Doctors in Indianapolis discuss traumatic impacts of gunshot injuries on juveniles

Crime in Indianapolis

INDIANAPOLIS — Since the start of 2021, at least 70 children or teens have been injured in shootings in Indianapolis alone.

Two of those occurred within the last week, including one that left a teenage boy injured on the near north side, and a shooting on Indy’s east side, where two people were shot, including a 15-year-old boy.

We’ve previously shared the longterm physical and emotional impacts faced by survivors of gun violence and their families in the circle city and beyond, but what about the initial moments after the bullet is fired?

The injuries can be traumatic, life-changing and every second to get a victim to the hospital, especially when a young child or teen is involved, matters.

Doctors we spoke with said the implications of gunshot wounds on children and teens is not something to take lightly and they hope people people will not only think twice about resolving conflict with a gun, but also that it will encourage more conversations to happen on a community level.

“Our paramedics and our EMTs, fire department, they’ve had to respond to this dramatic increase in gun violence,” said Dr. Mark Liao, Medical Director for Indianapolis EMS.

“This past year, our first responders have faced so much difficulty with COVID-19 responding to just an increased number of calls and on top of it, these very traumatic injuries,” he added.

The same goes for Riley Hospital for Children and other trauma centers across the midwest, according to Dr. Matt Landman, Trauma Medical Director for Riley Hospital.

“We definitely saw a pretty marked increase of gun violence throughout our trauma centers,” he said.

“It’s not only the interpersonal violence, which does seem to have increased over the last year, but it’s also random shootings, drive-by shootings, and sadly suicide is a large volume of our patients that have suffered from gun violence,” Landman added.

The ugly and unseen truth for many is how violent a gunshot injury can be. It’s something medical professionals are seeing more often among children, including in the city of Indianapolis.

“The violence that a single bullet can inflict on a child is almost mind-boggling,” said Landman. “We’ve seen patients, particularly our smaller pediatric patients who’ve had you know, just entire abdomens that have been nearly destroyed from gunshot wounds.”

“If you take away the horrible mechanism by which it happened, you’re looking at these physical injuries and it’s an incredibly difficult process to try to put together the pieces if you will. Many times that occurs over the course of days and even weeks,” said Landman.

Landman credits the actions of EMS personnel, critical access hospitals and those who are responsible for providing immediate, life-saving medical care to the patients they see as they arrive at the hospital.

“For children in particular, we’re very concerned about how quickly we can get them to a pediatric trauma center,” said Liao. “Younger kids, they can compensate well initially, but they don’t have a lot of blood in them if they lose a lot of blood.”

Liao said, “As they respond to the scene, they’re thinking, what equipment do I need to bring on scene? Is it going to be tourniquets, does it need to be warm blankets? Do I need to start warming up my ambulance?”

He said when responding to a call involving a victim suffering from a gunshot wound, their priority is to stop any major hemorrhage, protect the patient’s airway and rapidly transport them to the hospital, with the goal to get off scene within 10 minutes of arriving.

Frequently, Liao said IEMS utilizes combat casualty equipment, but credits those on scene even before they arrive, for also helping save patient’s lives.

“Thankfully because of the police department applying tourniquets, they really are the ones saving a lot of lives applying the tourniquet first,” said Liao.

First responders, including EMS personnel racing against the clock to get patients to the hospital and then those working to save their lives as they arrive, are some of the people who see the worst impacts gun violence can have.

“In the past year, we’re only in November, we have essentially had 8 deaths, which doesn’t seem like a lot in our pediatric population, but if you look historically, that’s essentially 2018, 2019 and 2020 combined,” said Landman.

In 2021, Riley Hospital for Children, one of two level one pediatric trauma centers in Indianapolis, has treated 53 victims with gunshot wounds, including 8 who have died.

In 2020, during that same time period, there were 44 victims injured in shootings, including two who died. The previous year, there were 37 victims of gunfire in the same period, including one who died. In 2018, there were 29 victims treated at Riley Hospital for Children during the same time period, including five who died.

“The deaths are skyrocketing, sadly, and the number of patients that are injured and many are severely injured requiring a significant number of blood transfusions and operations and time spent in the ICU has also gone up,” said Landman.

Because of that, Landman said that also means even more difficult conversations with the families of victims — whether their injuries were due to interpersonal conflict, accidental, or self-inflicted.

“For the family, for the care team that’s tried to save a life, for our EMS colleagues, everyone suffers in some way but obviously the family bears the huge brunt of that,” said Landman.

“They have the physical aspects, but also the emotional impacts of recovering from that injury. It’s known that patients are going to have stress, PTSD down the road. It’s not something you put a cast on, and it goes away, it takes some time to get over it,” he said.

Not all patients treated for traumatic injuries at Riley Hospital for children are from the Indianapolis area, however.

“About half the patients that come to our trauma center are actually transfers from another medical center, whether it’s a separate trauma center or one of our critical access hospitals here in Indiana,” said Landman.

But that doesn’t change the fact that their team has seen more patients coming in with gunshot wounds in 2021, in fact, in only opens the conversation more to the impacts that increase is having.

“The need for blood right now is huge, not only because we’ve been using it more with violent injuries but also the number of donations are down,” said Landman. “I know it’s really hard to think about you know, how can I do something to affect a problem that seems somewhat overwhelming, but something as simple as giving blood – a blood donation – will help that next person and hopefully save a life.”

Landman and Liao said they hope the individuals committing acts of violence against others by using a gun, will consider the consequences and search for solutions that don’t involve children and teens losing their lives or suffering life-long impacts as a result of their injuries.

“Really when it comes to things like violence, we really need to try to get to the root of these things are try to get whoever’s out there who’s gonna perpetrate this somehow in touch with their local community,” said Landman. “As a surgeon it’s so hard to sit here in an operating room in a hospital to sort of preach that to someone, it really has to happen on a community level.”

He said he also hopes the conversation of safe gun storage and gun safety is something that families are willing to discuss, because they have also seen a number of teens die by suicide by using a gun.

“It’s all around us and no one sadly is immune to what can happen with gun violence,” said Landman.

Liao added, “Gun violence is a public health issue and one of the things I would encourage all of us to have an honest discussion about is how young people try to settle their complaints or frustrations. There is a better way today to resolve conflict and violence without having to reach for a handgun.”

“Using a handgun, you may not realize it, but it may have devastating consequences, things you did not intend. But the life that you take is something that is irreplaceable, “said Liao. “Human life is precious and we’re seeing that every single day in every family that grieves.”

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