INDIANAPOLIS — The Centers for Disease Control and Prevention report firearm related injuries are the leading cause of death for Americans between the ages of 1 and 19.

In Indianapolis, the Riley Hospital for Children Emergency Department, the only Level One Pediatric Trauma Center in the state, has treated 220 child gunshot wound patients from across Indiana since the start of 2018.

The tally this year is 14, half of them wounded unintentionally.

In 2023, at least a dozen youngsters in Marion County have lost their lives to gunfire, two of them young children who suffered accidental self-inflicted wounds.

”There’s a lot easier jobs to do than be here in the middle of the night and take care of kids who are shot,” said Dr. Cory Showalter, interim division chief of Pediatric Emergency Medicine at Riley.

Showalter still recalls the first pediatric gunshot patient he worked on while in training more than a decade ago.

”This was just a pristinely healthy 15-, 16-year-old kid, had his whole future in front of him and despite 50 people doing all they could with all their training….no one could help this child, it was too late, and it was just a waste, just a terrible waste, this completely healthy person was shot and died despite all these people trying to help. That will never leave me.”

Last Friday a 5-year-old on North Kealing Avenue found a gun stuffed into a couch cushion after an adult left the room.

The child fatally wounded himself in the head.

Jahbar Hakiem Scott has been charged with Neglect of a Dependent Causing Death.

In April, a 5-year-old shot himself to death with a gun left behind by an adult who was at work that day.

In that case, the father was not charged.

In any case, when a pediatric gunshot victim is wheeled into the Riley ED for lifesaving treatment, tough conversations follow, especially with the child.

”Many times it is difficult to have that conversation ‘Why?’ because there’s not a great answer,” said Dr. Matthew Landman, Riley Trauma medical director. ”We really focus on this is what has happened to you, these are your injuries and understanding the process of healing but then giving them a sense of security. I think a lot of innocence and security is lost when something like this happens.”

”It’s much easier to prevent the injury that try to fix and treat the injury,” said Dr. Showalter, who finds families of young firearms victims often don’t think about gun safety in the home until their child is wounded. ”If you have an asthma attack and it smells like cigarettes in the room, that’s a really key moment to talk about smoke exposure for kids. I think that is something we push more on our primary care residents to talk about gun safety in the home just like you talk about proper feeding techniques and seat belts.

”It’s a high-impact moment to talk about key pieces of intervention that families can do.”

Dr. Landman said additional mental health services and conversations about gun safety could serve to reduce the firearms injury rate among his patients.

”Anyone who cares for kids or anyone who thinks about kids, whether you’re in the medical profession or not, certainly I’ve seen this epidemic of firearm injuries as disturbing.”