Gunshot wounds in the PICU

Unfortunately my PICU colleagues and I sometimes care for children with gunshot wounds. It isn’t common, but it isn’t infrequent, either. In my experience, most of these are to the head, and most cause death or disability. Although gang-related violence occasionally affects adolescents, and thus our PICU practice, the majority of these wounds are accidental. The typical scenario is a child playing with a loaded gun, which then accidentally goes off. Less commonly, but still something I see, is a suicide attempt by a troubled adolescent, usually a boy.

There has been a great deal of research on the epidemiology of gunshot wounds, the best of which treats the problem as it would any other public health problem. You can read a good summary of that research here, although the article is by a person who favors some sort of gun control laws.

The root of the legislative debate about gun control concerns the meaning of the Second Amendment to the Constitution. Depending upon your politics, it either does or does not protect an individual citizen’s right to own guns for personal use. The best discussion of the legal ramifications I have seen is here, where a legal scholar examines both sides of the debate and concludes the arguments are nearly equally matched — both sides have valid positions. Thus, although partisans on both sides see their view as clearly correct, neither is.

For myself, although I grew up owning and using guns to hunt, I am convinced that a gun in the household makes it a more dangerous place for children, not a safer one.