儿童 firearm 伤害： firearm 安全教育的错失机会。
Firearm injuries in children: a missed opportunity for firearm safety education.
机构信息
Department of Surgery, University of California Davis Medical Center, Sacramento, California, USA
Department of Surgery, University of California Davis Medical Center, Sacramento, California, USA.
出版信息
Inj Prev. 2021 Dec;27(6):554-559. doi: 10.1136/injuryprev-2020-044051. Epub 2021 Jan 12.
BACKGROUND
Surgeons frequently care for children who have sustained gunshot wounds (GSWs). However, firearm safety education is not a focus in general surgery training. We hypothesised that firearm safety discussions do not routinely take place when children present to a trauma centre with a GSW.
METHOD
A retrospective review of patients <18 years presenting with GSWs to a level 1 paediatric trauma centre from 2009 to 2019 was performed. The primary outcome was discussion of firearm safety with the patient or family. The secondary outcome was notification of child protective services (CPS).
RESULTS
A total of 226 patients with GSWs were identified, 22% were unintentional and 63% were assault. Firearm safety discussions took place in 10 cases (4.4%). Firearm safety discussions were more likely to occur after unintentional injuries compared with other mechanisms (16.0% vs 1.3%, p<0.001). CPS was contacted in 29 cases (13%). CPS notification was more likely for unintentional injuries compared with other mechanisms (40% vs 3.9%, p<0.001) and for younger patients (7 years vs 15 years, p<0.001).
CONCLUSION
At a paediatric trauma centre, firearm safety discussions occurred in 4.4% of cases of children presenting with a GSW. There is a significant room for improvement in providing safety education interventions.
背景
外科医生经常照顾遭受枪伤（GSW）的儿童。然而，在普通外科培训中，枪支安全教育并不是重点。我们假设当儿童因 GSW 到创伤中心就诊时，不会经常进行枪支安全讨论。
方法
对 2009 年至 2019 年期间在一级儿科创伤中心就诊的 18 岁以下儿童进行回顾性研究。主要结局是与患者或家属讨论枪支安全。次要结局是通知儿童保护服务机构（CPS）。
结果
共确定了 226 例 GSW 患者，22%为非故意，63%为袭击。10 例（4.4%）进行了枪支安全讨论。与其他机制相比，非故意损伤后更有可能进行枪支安全讨论（16.0%比 1.3%，p<0.001）。29 例（13%）通知了 CPS。与其他机制相比，非故意损伤更有可能通知 CPS（40%比 3.9%，p<0.001），而且年龄较小的患者（7 岁比 15 岁，p<0.001）也更有可能通知 CPS。
结论
在儿科创伤中心，因 GSW 就诊的儿童中，有 4.4%的儿童进行了枪支安全讨论。在提供安全教育干预措施方面还有很大的改进空间。
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