Firearm Homicide and Suicide During the COVID-19 Pandemic

Patterns in Location of Death From Firearm Injury in the US

“…The increase in firearm death rates in the US has been attributed to many factors, including higher gun sales, social isolation during the COVID-19 pandemic, and lack of new federal firearm legislation. 1 Studies suggest that both the risk and lethality of firearm injuries have increased, partly due to larger magazine capacity and growing use of high-caliber weapons. [2][3][4][5] Location of death after traumatic injury informs resource organization for both treatment and prevention.…”

Prehospital Needle Decompression Should Not Be Compared With Trauma Center Chest Tube Placement

“…To the Editor We read with great interest the recent article by Muchnok et al 1 reporting that prehospital needle decompression (PHND) was associated with lower 24-hour mortality compared with emergent trauma center chest tube placement in trauma patients. While we fully agree with the authors that PHND is a rare potentially lifesaving procedure, we believe that their results interpretation require some comments.…”

“…Respiratory rate is also affected by the underlying pH status, ie, acidemia induced by the shock status, irrespective of its origin. 2 As underlined by Muchnok et al, 1 prehospital diagnosis of patients needing PHND is not easy, all the more so if the pneumothorax is small and without immediate clinical repercussions, eg, respiratory distress, hypoxemia, and/or obstructive shock. The study by Muchnok et al 1 does not specify the indications of tube thoracostomy insertion, all pneumothorax independently of its size, or only pneumothorax with clinical impact, which may limit their results interpretation.…”

“…2 As underlined by Muchnok et al, 1 prehospital diagnosis of patients needing PHND is not easy, all the more so if the pneumothorax is small and without immediate clinical repercussions, eg, respiratory distress, hypoxemia, and/or obstructive shock. The study by Muchnok et al 1 does not specify the indications of tube thoracostomy insertion, all pneumothorax independently of its size, or only pneumothorax with clinical impact, which may limit their results interpretation. Prehospital time duration in the study was relatively short, less than 45 minutes in both groups, reflecting the US prehospital emergency service organization.…”

“…In Reply We appreciate the interest of Jouffroy and Vivien in our study. 1 Given the reported failure rates and complications of prehospital needle decompression (PHND), the value of the intervention has been questioned. 2,3 Thus, we sought not to provide another detailed description in a case series but investigate in one of the largest populations undergoing PHND whether there is a potential outcome benefit to support further refinement and advancement of this technique.…”