In this episode, Sam Ashoo, MD interviews Rawad Rayes, MD and Eva Tovar Hirashima, MD, MPH – two of the authors of the August 2022 PEMP article on Pediatric Firearm Injuries to the Extremity: Management in the Emergency Department (https://www.ebmedicine.net/topics/trauma/pediatric-emergency-medicine-extremity-firearm-injuries).Episode Outline:How common are pediatric firearm injuries? What is the most common location of these injuries? Is there much literature published on this topic? Epidemiology * What’s been the trend in pediatric firearm injuries over the past 10 years? * Do we have any idea how/why these are occurring (ie, accidental, intentional, etc)Terminology: For those unfamiliar with firearms (table 1)Ballistics: Mechanisms of damage. Pre-hospital care* Trauma center transport* Prehospital hemorrhage control -- Combat application tourniquet, anything else? ED Evaluation* SIPA -- What is it and why use it? * Primary survey -- Tachycardia -> delayed cap refill -> hypotension in children? * Secondary Survey* Diagnostic Studies: * Damage Control Resuscitation* Wound Care -- Do we remove projectiles? Can they stay in? * Antibiotics * Joint Involvement* Compartment Syndrome -- 3 As vs 6 Ps* RhabdomyolysisControversies* CTA for all injuries? * Hemostatic devices -- Any role for these in the ED?