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Abstract
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The room changes from hospital to hospital, but the ritual and purpose of The Quiet Room (1) is the same. "Your child did not make it. Your child is not going to make it. Your child will never be the same." Although we can never know the suffering of our patients' families, we grieve with them. As pediatric intensivists, we chose a field dedicated to caring for critically ill and injured children, and we find it unacceptable that our patients are dying preventable deaths. More than 3,000 families a year lose a child to gun violence and injury in the United States. It is the second leading cause of death for children in this country, and firearm deaths occur at a rate thirty times that in other high-income countries and five times that in low- and middle-income countries (2).
Gun violence prevention research has largely been stymied for the last two decades due to the Dickey Amendment, which stated "[n]one of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control" (3). Fortunately, although federal funding was unavailable, many private foundations and other organizations have continued to support this important research, so that although much work remains to be done, we do have a foundational knowledge of the problem and some means of addressing it. A recent study by Kamat et al (4) using the Pediatric Health Information System database looked at critical care resource use, cost, and mortality associated with firearm injuries. However, a huge knowledge gap still exists with respect to the burden of pediatric critical firearm injury.
When we searched the archives of Pediatric Critical Care Medicine for past publications on firearm violence, the "best matches" for firearm and gun were forearm and gut. But this is changing. In this issue of Pediatric Critical Care Medicine, Bagdure et al (5) provide a significant contribution to our knowledge of outcomes of children injured by firearms who were admitted to PICUs in the United States. The study by Bagdure et al (5) looked at data from 107 sites contributing to Virtual PICU Systems to evaluate mortality and functional status at discharge for surviving children using Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scores. Rates of mortality from firearm injuries are five times that of all-cause PICU mortality, and risks are not the same for all children. Although unintentional firearm injuries were the most common, suicide attempts by firearm carried the highest risk of mortality...
Language: en |