Pediatric Firearm Injuries to the Extremity

<p>In this episode, Sam Ashoo, MD interviews Rawad Rayes, MD and Eva Tovar Hirashima, MD, MPH – two of the authors of the August 2022 PEMP article on <a href="https://www.ebmedicine.net/topics/trauma/pediatric-emergency-medicine-extremity-firearm-injuries">Pediatric Firearm Injuries to the Extremity: Management in the Emergency Department</a>.</p><p></p><p>Episode Outline:</p><p>How common are pediatric firearm injuries? </p><p>What is the most common location of these injuries? </p><p>Is there much literature published on this topic?</p><p> </p><p>Epidemiology </p><ul><li>What’s been the trend in pediatric firearm injuries over the past 10 years? </li><li>Do we have any idea how/why these are occurring (ie, accidental, intentional, etc)</li></ul><p>Terminology: For those unfamiliar with firearms (table 1)</p><p>Ballistics: Mechanisms of damage. </p><p>Pre-hospital care</p><ul><li>Trauma center transport</li><li>Prehospital hemorrhage control -- Combat application tourniquet, anything else? </li></ul><p>ED Evaluation</p><ul><li>SIPA -- What is it and why use it? </li><li>Primary survey -- Tachycardia -&gt; delayed cap refill -&gt; hypotension in children? </li><li>Secondary Survey</li><li>Diagnostic Studies: </li><li>Damage Control Resuscitation</li><li>Wound Care -- Do we remove projectiles? Can they stay in? </li><li>Antibiotics </li><li>Joint Involvement</li><li>Compartment Syndrome -- 3 As vs 6 Ps</li><li>Rhabdomyolysis</li></ul><p>Controversies</p><ul><li>CTA for all injuries? </li><li>Hemostatic devices -- Any role for these in the ED? </li></ul>