firearm (gun, rifle, handgun)
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Introduction
Also see gunshot wound
Epidemiology
- 22,000 firearm homicides (3.7 per 100,000 residents) 2009-2010
- 38,000 firearm suicides (7.0 per 100,000) 2009-2010[1]
- access to firearms associated with increased mortality[2]
- gun-owning guardians of children with psychiatric disease are no more likely to safely store guns than guardians of normal children[6]
- 20% of high school students in Colorado report easy access to guns[9]
Management
- counsel patients on the risks of firearms in the home, especially with minors, people with dementia, mental illness, or substance abuse in the home[3]
- family should be encouraged to contact local law enforcement agency to remove firearm & ammunition from the home of a demented family member[10]
- discussions of firearms appropriate when risk factors present[8]
Notes
- no validated screening tool to assess whether a cognitively impaired person can safely handle firearms[10]
- a 2011 Florida gag law designed to prevent discussions of firearms between patients & physicians[4]
- however, firearm ownership is relevant to the health of the patient or others under 3 conditions (even in Florida):
- risk for violence to self or others
- risk factors for violence or unintentional firearm injury (violent history, substance abuse, serious mental illness)
- patient is a member of a group at increased risk for firearm violence (children, adolescents, young black men, middle-aged & older white men)[4]
- in Feb 2017, the U.S. Court of Appeals for the 11th Circuit invalidated parts of Florida's Firearm Owners Privacy Act (FOPA) affirming that the First Amendment applies to speech between physicians & patients[5]
- decision ensures that physicians may continue to make efforts to protect their patients from gun-related injuries[5]
Additional terms
References
- ↑ 1.0 1.1 Centers for Disease Control and Prevention (CDC) Firearm Homicides and Suicides in Major Metropolitan Areas - United States, 2006-2007 and 2009-2010. MMWR. August 2, 2013 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a1.htm
- ↑ 2.0 2.1 2.2 Anglemyer A et al The Accessibility of Firearms and Risk for Suicide and Homicide Victimization Among Household Members: A Systematic Review and Meta-analysis. Ann Intern Med. 2014;160(2):134-135-135. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24592495 <Internet> http://annals.org/article.aspx?articleid=1814430
Hemenway D Guns, Suicide, and Homicide: Individual-Level Versus Population-Level Studies. Ann Intern Med. 2014;160(2):134-135-135 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24592499 <Internet> http://annals.org/article.aspx?articleid=1814430 - ↑ 3.0 3.1 Butkus R, Doherty R, Downey H et al Reducing Firearm-Related Injuries and Deaths in the United States: Executive Summary of a Policy Position Paper From the American College of Physicians. Ann Intern Med. Published online 10 April 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24722815 <Internet> http://annals.org/article.aspx?articleid=1860325
- ↑ 4.0 4.1 4.2 Wintemute GJ et al Yes, You Can: Physicians, Patients, and Firearms. Ann Intern Med. Published online 17 May 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27183181 <Internet> http://annals.org/article.aspx?articleid=2522436
Weinberger SE Curbing Firearm Violence: Identifying a Specific Target for Physician Action. Ann Intern Med. Published online 17 May 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27183475 <Internet> http://annals.org/article.aspx?articleid=2523533 - ↑ 5.0 5.1 5.2 Parmet WE, Smith JA, Miller M. Physicians, Firearms, and Free Speech - Overturning Florida's Firearm-Safety Gag Rule. N Engl J Med 2017; 376:1901-1903. May 18, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28402707 Free Article <Internet> http://www.nejm.org/doi/full/10.1056/NEJMp1702516
- ↑ 6.0 6.1 Scott J, Azrael D, Miller M. Firearm Storage in Homes With Children With Self-Harm Risk Factors. Pediatrics. 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29467279 <Internet> http://pediatrics.aappublications.org/content/early/2018/02/19/peds.2017-2600
Grossman DC Reducing Youth Firearm Suicide Risk: Evidence for Opportunities. Pediatrics. 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29467277 <Internet> http://pediatrics.aappublications.org/content/early/2018/02/19/peds.2017-3884 - ↑ Kegler SR, Dahlberg LL, Mercy JA. Firearm Homicides and Suicides in Major Metropolitan Areas- United States, 2012-2013 and 2015-2016. MMWR Morb Mortal Wkly Rep 2018;67:1233-1237 https://www.cdc.gov/mmwr/volumes/67/wr/mm6744a3.htm
- ↑ 8.0 8.1 Pallin R et al. California public opinion on health professionals talking with patients about firearms. Health Aff (Millwood) 2019 Oct; 38:1744 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31589535 https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.00602
- ↑ 9.0 9.1 Brooks-Russell A, Ma M, Brummett S. Perceived Access to Handguns Among Colorado High School Students. Pediatrics. 2021. March 29;e2020015834 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33782105 https://pediatrics.aappublications.org/content/early/2021/03/25/peds.2020-015834
- ↑ 10.0 10.1 10.2 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ Betz ME, McCourt AD, Vernick JS et al. Firearms and dementia: clinical considerations. Ann Intern Med. 2018;169(1):47-49 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29801058 PMCID: PMC6546108 Free PMC article https://www.acpjournals.org/doi/10.7326/M18-0140
- ↑ Timmer-Murillo SC, Schroeder ME, Trevino C et al Comprehensive Framework of Firearm Violence Survivor Care. A Review. JAMA Surg. 2023;158(5):541-547 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36947025 https://jamanetwork.com/journals/jamasurgery/fullarticle/2802862