Gun Safety in Pediatrics

BHANU MUNIYAPPA
SETH BRANAHL

Objectives
Describe the problem of kids having access to guns
Discuss relevant studies
Describe Utah gun laws
Review AAP statement
Describe how we can help and how we can counsel

our families

Case
6yo male playing with 8yo brother at grandmothers

flower shop
Boys found a handgun kept loaded under the counter
for protection
8yo pulled the trigger resulting in massive
maxillofacial trauma to right side of brothers head
Minimal brain injury, but lost sight and hearing on
right side requiring extensive reconstructive surgery
including tissue grafting and eye prosthesis

In Utah from 2009-2013 in youths 17 years and younger1:

There were 46 firearm suicides. The number has

increased every year for the last three years.

Firearms were involved in 43% of youth suicides.
43 hospitalizations from firearms (average 9/yr).

Guns and Suicide

Access to improperly stored gun makes the risk of

youth suicide 5x more likely.2

Guns are the most lethal method of suicide. 85% of

attempts are lethal compared to 3% for pill ingestion

and wrist cutting.3

Gun Storage Practices and Risk of Youth Suicide and Unintentional

Firearm Injuries.

Case Control study

Compared with control incidents where individual

was less than 20 years of age and also

Shot self accidentally

Shot another individual accidentally
Shot self intentionally

Risk factors for being Case rather than Control

Keeping gun unlocked

Keeping gun loaded
Keeping ammunition unlocked
Storing gun near ammunition

Seeing is Believing: What Do Boys Do When

They Find a Real Gun?

Sample of 8-12 yr boys, mean age 9.8 yrs

Before the the experiment, parental rating of

childs interest in guns was measured

Groups of children were placed in a monitored
room which contained a desk with 2 water guns
and one 0.380 caliber handgun.

RESULTS5
72% found the gun
76% of those handled the gun
48% of those pulled the trigger
90% of those who pulled the trigger had previous

gun safety education

Parental estimation of their childs interest in guns
did not predict actual behavior on finding the
handgun.

Florida gun law6

2011 Firearm Owners Privacy Act

Physicians not allowed to make verbal or written inquiry into patients

firearm ownerships when doctors do not in good faith believe such
inquiries to be relevant to the patients medical care or safety.

2012: The act was stayed by a District Court

Wollschlaeger vs Florida: On July 25, 2014 the 11 th Circuit of

Appeals overturned previous ruling and reinstated the law.

There is no First Amendment protection for physicians
providing their best medical advice to their patients and a
state legislature can prohibit doctors from discussing any
medical issue with a patient that the legislature finds
politically distasteful.

Legislation Restricting Physician Counseling on Firearm

Safety
Yellow: Adopted
Blue:
Introduced

Gun storage laws in UT7

State law prohibits Intentional, knowing or reckless

provision of firearms to minors

There is no liability if a minor finds a loaded firearm.
Only a few states (California, Hawaii, Massachusetts
and DC) have criminal liability for negligent storage
of fire arms.

AAP Policy Statement

Most effective measure to prevent firearm related

violence is the absence of guns in homes and

communities
Safer storage reduces injuries
Gun avoidance programs do not prevent risk
behaviors
Targeting education at younger children may yield
positive results

Information for parents

Firearms should be stored unloaded
Keep firearms in a locked cabinet or safe
Consider using gun locks
Ammunition should be stored separately from

firearms
Pay attention to where children play

What to teach children

Do not search for guns
If you find a gun, do not touch the gun. Find an adult

right away
Guns should never be pointed at anything you do not
want to hurt

Community Resources

What we can do
Commit to asking families about guns in the home
Think about talking with legislators
Learn about community resources to provide more

information about gun safety to families

Askingsaveskids.org

Resources
1.
2.
3.
4.

5.
6.

7.
8.

http://bulletproofkidsutah.org/statistics/
http://www.childrensdefense.org/library/data/state-datarepository/the-truth-about-guns.pdf
www.hsph.harvard.edu/means-matter/means-matter/case-fatality/
Gun Storage Practices and Risk of Youth Suicide and Unintentional
Firearm Injuries. JAMA Feb 2005.4
Seeing is Believing: What Do Boys Do When They Find a Real
Gun? Geoffrey Jackman, et al. Pediatrics, June Pediatri2001.5
Firearm-Related Injuries Affecting the Pediatric Population. cs Vol.
130 No. 5 November 1, 2012
pp. e1416 -e1423
http://harvardlawreview.org/2015/01/wollschlaeger-v-governor-offlorida/
http://smartgunlaws.org/child-access-prevention-policysummary/#identifier_44_5958