Proceedings from the Medical Summit on Firearm Injury Prevention: A Public Health Approach to Reduce Death and Disability in the US

Bulger, Eileen M.; Kuhls, Deborah A.; Campbell, Brendan T.; Bonne, Stephanie; Cunningham, Rebecca M.; Betz, Marian E.; Dicker, Rochelle; Ranney, Megan L.; Barsotti, Chris; