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Clinicians should play role in preventing firearm injuries

Pediatricians should discuss unintentional and suicide-related firearm injury prevention in their practices using a pragmatic and nonjudgmental approach, according to a recent article that appeared in Pediatric Annals.

“Guns are ubiquitous in the U.S.; there is nearly one firearm for each person in America,” wrote M. Denise Dowd, MD, MPH, professor of pediatrics, University of Missouri, Kansas City School of Medicine. “About one-half of all homes contain at least one gun, including those with children; therefore, most American children have a high probability of being in an environment with a gun at some point during their childhood or adolescence.”

Of the 33,000 firearm deaths in America each year, about seven every day are in children and teens aged 20 years and younger, Dowd wrote. The AAP considers firearm injury prevention a high priority and has emphasized the importance of anticipatory guidance in clinical practice — in addition to advocating for better regulation of the use of and sale of firearms.
Dowd noted that programs that teach children to tell an adult if they see a gun, or not to touch a gun, are “ineffective” in keeping children away from handguns. She suggested ways pediatricians can broach and discuss the subject of firearms with parents:

•emphasize small children’s curiosity and the impulsivity of older teens, as well as a person’s safety, not gun safety;

•offer language that focuses on you, your child and current events;

•promote safe firearm storage by ensuring guns are locked, unloaded and ammunition is stored separately; and

•have gun locks available when providing safety instructions.

“When case fatality is high and second chances are few, it is best to think about ‘layers’ of protection,” she wrote. “Yes, it is important to teach children not to touch a gun, but like swimming lessons alone such education is far from sufficient to protect a child. A physical separation (ie, gunlock, fencing around a pool) is required to prevent tragic outcomes that cannot be prevented by child education or supervision alone.”

According to Dowd, since a federal appeals court overturned a Florida state law that prohibited doctors from talking to their patients about reducing injuries and deaths from firearms, medical professionals do not need to worry about legal repercussions when discussing firearms with patients.

In the wake of the mass shooting — the deadliest in U.S. history — at a Florida nightclub last June, AAP, AAFP, ACP and AMA called on Congress to lift a ban on gun research.

Since then, U.S. Rep. Stephanie Murphy, D-Fla., has introduced legislation that would allow the CDC and agencies within HHS to research the root causes of gun violence as well as medical advancements to reduce gun deaths. According to a press release, the bill was referred to the House Energy and Commerce Committee. Murphy’s website also stated that her proposed legislation has the support of seven national gun safety organizations, including Doctors for America and Everytown for Gun Safety. – by Janel Miller

Disclosure: Dowd reports no relevant financial disclosures. Healio Family Medicine was unable to determine Murphy’s relevant financial disclosures prior to publication.