Missing the target: a comparison of buyback and fatality related guns.
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OBJECTIVES: To determine whether the firearms recovered in buyback programs in a large urban community are the types most closely associated with firearm fatalities in the same geographic area. METHODS: The type, caliber, and manufacturer of 941 handguns recovered in Milwaukee County 1994-96 buyback programs were compared with 369 homicide related and 125 suicide related handguns used in Milwaukee during 1994-97. RESULTS: Buyback handguns differed substantially from those used in homicide and suicide. One third of buyback handguns were semiautomatic pistols versus two thirds of homicide related handguns (p<0.001) and 40% of suicide related handguns (p=NS). Over 75% of buyback handguns were small caliber compared with 24% of homicide and 32% of suicide handguns (p<0.001). The top two manufacturers of buyback handguns represented 30% of these guns but only 5% of fatality related handguns (p<0.001). Companies currently out of business manufactured 15% of buyback handguns versus 7% of fatality related handguns (p<0.001). CONCLUSIONS: Handguns recovered in buyback programs are not the types most commonly linked to firearm homicides and suicides. Although buyback programs may increase awareness of firearm violence, limited resources for firearm injury prevention may be better spent in other ways. (+info)
Risk factors associated with non-fatal adolescent firearm injuries.
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STUDY OBJECTIVES: To identify behavioral, environmental, and sociodemographic risk factors associated with non-fatal firearm injuries among inner city adolescents in the United States. DESIGN: A case-control study in which patients with firearm injury serve as cases and those with medical conditions serve as controls. SETTING: A level I trauma center in a metropolitan area serving a predominately lower socioeconomic status population. PARTICIPANTS: Cases were 45 consecutive patients 11-18 years presenting to the emergency department with non-fatal firearm injury; controls were 50 age and gender matched patients presenting with acute medical problems. OUTCOME MEASURE: Odds ratios (OR) and associated 95% confidence interval (CI) as estimates of the magnitude of association between risk factors and non-fatal firearm injury. RESULTS: After adjusting for age, gender and socioeconomic status, multivariate analysis identified four risk factors independently associated with firearm injury: living with less than two parents (OR 3.8, 95% CI 1.2 to 12.2), skipping class (OR 7.1, 95% CI 1.7 to 28.9), previous arrest (OR 6.2, 95% CI 1.9 to 20.7), and being African-American (OR 4.2; 95%CI 1.4 to 14.9). CONCLUSION: Risk factors for adolescents sustaining a non-fatal firearm injury are sociodemographic and environmental, not just behavioral. Thus interventions that foster protective and supportive environments may help prevent firearm injuries. (+info)
An unusual case of birdshot embolism.
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There are numerous cases of arterial and venous bullet embolism to the heart. An unusual case of birdshot embolus to the right ventricle from the femoral vein caused diagnostic confusion. Distant migration of the foreign bodies via blood vessels has to be taken into consideration after gunshot wounds. (+info)
Aiming for prevention: medical and public health approaches to small arms, gun violence, and injury.
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The level of global small arms violence is enormous and the scale of human suffering it causes is immense, although poorly counted. It causes at least hundreds of thousands of deaths and more than a million injuries each year, as well as permanent physical and psychological damage, destruction of families, lost productivity, and diversion of resources from basic health services. Research is required on three basic issues, as follows: health effects of weapons; the contributing factors and causes, including behavioral issues; and impacts of interventions and their cost-effectiveness. Policies and programs designed to reduce the human and social impacts of small arms should make use of public health knowledge and analysis of risk factors as a means of bringing increased focus and effectiveness to their objectives. At its international conference on small arms, gun violence, and injury, "Aiming for Prevention" in Helsinki in September 2001, International Physicians for the Prevention of Nuclear War called on health professionals as well as scientists, activists, humanitarian and development workers to contribute to an effective confrontation of the small arms pandemic. (+info)
Evaluation of community based intervention for the protection of children from small arms and explosive devices during the war: observational study.
