Journal of Pediatric Nursing (2014) 29, 279–280
HOT TOPICS DEPARTMENT Editor: Deborah McBride MSN, RN, CPN, CPON, CCRN
Deborah McBride MSN, RN, CPN, CPON, CCRN
Hospitalizations for Firearm Injuries Prevalent Among Children Deborah L. McBride MSN, RN, CPN, CPON, CCRN ⁎ Kaiser Permanente Oakland Medical Center, Oakland, CA Received 7 February 2014; accepted 10 February 2014
ABOUT 20 CHILDREN per day in the United States are injured by firearms seriously enough to require hospitalization, and more than six percent of these children die from their injuries, according to a new study by Yale School of Medicine researchers and their colleagues. The new study analyzed data of children and adolescents under the age of 20 who had been admitted to a hospital in the United States in 2009 using the Kids' Inpatient Database, the most recent data available. The researchers found that 7,391 hospitalizations occurred as a result of firearm injuries, and 453 of these patients died while in the hospital (6.1%; Leventhal, Gaither, & Sege, 2014). Most of these hospitalizations occurred as a result of assaults (4,559), but in children younger than age 10, 75% of the almost 400 hospitalizations were due to unintentional or accidental injuries. Although suicide attempts accounted for the fewest hospitalizations (270), injuries from these most often resulted in inpatient death (35%). The researchers found that the most common types of firearms injuries included open wounds (52%), fractures (50%), and internal injuries of the thorax, abdomen or pelvis (34%). Traumatic brain injuries occurred most often in children younger than 5. Of all the hospitalizations, 89.2% occurred in males; the hospitalization rate for males was 15.22 per 100,000 and for females was 1.93 per 100,000. This gender difference was apparent even in young children. The rate for Black males was 44.77, a rate more than 10 times that of White males. Rates were highest for those aged 15 to 19 years. The researchers noted the significantly higher poverty rate for young Black males compared with young White males, but the data did not allow researchers to separate the effects of poverty from the effects of race. ⁎ Corresponding author: Deborah L. McBride. E-mail address: [email protected]. 0882-5963/$ – see front matter © 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.pedn.2014.02.003
Children who survived firearm injuries often needed extensive follow-up treatment after they were released from the hospital, including rehabilitation, home health care, hospital readmission from delayed effects of the injury and mental health or social services. Although a Healthcare provinumber of previous studies have ders should incorused vital statistics to examine porate questions pediatric fatalities related to fireabout availability arms, this is the first to highlight the burden of non-fatal injuries using of firearms in the hospitalization data. According to patient history and the researchers, the data highlight counsel parents the toll of gun-related injuries that about the dangers extend beyond high-profile cases, of access to guns. and those children and adolescents who die before being hospitalized. Healthcare providers can play an important role in preventing firearm injuries through counseling about firearm safety, including safe storage. According to the 2013 American Academy of Pediatrics (AAP) policy statement on firearm injuries, among the pediatric population firearm injuries are one of the top 3 causes of death among American children and the cause of one in four deaths in adolescents ages 15 to 19 years (http://dx.doi.org/10.1542/peds.20122481). The researchers pointed to the AAP policy statement that the safest home for a child is a home without guns, and if there is a gun in the home, that it must be stored unloaded and locked, with the ammunition locked separately. The policy also suggested that the most effective way to prevent firearm injuries is to eliminate guns from homes and communities. The AAP recommended that healthcare providers should incorporate questions about availability of firearms in the patient history and counsel parents about the dangers of allowing access to guns. The researchers noted that
280 their results support the fact that firearm injuries contribute to health disparities, individually and in communities. Among all U.S. children and adolescents, males, Blacks and those receiving Medicare were at the highest risk of firearm related hospitalizations. These high rates of violence have wide-ranging effects on affected communities. The study did not discuss the longterm health of children and adolescents and did not provide data on the lasting effects from brain, spinal cord or other types or injuries, including the long-term impact of firearm-related injuries on psychological well being. The researchers also noted
D.L. McBride that the economic costs of firearm injuries, which incur the highest acute care costs of any childhood injury, $28,510 per patient, nearly double the costs of the next highest injury category (being struck by a motor vehicle, $15,566).
Reference Leventhal, J. M., Gaither, J. R., & Sege, R. (2014). Hospitalizations due to firearm injuries in children and adolescents. Pediatrics, 133, 219–225.
