title: Nonpowder firearms cause significant pediatric injuries.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Epidemiologic study, level V.
authors.affiliation: From the Department of Pediatric Surgery, Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Michelle
authors.initials: M
authors.lastname: Veenstra
authors.forename: Jai
authors.initials: J
authors.lastname: Prasad
authors.forename: Heather
authors.initials: H
authors.lastname: Schaewe
authors.forename: Lydia
authors.initials: L
authors.lastname: Donoghue
authors.forename: Scott
authors.initials: S
authors.lastname: Langenburg
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D010988:Play and Playthings / Q000293:injuries*; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D014193:Trauma Centers; D014754:Violence / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000453:epidemiology* / Q000473:pathology