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AIM: To evaluate the influence of a community-based intervention aimed at reducing the risk of unintentional injuries caused by small arms and explosive devices accessible to children during the 1991-1995 war in Croatia. METHOD: From May 5 to June 15 in 1994 and 1995, we performed a cross-sectional survey on exposure of the children in Croatia to different small arms and explosive devices, using specially prepared questionnaires. The survey was conducted in Dubrovnik-Neretva and Karlovac counties, where community-based intervention was carried out, and Lika-Senj and Sisak-Moslavina counties, where only national intervention was implemented. The sample included a total of 5,317 parents and 2,581 children. The response rate was 98%. All participants were asked to give answers according to current situation. RESULTS: Approximately a third of children in the counties without community-based intervention and a fifth in the counties with community-based intervention could access small arms and explosive devices at home. Boys were more exposed than girls (p=0.001). In the communities with community-based intervention, children were less exposed to the devices, such as small-arms, hand grenades, and explosives, which were the main cause of injuries. In 1994, parents in counties without community-based intervention handled weapons in front of their children in 45% cases vs 31% of those in the counties with community-based intervention (p<0.001). In 1995, the percentages were 44 and 32, respectively (p<0.001). CONCLUSION: Although it is impossible to quantify the exact amount of risk reduction due to health intervention alone, community-based intervention reduced the exposure of children to weapons. (+info)
Spontaneous subfalcial transcallosal migration of a missile to the contralateral hemisphere causing deterioration in neurological status--case report.
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A 26-year-old man sustained a gunshot injury. Computed tomography (CT) demonstrated the missile in the right parietal region. Twenty-four hours later, the missile had moved towards the midline. Following slight deterioration in his neurological condition one week later, follow-up CT revealed that the missile had crossed the midline through the corpus callosum and was located in the left parietal region. CT during the second week demonstrated that the missile had stopped close to the left parietal bone. Spontaneous migration of a missile to the contralateral side via a subfalcial-transcallosal route with deterioration in neurological status is unusual. The missile may have moved under the influence of the intracranial pressure and pulsatile effect of the cerebrospinal fluid. (+info)
Aide memoire for the management of gunshot wounds.
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The hospitals in Johannesburg deal with about 4,000 gunshot wounds a year. Although most are from hand guns, a number are from high velocity, military-type weapons. Extensive experience has been built up and many lessons learned. Attention is directed to the actual damage inflicted rather than on theoretical predictions based on presumed velocity of the bullets involved, as this can often be misleading. Some patients are delayed in their presentation to emergency departments, in other cases several gunshot wound patients arrive at the same time, requiring appropriate triage and urgent management. (+info)
Trends in BB/pellet gun injuries in children and teenagers in the United States, 1985-99.
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OBJECTIVE: To characterize national trends in non-fatal BB/pellet gun related injury rates for persons aged 19 years or younger in relation to trends in non-fatal and fatal firearm related injury rates and discuss these trends in light of injury prevention and violence prevention efforts. SETTING: The National Electronic Injury Surveillance System (NEISS) includes approximately 100 hospitals with at least six beds that provide emergency services. These hospitals comprise a stratified probability sample of all US hospitals with emergency departments. The National Vital Statistics System (NVSS) is a complete census of all death certificates filed by states and is compiled annually. METHODS: National data on BB/pellet gun related injuries and injury rates were examined along with fatal and non-fatal firearm related injuries and injury rates. Non-fatal injury data for all BB/pellet gun related injury cases from 1985 through 1999, and firearm related injury cases from 1993 through 1999 were obtained from hospital emergency department records using the NEISS. Firearm related deaths from 1985 through 1999 were obtained from the NVSS. RESULTS: BB/pellet gun related injury rates increased from age 3 years to a peak at age 13 years and declined thereafter. In contrast, firearm related injury and death rates increased gradually until age 13 and then increased sharply until age 18 years. For persons aged 19 years and younger, BB/pellet gun related injury rates increased from the late 1980s until the early 1990s and then declined until 1999; these injury rates per 100 000 population were 24.0 in 1988, 32.8 in 1992, and 18.3 in 1999. This trend was similar to those for fatal and non-fatal firearm related injury rates per 100 000 which were 4.5 in 1985, 7.8 in 1993, and 4.3 in 1999 (fatal) and 38.6 in 1993 and 16.3 in 1999 (non-fatal). In 1999, an estimated 14 313 (95% confidence interval (CI) 12 025 to 16 601) cases with non-fatal BB/pellet gun injuries and an estimated 12 748 (95% CI 7881-17 615) cases with non-fatal firearm related injuries among persons aged 19 years and younger were treated in US hospital emergency departments. CONCLUSIONS: BB/pellet gun related and firearm related injury rates show similar declines since the early 1990s. These declines coincide with a growing number of prevention efforts aimed at reducing injuries to children from unsupervised access to guns and from youth violence. Evaluations at the state and local level are needed to determine true associations. (+info)