HOT TOPICS DEPARTMENT Editor: Deborah McBride MSN, RN, CPN, CPON, CCRN
Deborah McBride MSN, RN, CPN, CPON, CCRN
Hospitalizations for Firearm Injuries Prevalent Among Children Deborah L. McBride MSN, RN, CPN, CPON, CCRN ⁎ Kaiser Permanente Oakland Medical Center, Oakland, CA Received 7 February 2014; accepted 10 February 2014
ABOUT 20 CHILDREN per day in the United States are injured by firearms seriously enough to require hospitalization, and more than six percent of these children die from their injuries, according to a new study by Yale School of Medicine researchers and their colleagues. The new study analyzed data of children and adolescents under the age of 20 who had been admitted to a hospital in the United States in 2009 using the Kids' Inpatient Database, the most recent data available. The researchers found that 7,391 hospitalizations occurred as a result of firearm injuries, and 453 of these patients died while in the hospital (6.1%; Leventhal, Gaither, & Sege, 2014). Most of these hospitalizations occurred as a result of assaults (4,559), but in children younger than age 10, 75% of the almost 400 hospitalizations were due to unintentional or accidental injuries. Although suicide attempts accounted for the fewest hospitalizations (270), injuries from these most often resulted in inpatient death (35%). The researchers found that the most common types of firearms injuries included open wounds (52%), fractures (50%), and internal injuries of the thorax, abdomen or pelvis (34%). Traumatic brain injuries occurred most often in children younger than 5. Of all the hospitalizations, 89.2% occurred in males; the hospitalization rate for males was 15.22 per 100,000 and for females was 1.93 per 100,000. This gender difference was apparent even in young children. The rate for Black males was 44.77, a rate more than 10 times that of White males. Rates were highest for those aged 15 to 19 years. The researchers noted the significantly higher poverty rate for young Black males compared with young White males, but the data did not allow researchers to separate the effects of poverty from the effects of race. ⁎ Corresponding author: Deborah L. McBride. E-mail address: [email protected]. 0882-5963/$ – see front matter © 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.pedn.2014.02.003
Children who survived firearm injuries often needed extensive follow-up treatment after they were released from the hospital, including rehabilitation, home health care, hospital readmission from delayed effects of the injury and mental health or social services. Although a Healthcare provinumber of previous studies have ders should incorused vital statistics to examine porate questions pediatric fatalities related to fireabout availability arms, this is the first to highlight the burden of non-fatal injuries using of firearms in the hospitalization data. According to patient history and the researchers, the data highlight counsel parents the toll of gun-related injuries that about the dangers extend beyond high-profile cases, of access to guns. and those children and adolescents who die before being hospitalized. Healthcare providers can play an important role in preventing firearm injuries through counseling about firearm safety, including safe storage. According to the 2013 American Academy of Pediatrics (AAP) policy statement on firearm injuries, among the pediatric population firearm injuries are one of the top 3 causes of death among American children and the cause of one in four deaths in adolescents ages 15 to 19 years (http://dx.doi.org/10.1542/peds.20122481). The researchers pointed to the AAP policy statement that the safest home for a child is a home without guns, and if there is a gun in the home, that it must be stored unloaded and locked, with the ammunition locked separately. The policy also suggested that the most effective way to prevent firearm injuries is to eliminate guns from homes and communities. The AAP recommended that healthcare providers should incorporate questions about availability of firearms in the patient history and counsel parents about the dangers of allowing access to guns. The researchers noted that
280 their results support the fact that firearm injuries contribute to health disparities, individually and in communities. Among all U.S. children and adolescents, males, Blacks and those receiving Medicare were at the highest risk of firearm related hospitalizations. These high rates of violence have wide-ranging effects on affected communities. The study did not discuss the longterm health of children and adolescents and did not provide data on the lasting effects from brain, spinal cord or other types or injuries, including the long-term impact of firearm-related injuries on psychological well being. The researchers also noted
D.L. McBride that the economic costs of firearm injuries, which incur the highest acute care costs of any childhood injury, $28,510 per patient, nearly double the costs of the next highest injury category (being struck by a motor vehicle, $15,566).
Reference Leventhal, J. M., Gaither, J. R., & Sege, R. (2014). Hospitalizations due to firearm injuries in children and adolescents. Pediatrics, 133, 219–225.
