Fatal laryngeal oedema in an adult from an air rifle injury, and related ballistics

Targeting safety: Exploring trends and risk factors in pediatric head and neck BB gun injuries and hospitalization

OBJECTIVE

To examine head and neck injuries caused by BB (Ball Bearing) guns treated in US emergency departments among children under 18 to identify trends in injury frequency over time and risk factors associated with severe injuries leading to hospital admission.

METHODS

This retrospective study utilized data from the National Electronic Injury Surveillance System (NEISS), a single database, to analyze head and neck injuries caused by BB guns between 1993 and 2019. The analysis explored demographic characteristics and injury patterns, including sex, age, incidence, injury location, hospital type, and disposition. Linear regression was employed to assess trends in the yearly frequency of injuries, while univariate and multivariate binary logistic regression was used to calculate the odds ratios associated with hospitalization.

RESULTS

A total of 4041 cases of pediatric head and neck injuries caused by BB guns and treated in US emergency departments were identified. Most patients were male (84 %), with the highest proportion of injuries occurring in the 10-14 age group (49.7 %). The face (35.8 %) and eye (27.4 %) were the most affected injury sites, and 7.5 % of patients required hospital admission. No significant linear trend was observed in injury frequency over the study period. However, children aged four and under had higher odds of hospitalization (OR 2.77, 95 % CI 1.61-4.75) despite a lower incidence of injuries. Injuries to the eye (OR 12.37, 95 % CI 8.31-18.43) and neck (OR 7.58, 95 % CI 4.76-12.06) were strong predictors of hospital admission.

CONCLUSION

Pediatric BB gun-related head and neck injuries remain a source of emergency room visits nationally. Younger children are at increased risk of admission to the hospital. Eye and neck injuries were the strongest predictors of hospital admission. Implementing safety precautions for younger children is crucial, as injuries might be more severe in this age group.

Variable Mechanisms of Sudden and Unexpected Death in Cases of Occult Carcinoma of the Larynx

ABSTRACT

Two cases of clinically undiagnosed laryngeal squamous cell carcinomas in men aged 57 and 66 years, respectively, are reported that resulted in sudden death from upper airway occlusion. The cause of the terminal event differed between the 2 cases with acute airway narrowing being precipitated by tenacious mucopurulent secretions in case 1 and hemorrhage from surface ulceration with glottic occlusion by blood clot in case 2. At autopsy, the immediate cause of acute airway compromise in cases of space-occupying laryngeal lesions may, therefore, be due to the synergistic effects of different factors.

Brain death of an infant caused by a penetrating air gun injury

Air guns are shooting projectiles (pellets) from the expansion of compressed air without involving any chemical reactions. Air guns are often regarded as harmless by the public, but these weapons can produce severe, sometimes lethal injuries, especially in children. A case of a penetrating head injury of an eleven-month-old infant, caused by an ordinary air gun pellet, is presented. The air gun pellet created an exceptionally severe brain injury, and brain death. The factors influencing the severity of air gun injuries - muzzle velocity, muzzle energy, skull thickness - are discussed.

Laparoscopic retrieval of an intra-abdominal air gun pellet

A 19-year-old man presented to the emergency department following an air gun pellet injury to the abdomen. He was clinically stable and underwent laparoscopic retrieval of the pellet, which was found embedded in the small bowel mesentery. He recovered fully and was discharged after 2 days. We further discuss air gun-related injuries.