Trends in EMS encounters and outcomes among children and adolescents with firearm injuries from 2018 to 2022.

Objective: To describe changes in patient and encounter characteristics among Emergency Medical Services (EMS) responses for patients ages 0-19 with firearm-related injuries.

Methods: This retrospective national analysis used data from the 2018-2022 ESO Data Collaborative and included all 9-1-1 records for patients ages 0-19 years with documentation of firearm-related injuries. Percent changes are reported; annual changes were evaluated using a non-parametric test of trend.

Results: Among 7913 total EMS encounters from 586 agencies, median age was 16 years and 82 % were male. 9-1-1 call volume increased 8 % over the study period while firearm injuries increased by 79 % (p-trend<0.01), peaking in 2021 (n = 2036). Assault was the most documented intent category across all years (96 % total increase). Black and Hispanic patients experienced the largest percent increase (86 %, 110 %). Most encounters occurred in communities of the greatest socioeconomic vulnerability (57 %). Overall, 10 % of patients died on-scene; among those transported with outcome data (n = 1514), 9 % died.

Conclusions: We observed a continued upward trend in EMS encounters for firearm injuries among children and adolescents between 2018 and 2022. Injury burden disproportionately impacted minorities and socioeconomically vulnerable communities.