The article on the topic Firearm Injury and Mortality Prevention in Pediatric Health-care Settings by Roberts et al (10.1542/pir.2020-001305) in the April issue of Pediatrics in Review should be read and reread at least 3 times by any practicing pediatrician. It is carefully written and timely; since this article was printed, a new study published in Pediatrics shows that firearm deaths in children have now moved from second to first place as the leading cause of death among children ages 0–19, a trend clearly moving in the wrong direction.
The article—and this blog post—are not about the second amendment. Many of my friends and relatives have firearms, use them responsibly, and keep them secured.
The main takeaway from the article for me is that we are, as pediatricians, too unfamiliar with weapons regarding their storage and safe locking to adequately counsel patient families. Some (rare) pediatric training programs do offer such training, with the help of local police departments, but most do not. If we were better informed, perhaps we would be as comfortable discussing gun safety as we are with ensuring pool safety and locking cabinets that contain household chemicals to protect little ones. As pediatricians we can do little about gang warfare, but we can certainly discuss safety with the households we serve, 1/3 of which own guns.
Recognizing at risk patients, especially adolescents who may have suicidal ideation, is important; there are strategies, safety measures, and resources to keep weapons out of their reach. I had one such adolescent patient who died after discharging a shotgun into his mouth. The impact on his family, school, and community is still felt. I failed to see his at-risk symptoms and am haunted to this day about the situation.
Please read this article carefully, considering the laws, access, interventions, and screenings, and implement its suggestions into your practice. Perhaps you can save a life and do a better service than I did.