When a bullet meets a child’s body: Interview with a pediatric trauma surgeon

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COLUMBUS, Ohio (WCMH) — A gunshot wound in a child can be tiny, like a puncture wound, but with utter devastation on the inside.

During the pandemic, Dr. Jonathan Groner, a Pediatric Trauma Surgeon in an area hospital, estimates that gunshot injuries in kids have more than doubled. Most of those kids were shot in the home, a result of an improperly secured gun, he said.

“I’ve seen kids roll into the ER looking pale, and there’s a tiny little hole on the abdomen or chest, and they’re dying, actively. Their blood volume is leaking out, but it’s inside, so you can’t see it. That’s one thing that’s really dramatic and hard for people to understand.

The hole can be tiny — the size of the tip of my finger. But what goes on in the inside can be devastating.

“Another thing that strikes me is just how random it is. Two weeks ago I was on call and two kids were shot and they both weren’t injured, they just got grazed, by luck. Another kid can be shot with the same weapon and die.

We absolutely cannot fix brains.

“One thing we absolutely cannot fix are brains. When kids get shot in the head, they almost always die. We have really good neurosurgeons, and they will look at you, and you’ll show them the scans, but if the bullet passed through both sides of the brain they will say ‘there’s nothing to do. They are going to die.’ We absolutely cannot fix brains.

“If someone comes in and they have two holes, it doesn’t mean the bullet travelled in a linear path from one side to the other. Frequently it can hit bone, it can shatter. Our job as surgeons is to try to find everything that’s hurt, because if you miss one little thing, the patient dies. You can fix nine holes in the intestine, but if there’s a tenth hole and you miss it, patient dies. It’s really hard, very demanding surgery, and it’s very easy for patients to bleed to death.

Pediatric Damage Control…Sometimes the damage is so bad you can’t fix it in one sitting, and you plug holes….

“There’s a whole field of surgery called Damage Control, that started with taking care of people who got shot, and there’s a subset of the field called Pediatric Damage Control which is taking care of kids who’ve been shot because sometimes the damage is so bad you can’t fix it all in one sitting, and you kind of plug holes, and then next day and do more operations and the next day do more operations. I can be really devastating.

“I had a child who spent one year after being shot on the East Side, one year in the hospital. And when he got out, the family left the city for [another city]..it’s hard for the child to go back into the same community.

Bullets move at the speed of sound.

“Just in terms of injuries, it’s devastating. Tiny little marks on their skin, tiny little holes, but devastated on the inside. That’s the hard part to remember. What can look benign on the outside will be terrible on the inside.

“I will say because of the injuries they sustain, you internal organs don’t hurt, there aren’t pain fibers in those organs. A puncture wound on the skin, and they are bleeding inside. People walk in and try to die immediately… to be in shock in minutes.

“Children who are shot are victims of kinetic energy. Bullets move at almost the speed of sound. That energy gets off loaded into tissues as it moves through. Children have less protection on the outside and those shock waves occur as bullets pass through organs, and that’s why they die.

Most of the kids I take care of have been shot inside the home, but there is a huge halo effect. Violence begets violence.

“People were hoping that the pandemic will quiet things down, less social interaction, actually the opposite is true. From the start of the pandemic, compared to the same period [in 2019] firearm injuries have more than doubled, close to tripled. The pandemic has been very bad for pediatric firearm trauma — for children.

“The city has tried to focus on gang violence which I applaud…but the kids that I see are not always shot in these group violence situations. But there’s a halo effect. If people are worried about their safety, they go to the gunshop.

“They carry the gun, and leave them in a drawer. Not every kid I take care of is a victim of violence on the streets. Most of the kids I take care of have been shot inside the home, but there is a huge halo effect — violence begets violence.”

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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