Barely benign: The dangers of BB and other nonpowder guns

Objective: To characterize the risks of nonpowder guns commonly used by children for recreation. Methods: We conducted a retrospective review of children ≤ 18 years of age treated for nonpowder gun injuries at a pediatric level I trauma center during 2013–2017. Demographics, injury characteristics, treatments, and outcomes were reviewed and analyzed using descriptive statistics. Results: Forty-six cases were identified; of these, 78% were male and the median age was 10 years (IQR 7–13). All guns were either ball-bearing or pellet guns. Eighty-five percent (38/46) of injuries were penetrating. The most common location was the head and neck (28%), followed by the anterior torso (26%) and eye (24%). Significant injuries that penetrated organs or body cavities occurred in 39% (18/46) and included subarachnoid hemorrhage; lung, liver, and kidney lacerations; pulmonary artery injury; and tracheal injury. Nine percent (4/26) were admitted to the intensive care unit, 37% (17/46) underwent surgery, and there were no deaths. Discussion: Injuries from recreational nonpowder guns such as ball-bearing or pellet guns can cause severe injuries in children. A thorough penetrating trauma workup should always be undertaken. Safety precautions should be taken when using these guns and access to young children should be restricted.