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AMA Update
Firearm injury prevention, safety tips and secure storage: Why do pediatricians ask about guns?
Apr 19, 2024
Featured topic and speakers
How do you keep guns safe from kids? What is the safest way to store a gun? Where is the best place to store a firearm? Can I put a gun safe in my house?
Our guest is Lois Lee, MD, MPH, a pediatric emergency medicine physician at Boston Children’s Hospital. AMA Chief Experience Officer Todd Unger hosts.
- Access AAP recommendations on gun safety for kids.
- Get the AAP gun safety toolkit for more resources on gun safety and children.
- For more about the AMA firearm injury prevention task force, watch this episode.
- Read the American Medical Association statement on guns.
- See all the AMA policies on firearms (gun violence policy).
- Review AMA policy on kids and guns.
- The AMA is your powerful ally in patient care. Join now.
Speaker
- Lois Lee, MD, MPH, pediatric emergency medicine physician, Boston Children’s Hospital
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Last year, the AMA formed a task force focused on firearm violence prevention. And today, we're talking about secure firearm storage with a member of the AMA Firearm Injury Prevention Task Force.
Our guest today is Dr. Lois Lee, a pediatric emergency medicine physician at Boston Children's Hospital in Boston. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Lee, it's great to have you with us today.
Dr. Lee: Thanks for having me.
Unger: Sadly, firearms are now the leading cause of death in children and youth in the United States. And I think that fact might surprise a lot of folks out there. Dr. Lee, can you start by talking about the trends that we're seeing with firearm-related injuries and deaths in this particular population?
Dr. Lee: So unfortunately, as you mentioned, firearms are the leading cause of death for U.S. children and youth. And we've been seeing this increase slowly over the last few decades, but really over the last 10 years. But we can't consider firearms all as one kind of injury. You really have to think about the mechanism of injury and the intent of injury, especially suicide and homicide. And what we do know is that there are increases in both firearm suicide and firearm homicide with important disparities by race and ethnicity.
Unger: Interesting. Well, of course, one way to reduce firearm-related injuries and deaths is to securely store firearms. And that might seem straightforward, but Dr. Lee why is it even more important than people might realize?
Dr. Lee: Well, I think people think about firearms and think it's an insurmountable problem. And it is if you think about trying to change laws. But it's also important for individuals and families to know that there are things they can do individually that can be very effective in both decreasing firearm homicide and suicide. And that is secure storage.
Unger: Well, let's get into the specifics then. Can you walk us through some of the best practices for storing firearms securely especially when there are kids in the house?
Dr. Lee: So the whole idea is that you want to prevent unauthorized access of the firearm to people in the home who would know how to handle it safely. So this might be a curious three-year-old or maybe an impulsive teenager. And so what injury prevention specialists recommend, and we at the American Academy of Pediatrics, is that you make sure your firearm is unloaded and that you have the ammunition and the firearm locked away separately out of reach of children and other kids in the home.
Unger: Those sound like pretty straightforward guidelines. Why aren't they more prevalent than they are right now? What is preventing people from following those guidelines?
Dr. Lee: Well, first of all, I think people don't realize how dangerous it is just to have a firearm in the home when you have people, you know, at risk, again, either that curious toddler who might fire it accidentally or an impulsive teenager who might be suicidal or even homicidal. And then I think families don't always know—well—what are their options, which include if you're going to have a firearm in the home to get a gun safe or use a gun lock. Or if you have several firearms, you can actually get very large gun safes.
And in certain situations, you may actually want to remove the firearm from the home altogether, if you have somebody who's at risk for suicide or for harming other people.
Unger: Now for parents or caregivers, making sure that firearms are stored securely is just, of course, one important step. How can they talk to children about firearms in the home?
Dr. Lee: Well, as you know, firearms are very prevalent in movies and video games. So I think it's very important for children to know that firearms are a very dangerous tool and that it's not a toy, and that they need to be handled carefully. And ideally, that children wouldn't be handling them at all unless they are supervised by an adult.
Unger: Now, it's also important for parents or caregivers to think about the places that their child plays and to ask whether there are unlocked guns in the home. Do you have any advice for how to have that conversation that could be obviously kind of awkward?
Dr. Lee: Obviously, nobody wants to have an awkward conversation when they're dropping their child off at another person's home. But really talking about the shared goals of safety. And that starts with talking about food allergies, with being safe in a car, and then talking about how firearms may be stored in the home. But it is important for you to think about how you're going to respond if perhaps the other parent doesn't share the same secure firearm storage practices that you would want and having alternatives like, well, maybe we should meet at the park or perhaps this time we should meet at our house. I think that's important as well.
And sometimes, you can throw your own kid under the bus, right? We could say something like little Jane, she's so curious. We just want to make sure she's going to be safe and she's always getting into things. So we'd really like to make sure if you do have firearms in the home, that they're secured away in a way that we know that children can't access them.
Unger: Dr. Lee, I'm curious, did you think as a physician that you would be learning so much and talking so much about something like gun storage or firearm storage?
Dr. Lee: When I worked in Philadelphia, certainly this was a conversation that I had with families. Then when I moved to Boston, really not something that I talked about. So I have to say that I have been surprised how much we're talking about it. And it really does depend on where you live. And I'm very grateful that the medical professional organizations are realizing this is an important conversation that we can have with our families and one that we really are starting to have and that, again, the shared goal of safety not just of our children really, but for all of us.
Unger: Dr. Lee, I just want to ask you one thing. There are obviously a lot of things that physicians have on their plates when they are talking with patients. Tell me a little bit more about when you can have a conversation like this and how that goes?
Dr. Lee: Well, I work in a pediatric emergency department. And so, when I talk about it with families, it's in the context of something we call lethal means counseling. And that's basically trying to keep things out of reach of the child or teenager that might allow them to kill themselves by suicide. And so, if I see a child who's come in after an ingestion of some pills, I'll explain to the family that it's important not just to keep pills out of reach of the child, but also sharp objects. And if they have firearms, to secure them in a way that the teenager can't access them.
And honestly, sometimes that means the best thing is to remove it from the home altogether. Research has shown even if you do secure your firearms in the way that we've discussed, which is unloaded with the ammunition and the firearm separated and locked away, that the children in the home, they know where you've hidden them just like they do the holiday gifts, right? And they can actually find both those things and put them together.
The important thing about firearms is if you try to kill yourself with a firearm, more than 90% of the time you will actually kill yourself and die. If you take pills, more than 90% of the time you'll make it to an emergency department and we'll be able to save your life. And so, this is where means matter. And when you talk to families like that, they get it.
Unger: Well, this discussion has been so informative. Dr. Lee, if people have questions and they want to learn more about secure firearm storage, where should they go?
Dr. Lee: So the American Academy of Pediatrics has some wonderful resources for children and families, but also for people in general. And so, you really can just Google "gun safety" and the "American Academy of Pediatrics" and there's a lot of information there readily available.
Unger: Dr. Lee, thank you so much for joining us. To support the work of the AMA Firearm Injury Prevention Task Force, and of course, all our public health efforts, we encourage you to become an AMA member at ama-assn.org/join.
That wraps up today's episode. And we'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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