Reducing Harm from Firearms: Evidence-Based Harm Reduction Measures Pediatricians Can and Should Implement

Guns are now the leading cause of death and injury in children in the United States 1 . In 2022, the American Academy of Pediatrics (AAP) released a policy statement in which they provide comprehensive recommendations to address this public health threat. In the statement, the AAP advocates for governmental regulations and legislation, funding for injury prevention research, in addition to recommending pediatricians provide anticipatory guidance related to firearms and partner with community based violence prevention organizations. Pediatricians have a growing list of priorities to address which can make implementation of these recommendations challenging. Evidence demonstrates that families believe their pediatrician should address the topic of firearms, however, many pediatricians do not consistently. By using a brief, evidence-based screening framework, including asking about firearm access at home and in places of play as well as identifying high risk individuals, pediatricians may more effectively screen, provide counseling, and follow up with patients at risk of harm from firearms. A 5 year old female is brought to the pediatric emergency department after being accidentally shot by her twin. The patient survives but faces a long road to recovery. The parents are shocked, they had never spoken to their pediatrician about firearm safety, nor were they aware of secure storage options for their firearms. At their next well child visit they ask the pediatrician why they have discussed car seat safety, safe sleep and how to contact the poison control center but never how to prevent firearm injury.