a southwestern US urban level I adult and pediatric trauma center. Specific emphasis was placed on intracranial injuries. Over the past 6 years, a total of 29 pediatric and 7 adult patients were identified as having nonpowder firearm injuries. The patient population was overwhelmingly male (89.7%; mean age, 11 years). Overall, 17 out of 29 pediatric patients (56.8%) sustained serious injury. Nine patients (30.0%) required operation, 6 (20.7%) sustained significant morbidity, and there were 2 deaths (6.9%). Injuries to the brain, eye, head, and neck were the most common sites of injury (65.6%). Specific intracranial injuries in 3 pediatric patients are described that resulted in the death of 2 children. We suggest that age warning should be adjusted to 18 years or older for unsupervised use to be considered safe of these potentially lethal weapons.

Air Guns

Air guns and blank guns may appear relatively harmless at first glance, but they are, in fact, potentially destructive, even lethal, weapons. Approximately 2 to 2.5 million nonpowder firearms are sold annually, and again approximately 12.9 per 100,000 population are treated for such injuries in hospital emergency departments each year in the United States. Unfortunately, these guns are considered to be a toy for children. Therefore, incidents of air gun injuries are gradually increasing. Although such injuries may initially be considered trivial, it may signify severe internal tissue pathologies. These apparently trivial injuries may have catastrophic consequences if unnoticed. In this study, we report 4 cases with head injury due to a shot by these guns. The cases indicate that these people had used the guns belonging to their parents for the purpose of suicide. The cases also show that these machines are not innocent.

Incidence and circumstances of nonfatal firearm-related injuries among children and adolescents.

To describe the incidence and circumstances of nonfatal firearm-related injuries among children and adolescents treated in US emergency departments. Data were obtained from the Firearm Injury Surveillance Study, 1993-1997; data were collected through medical record review at hospitals participating in the National Electronic Injury Surveillance System. The hospitals participating in National Electronic Injury Surveillance System are a stratified probability sample of all US hospitals. Numbers and population rates for nonfatal firearm-related injuries among children and adolescents younger than 20 years old. An estimated 115,131 (95% confidence interval, 76,769-153,493) children and adolescents were treated for a nonfatal gunshot wound during the study period. The estimated annual rates of injury (per 100,000) were 2.0 (children 0-4 years old), 2.2 (children 5-9 years old), 15.4 (children 10-14 years old), and 106.5 (adolescents 15-19 years old). The ratios of nonfatal to fatal firearm-related injuries were 4.0 (children 0-4 years old), 4.4 (children 5-9 years old), 5.0 (children 10-14 years old), and 4.4 (adolescents 15-19 years old). An additional estimated 103,814 children (95% confidence interval, 69,223-138,405) were shot with a nonpowder firearm (BB or pellet gun). Boys 5 to 9 and 10 to 14 years old had the highest rates of injury related to nonpowder firearms, an estimated 36.2 and 99.8 per 100,000, respectively. Fifty-six percent of those 15 to 19 years old were assault victims. An estimated 48% of children and adolescents with powder firearm-related gunshot wounds and an estimated 4% with nonpowder firearm injuries were admitted to the hospital. Nonfatal injuries related to powder firearms and nonpowder firearms (BB or pellet guns) are an important source of injury among US children and adolescents. Ongoing surveillance of nonfatal firearm-related injury among children and adolescents is needed.

Air Guns Aren't Toys

Air guns are nonpowder firearms from which a pellet or BB is propelled by compressed gas. Though often marketed as toys and sold in department-store

The childhood air gun: serious injuries and surgical interventions.

Increasingly powerful nonpowder firearms or air guns are frequently given to children as toys. We undertook the present study to evaluate the injuries caused by these firearms, based on the concern that they are capable of inflicting serious trauma. Descriptive, retrospective chart review. Urban level I pediatric trauma center. The study included all children with injuries secondary to air guns who were admitted between July 1988 and March 1995. Type of weapon, circumstances of injury, anatomic location of injury, injury severity, surgeries performed, morbidity. None. There were 42 admissions with a mean hospital stay of seven days (range 1 to 136 days). The average age was 10 years (range 1 to 23 years) with a median age of 11 years. There were 35 boys and 7 girls. Twenty-nine of the 42 injuries were caused by a family member or friend and five were self-inflicted. The mean injury severity score was 8.3. While there were no fatalities, 21 children (50%) underwent operative procedures for their injuries. Ten of the injuries were potentially lethal, of which seven were due to the "pump" action air gun. Sixteen patients had serious long-term disability as a result of their injuries. Air guns can cause a variety of serious injuries, often requiring operative intervention. The long-term morbidity from some of these injuries is significant. Both parents and physicians should be aware that nonpowder guns are not toys, but weapons capable of inflicting serious trauma. The evaluation and treatment of air gun injuries should be similar to that currently used for powder weapon injuries. Recommendations for evaluation and treatment are made.

Pediatric nonpowder firearm injuries: outcomes in an urban pediatric setting.

