**Introduction** Blunt or penetrating thoracoabdominal firearm trauma necessitates a multi-disciplinary approach in the acute and long-term settings. We report an accidental self-inflicted gunshot wound to the upper abdomen resulting in a perforated inferior vena cava (IVC), shattered thoracic vertebrae, perforated stomach, duodenum, and jejunum, spinal cord injury with lower extremity paraplegia, nutritional intolerance, and severe emotional distress. **Case Description** A 2-year-old presented to the emergency department in hemorrhagic shock after an accidental self-inflicted gunshot wound through the abdomen, necessitating an emergent exploratory laparotomy and massive transfusion protocol. The child was admitted to the PICU, initially requiring central and arterial line placements, intubation, vasopressors, and post operative antibiotics. During this stay, the child regressed to a mostly non-verbal state and was clearly distressed by medical attention without a mature coping mechanism to alleviate fear. The child developed traumatic rhabdomyolysis, pancreatitis, and hemiplegia of the left leg due to L3/L4 vertebral fractures with bone fragments in the left side of the spinal canal. The child's IVC injury resulted in significant lymphedema with pressure ulcers in the lower extremities, and an intolerance of oral feeds resulted in ultimate dependence on Jejunostomy tube feeds for nutrition. After a 20-day hospital stay, the child was discharged to a pediatric rehabilitation center with significant improvement in stability and movement. The child's extensive inpatient care team prioritized presenting to the parents as a unified front to minimize confusion and ongoing trauma associated with unclear expectations and advancements of care. Nurses worked to coordinate care with physicians to minimize interruptions and avoid unnecessary emotional distress. With DHS involvement, the child's parents were allowed to remain at bedside and make all medical decisions throughout hospital stay, helping the child adjust to unfamiliar environments, anxiety, and stress. **Discussion** In this case, interdisciplinary communication was imperative, yet the varying schedules and plans of different specialties presented a logistic challenge to organize care cohesively. At times, it was necessary for the general pediatric hospitalist team to address conflicting advice between specialties and work with various providers to come to the best solution for the child in regards to all affected organ systems. Optimizing recovery included minimizing the impact on child development. Identifying medical and social challenges, utilizing resources to promptly address evolving needs, and effective communication with all care providers is challenging, but essential in the hospital setting.