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. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.