Emergency Trauma Anesthesia Care and Outcomes in Pediatric Firearm and Nonfirearm Injuries: 9-Year Experience From a Regional US Level 1 Trauma Center
Authors' conclusion
Pediatric trauma patients required high intraoperative therapeutic intensity, which was higher during firearm injury anesthesia care. Postoperative firearm injury mortality was high but less than from nonfirearm injury. Firearm injury patterns, anesthesia care and outcomes varied by age group.
Study context
- Population
- Injured patients <18 years admitted to a regional level 1 US pediatric trauma center 2014–2022 receiving anesthetic care within 2 hours of arrival
- Participants
- 266 trauma admissions
- Exposure
- Firearm vs nonfirearm injuries
- Firearmn = 69
- Outcome
- Anesthesia care and therapeutic intensity
Methodological detailssingle-centre, level 1 pediatric trauma center
- Single-centre
- Level 1 pediatric trauma center
Main finding
As reported in the abstract
- Time to anesthetic care shorter in firearm group
- P < .001
- Arterial cannulation more common in firearm group
- P < .02
- Estimated blood loss greater in firearm group
- P < .001
- Massive transfusion more common in firearm group
- P < .0001
- Etomidate use more common in firearm group
- P = .01
- Midazolam use more common in firearm group
- P < .01
- TXA use more common in firearm group
- P < .01
- Larger crystalloid resuscitation in firearm group
- P < .0001
Observational data: associations, not effects.
Further findings
Polytrauma
Mortality
- Intraoperative mortality, Firearm vs Nonfirearm
- 1% and 2%
- Mortality after first anesthetic, Firearm vs Nonfirearm
- 6% vs 10%
ICU and hospital LOS
- ICU LOS longer in firearm group
- P < 0.01
- Hospital LOS longer in firearm group
- P < 0.01
Patient characteristics
- Firearm patients older
- P < 0.0001
- Fewer American Society of Anesthesiologists (ASA) physical status I in firearm group
- P = 0.03
- More ISS 16-25 injuries in firearm group
- P < 0.01
- Firearm patients under 10 years
- 6 (8.8%)
Original publication
Emergency Trauma Anesthesia Care and Outcomes in Pediatric Firearm and Nonfirearm Injuries: 9-Year Experience From a Regional US Level 1 Trauma Center. Anesth Analg. Published 4 August 2025. doi:10.
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