Approximately 32 000 nonpowder firearm injuries are reported annually with more than 60% occurring in the pediatric population. Case reports of serious and fatal injuries have been described; however, no large inclusive series have been published. We reviewed an 11-year experience of an urban pediatric emergency department to evaluate the circumstances, spectrum of injuries, and outcomes attributable to nonpowder firearms. A retrospective, descriptive case series of all children 18 years of age or younger evaluated at an urban children's hospital from January 1983 through December 1994 were eligible for study. Patients were identified using a computerized database, the National Electronic Injury Surveillance System, and the trauma registry in the department of surgery. Medical records were reviewed to collect demographic information, circumstances of injury, anatomic site and type of injury, treatment, and outcomes for nonpowder firearm injuries. One hundred eighty patients were identified, and a complete data set was available for 166 (92%). The mean age was 12 +/- 3.7 years, 24% of children were <10 years old, and 71% of the children were male. Three patients returned with a second nonpowder firearm injury during the study period. Forty-nine percent of injuries were intentional and 44% of all injuries occurred during the summer and early fall months. The most common sites of injury were the extremity/buttocks (39%), head and neck (33%), thorax (13%), and eye (8%). Serious injuries included intracranial hemorrhage, cardiac right ventricle laceration, hyphema, and abdominal visceral injury (liver laceration, pancreatic laceration, intestinal perforation). The majority of wounds required local wound care, and the children (74%) were discharged from the emergency department. Of the patients admitted to the hospital (27%), 45% required operative intervention. There were no deaths. Seven percent (12/166) of patients sustained some functional deficit with 42% (5/12) the result of an ocular injury. The majority of nonpowder firearm injuries are minor; however, the potential for serious injury should not be underestimated. Minor injuries can be treated with local wound care and tetanus prophylaxis, and patients can be discharged from the emergency department. Education of parents and children to the potential risks associated with these weapons is essential. Stricter regulations regarding ownership of nonpowder firearms and mandatory safety instruction should be considered.

Unintentional Firearm Injuries: The Price of Protection

Firearms may provide a measure of self-protection, but they also yield tragic consequences. Although the rate of unintentional firearm deaths in the United States has declined steadily for the past 50 years, 1,500 people still die annually because of the unintentional discharge of firearms. Less is known about nonfatal injuries; powder firearms are estimated to injure 12,000 to 30,000 people annually, and nonpowder firearms are estimated to injure 19,500 to 34,500 people annually. Compared with other injury circumstances, unintentional firearm injuries disproportionately affect children younger than 15 years of age and men who injure themselves or other people. Injuries among children often occur in homes and are characterized by a lack of parental supervision and by ready access to loaded firearms. Potential primary prevention strategies include requiring design modifications, such as trigger locks and redundant safety devices; educating firearm owners, children’s caretakers, and health care providers about the risk of firearm injury and about prevention; and restricting children’s access to firearms.

Penetrating eye injuries related to assault. The National Eye Trauma System Registry.

From 1985 to 1991, 648 cases of assault-related penetrating ocular injury were reported to the National Eye Trauma System Registry. We examined the circumstances surrounding and initial clinical findings related to this case series of injuries. Eighty-three percent of the patients were male. The median age was 28 years; 77% were younger than age 40 years, and 17% were younger than age 20 years. The ocular injury was part of multiple trauma in 34% of cases. There was evidence of alcohol and illicit drug use by at least 48% and 6% of the injured persons, respectively. Seventeen percent of the injuries involved powder or nonpowder firearms. Fists, glass fragments, metal rods or pipes, knives, and scissors were among the other objects causing injury. Posterior segment trauma, which occurred in 70% of cases, included vitreous hemorrhage (40% of cases), retinal detachment (11%), presence of intraocular foreign bodies (6%), and optic nerve damage (4%). The initial visual acuity after injury was hand motion or worse in 74% of the cases. Strategies to prevent such injuries focus on the origins of violence in general and are more difficult to devise than strategies to prevent eye injuries in other settings. Public health efforts to reduce the use of alcohol, drugs, and firearms may reduce the incidence of these injuries.

Causes of Pediatric Eye Injuries

Eye injuries are an important cause of ocular morbidity in children. We conducted a population-based study of eye injuries requiring hospital admission for children younger than 16 years in the state of Maryland during the 1982 calendar year. The population-based estimate of the incidence of ocular trauma in Maryland children was 15.2 per 100,000 per year (95% confidence interval, 12.8 to 17.7). Male patients outnumbered female patients as victims of eye injuries by a ratio of approximately 4:1; eye injuries in 11- to 15-year-old children occurred at more than twice the rate than for younger children. The most common cause of pediatric ocular trauma was accidental blows and falls (37%). Sports and recreational activities accounted for 27% of all eye injuries, 39% of all nonpenetrating injuries, and 40% of all injuries in 11- to 15-year-old children. A comparison of the causes of eye injuries at statewide specialty trauma centers and community-based hospitals indicated that sports-related injuries were treated at general hospitals more than 10 times more frequently than at the trauma centers. Other important causes of eye injuries were burns (9%), car crashes (11%), and nonpowder firearm accidents (4%). We conclude that the majority of pediatric eye injuries are preventable, and that the implementation of well-established safety precautions would greatly reduce this source of visual disability in our nation's children.