Anesthesia for a thoracic BB gun injury

Barely benign: The dangers of BB and other nonpowder guns

OBJECTIVE

To characterize the risks of nonpowder guns commonly used by children for recreation.

METHODS

We conducted a retrospective review of children ≤18 years of age treated for nonpowder gun injuries at a pediatric level I trauma center during 2013-2017. Demographics, injury characteristics, treatments, and outcomes were reviewed and analyzed using descriptive statistics.

RESULTS

Forty-six cases were identified; of these, 78% were male and the median age was 10 years (IQR 7-13). All guns were either ball-bearing or pellet guns. Eighty-five percent (38/46) of injuries were penetrating. The most common location was the head and neck (28%), followed by the anterior torso (26%) and eye (24%). Significant injuries that penetrated organs or body cavities occurred in 39% (18/46) and included subarachnoid hemorrhage; lung, liver, and kidney lacerations; pulmonary artery injury; and tracheal injury. Nine percent (4/26) were admitted to the intensive care unit, 37% (17/46) underwent surgery, and there were no deaths.

DISCUSSION

Injuries from recreational nonpowder guns such as ball-bearing or pellet guns can cause severe injuries in children. A thorough penetrating trauma workup should always be undertaken. Safety precautions should be taken when using these guns and access to young children should be restricted.

LEVEL OF EVIDENCE

Prognosis level IV.

Cardiac injury in child managed successfully in underprivileged hospital of Africa

Cardiac injuries are rare and the associated mortality is high. Their prognosis can be ameliorated by early diagnosis and management in a specialized hospital with appropriate resuscitation care. This report describes a case of cardiac penetrating injury in a child managed successfully in an underprivileged hospital of Africa.