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Wounding Patterns in Fatal and Nonfatal Pediatric Firearm Injuries
Mary Matecki1, Matthew Walker1, John Corbett1
1Department of Surgery, George Washington University School of Medicine and Health Sciences, Center for Trauma and Critical Care, Washington, DC.
Pediatric Emergency Care
|February 17, 2026
Summary
Pediatric firearm deaths are primarily caused by severe brain injuries. Preventing gunshot wounds (GSWs) is the most effective strategy to reduce child mortality from these injuries.
Area of Science:
- Trauma Surgery
- Pediatric Critical Care
- Forensic Pathology
Background:
- Gunshot wounds (GSWs) represent a significant cause of mortality in children.
- Understanding pediatric firearm injury patterns is crucial for identifying potential for survival.
Purpose of the Study:
- To define pediatric firearm wound patterns and fatal organ injuries.
- To identify factors influencing the salvageability of pediatric GSWs.
Main Methods:
- Analysis of GSW patients aged 14 and younger (2011-2021) from a pediatric trauma center and medical examiner data.
- Comparison of wound locations and fatal organ injuries between survivors and nonsurvivors.
- Correlation of injury patterns with adult GSW data.
Main Results:
- 165 patients analyzed; 90% were survivors.
- Nonsurvivors had significantly more head wounds (71% vs. 9%) and brain injuries (71% vs. 3%).
- Survivors predominantly sustained extremity wounds (68% vs. 12%), with no deaths from peripheral vascular injury.
Conclusions:
- Pediatric firearm fatalities are predominantly linked to nonsurvivable brain injuries.
- Injury prevention is the most critical approach to reducing child mortality from GSWs.
- Further research is needed to validate these findings in diverse populations and settings.
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