Firearms

Firearm-related injuries are the second leading cause of death in children. If one our goals as PCPs is to prevent premature deaths, we need to make this issue a focus of attention during WCCs. James W. Mold, MD, MPH

Free full text

View

Firearm-related injuries are an urgent health crisis in the United States, with firearm-related deaths surpassing deaths from motor vehicle crashes in 2017.1 In contrast to other conditions for which clinicians have evidence-based solutions to reduce harm, the 25-year gap in federal research funding2,3 halted substantial advances in the science of firearm-related injury prevention. Yet renewed funding and emerging science continue to highlight the critical role clinicians have in prevention efforts.2,3 Similar to other complex health issues, firearm-related injury is heterogeneous, with multiple causes (Figure 1). Each of these causes has entry points within clinical encounters that represent opportunities to interact, interrupt, and prevent negative outcomes.

The lack of research has resulted in a generation of clinicians currently lacking the training necessary to implement the solutions generated by recent science. As a result, despite clinicians recognizing the need for prevention and agreeing that prevention of firearm-related injury is within their scope of practice,13 few deliver evidence-based interventions even though their patients find such measures acceptable within the context of clinical care.14 This lack of training is compounded by a shortage of adequate health care infrastructure necessary to support the integration of useful approaches into practice. Clinicians note multiple barriers, including a lack of knowledge, guidelines, time, clinical support, and reimbursement, as well as a fear of offending patients or encountering legal trouble.15-17

Clinicians routinely provide harm-reduction measures and anticipatory guidance for a range of complex health issues (e.g., substance use and vaccination), capitalizing on available evidence, their relationships with patients, and their community standing to promote health and safety. Although gaps exist, there remain opportunities to improve the current standard of care for the prevention of firearm-related injury. In this article, we review clinical approaches to prevention, ranging from ones implemented within individual clinical encounters to ones advanced by health care leaders within the systems and communities they serve.

Author/s:

Patrick M Carter, Rebecca M Cunningham

Firearm-Related Violence in the Pediatric Population

Linda Fowler — Fri, 26 Jan 2024 21:39:50 +0000

Date Added:

January 26, 2024

Journal/Publication:

Pediatric Annals

Publication Date:

January 1, 2024

Issue:

Volume:

Pages:

e28 - e33

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3928/19382359-20231114-02

Keywords

PMID (1):

38194661

MeSH

Firearms

Adolescent Health

Mass Shooting Events

Violence / prevention & control

Humans

Disease Progression

Firearm-related events are one of the leading causes of death in children and adolescents. If one of our roles as clinicians is to prevent premature deaths, then we need to be sure that parents are educated regarding safe storage of firearms and other firearm safety measures. James W. Mold, MD, MPH

Free full text

View

Children, particularly adolescents, are dying from firearm-related injuries. Screening for firearms, early recognition of firearm-related concerns, appropriate referrals, and follow-up are crucial to the safety of our patients and their families. Clinicians are strongly encouraged to address firearm-related violence during clinical encounters. Risk reduction, advocacy, and policy implementation are key in mitigating the long-term negative sequelae of firearm violence in youth. The epidemiology of firearm-related death, mass shootings, school firearm violence, adolescent health, prevention, injury patterns, postinjury care, policy, and resources are all discussed in this article. [Pediatr Ann. 2024;53(1):e28–e33.]

Author/s:

Katherine M Marsh, Felicia Scott-Wellington

What Parents Should Know About Gun Safety in the Home and Vehicle

Erin Blanchette — Tue, 14 Nov 2023 20:28:26 +0000

Date Added:

November 14, 2023

Journal/Publication:

JAMA Pediatrics

Publisher:

American Medical Association

Publication Date:

October 30, 2023

URL:

What Parents Should Know About Gun Safety in the Home and Vehicle

Type:

Patient Education Materials

Format:

Article

DOI (1):

doi:10.1001/jamapediatrics.2023.4668

Keywords

PMID (1):

37902742

MeSH

Information for parents on safe gun storage in homes and vehicles. James W. Mold, MD, MPH

Free full text

View

This Patient Page describes safety measures parents can take to protect children from gun violence.

Guns are now the leading cause of death for children in the US.

Guns are even more lethal than motor vehicle crashes. The reasons for this gun violence increase in children are multiple, including a rapid rise in gun purchases, an increase in depression and anxiety in children and adolescents, and widespread stress from a global pandemic. The causes of these injuries and deaths vary by age. Younger children are more commonly injured unintentionally. Curious toddlers can find guns and fire them quickly. Older children and adolescents are more likely to be harmed by homicide or suicide.

The most important factor for children being injured or killed by guns is having a gun in the home where a child lives or the car where a child rides. Adults must make sure their guns are stored safely to prevent access by a child or adolescent. There are gun locks, safes, and other techniques to promote safer storage. As an additional safety measure, caregivers should strongly consider removing guns entirely from the home or vehicle, especially when children are older than about 11 years. These youths know how to find and access guns, even if they are stored safely. Considering the increase in mood disorders and risk of suicidal behaviors in older children and adolescents, they should not be around guns.

Parents and caregivers should follow the Be SMART framework to improve gun safety:

S: Secure all guns in your home and vehicle.

M: Model responsible behavior around guns.

A: Ask about unsecured guns in other homes.

R: Recognize the role of guns in suicide.

T: Tell others to Be SMART.

Author/s:

Rebecca J. Palmer, Leila H. DeWitt, Lindsay A. Thompson

Preventing Firearm-Related Death and Injury

Brian Desmarais — Wed, 05 Jun 2019 19:32:12 +0000

Date Added:

June 5, 2019

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

June 4, 2019

Issue:

Volume:

170

URL:

Preventing Firearm-Related Death and Injury

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/AITC201906040

Keywords

MeSH

A comprehensive summary of what we know about firearm-associated injuries and firearm safety to support physician-initiated patient education. James W. Mold, MD, MPH

Free full text

View

Deaths and injuries from firearms are significant public health problems, and clinicians are in a unique position to identify risk among their patients and discuss the importance of safe firearm practices. Although clinicians may be ill-prepared to engage in such discussions, an adequate body of evidence is available for support, and patients are generally receptive to this type of discussion with their physician. Here, we provide an overview of existing research and recommended strategies for counseling and intervention to reduce firearm-related death and injury.

Author/s:

Pallin, R., Spitzer, S.A., Ranney, M.L., Betz, M.E., Wintemute, G.J.