• Alison Treichel, Remle P Crowe, Antonio R Fernandez, Scott S Bourn, and Brent J Myers.
• ESO, Inc, Austin, TX, United States of America. Electronic address: Alison.treichel@eso.com.
• Am J Emerg Med. 2025 Jan 3; 90: 556055-60.

ObjectiveTo describe changes in patient and encounter characteristics among Emergency Medical Services (EMS) responses for patients ages 0-19 with firearm-related injuries.MethodsThis 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.ResultsAmong 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.ConclusionsWe 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.Copyright © 2025. Published by Elsevier Inc.

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