Pediatric emergency department physicians wary of discussing firearm injury prevention

Many emergency departments provide education on childhood injury prevention. But new research shows many physicians are leaving out one important topic: firearm injury prevention.

The study abstract, "Firearm Safety: A Survey on Practice Patterns, Knowledge and Opinions of Pediatric Emergency Medicine Providers," will be presented Friday, Sept. 15 at the 2017 American Academy of Pediatrics National Conference & Exhibition in Chicago. The study found many physicians do not discuss firearm injury prevention when discussing overall injury prevention issues such as helmet use, child passenger safety or childproofing.

"The best solution for firearm injuries in children is primary prevention," said lead researcher Sheryl Yanger, MD, FAAP, an attending physician in pediatric emergency medicine at Ann & Robert H. Lurie Children's Hospital of Chicago. "And we hope this study will lead to future efforts to increase pediatric injury prevention and firearm safety counseling in the emergency department."

Researchers conducted a prospective cross-sectional survey of pediatric emergency providers and received 185 responses. Approximately 35 percent of those who responded said they provide counseling on firearm injury prevention "sometimes" or "frequently" when compared with other injury prevention topics, such as helmet use and child passenger safety.

When asked about barriers to firearm safety counseling, respondents reported more political restraints, lack of awareness, and legal constraints as compared with barriers to general injury prevention counseling. About a third of respondents were unsure if the law in their state permitted them to have discussions about firearms.

Researchers suggest that future efforts to increase firearm safety screening and counseling by pediatric emergency department providers in the emergency department should focus on efforts to improve clinician confidence and increase the feeling of personal responsibility for providing this information. This, as well as continuing to analyze barriers to both general injury prevention and firearm safety in the emergency department, may lead to increased counseling among pediatric emergency department providers.