Airgun Injuries— Is More Education Needed?
Airgun Injuries Is More Education Needed?
ABSTRACT & COMMENTARY
Synopsis: Pediatric injuries resulting from air gun use usually involve head and neck injuries or fatalities. More regulations are called for concerning air gun purchase and use.
Source: Bratton SL, et al. Serious and fatal airgun injuries: More than meets the eye. Pediatrics 1997;100:609-612.
In an effort to better define the epidemiology of pediatric air gun injuries, Bratton and associates from Seattle, Cincinnati, and Kansas City retrospectively reviewed the records of children hospitalized at their institutions for such injuries between January 1989 and September 1996. A total of 101 children ranging in age from 0.5 to 18.8 years (median, 10.9 years) were identified; 81% were males. In 76% of the cases, the identity of the shooter could be determined from the chart. In 51 instances, the shooter was either a friend or a sibling. Twelve patients shot themselves11 unintentionally and 1 deliberately (an adolescent who committed suicide). Five instances were identified in which the patient was a victim of assault.
Hospital stays ranged from one to 17 days (median, 3 days), and 15 children required admission to an intensive care unit. The majority of the injuries involved head and neck injuries (63 total), with 38 ocular injuries, 11 intracerebral/skull injuries, and 14 neck injuries. The remainder of the injuries involved either the chest (15), abdomen (19), or extremities (6). The severity of the injuries was striking; 8 children suffered intracerebral hemorrhage, with the pellet crossing the midline of the brain and damaging both hemispheres in four cases. Included among the chest injuries were a laceration of the innominate artery with hemorrhagic shock, a pericardial and an intracardiac foreign body, and three pneumothoraces. The abdominal wounds included nine bowel lacerations and three liver lacerations. Fifty-six children required surgical interventions either to treat the injury sustained or for pellet removal. Three deaths occurred, all from intracranial injury. One death was that of an adolescent with a deliberately self-inflicted injury. A 2 year old and a 7 year old also died, both of unintentional injuries. Two other children had residual neurological deficits. Twenty-five (66%) of the 38 children with ocular wounds suffered permanent visual loss, with 15 left with complete blindness in the injured eye. The children with injuries to the chest, abdomen, or extremities all recovered uneventfully.
In their discussion, Bratton et al present data regarding the muzzle velocities produced by air guns, which can range from 250 to 900 feet/sec depending on the mechanism of air propulsion. The higher muzzle velocities overlap with those produced by lower caliber conventional firearms. Given that the impact velocity required to penetrate the human eye is only 130 feet/sec and skin and soft tissue penetration occurs at velocities as low as 330 feet/sec, it is not surprising that injuries as severe as those described in this study can occur. In their closing statements, Bratton et al point out that national and state regulations for air guns are minimal, other than for a voluntary statement advocating adult supervision for children under age 16 years and some restrictions regarding purchase by minors.
COMMENT BY DAVID T. BACHMAN, MD
Just a few weeks back, I treated an adolescent girl whose older brother unintentionally shot her in the head with a pellet rifle while they and several other children were playing in her bedroom. The pellet only penetrated her scalp and could be easily palpated in the subcutaneous tissue in her right temporal region. Certainly, she was more fortunate than many of the children described by Bratton et al, several of whom died and many more of whom sustained permanent visual or brain injury. As striking as the severity of the injuries reported are the data regarding the muzzle velocities generated by many of the air guns available these days and the paucity of regulations and standards on air gun manufacture, purchase, and use.
Air guns are not toys but are still regarded by many people as relatively harmless and, so, are suitable for unsupervised use by children and adolescents. Information regarding the severity of the injuries they can produce is not lacking. What is needed now is a more concerted effort to educate the public as to the dangers inherent in air gun use by children as well as to encourage national regulations. Much credit should be given to Bratton et al for providing data that support the need for education and reporting about air gun injuries.
Injuries from airguns:
a. are often inflicted by persons unknown to the victim.
b. most frequently involve the hand or extremities.
c. are influenced by muzzle velocity of the projectiles.
d. rarely produce permanent damage.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.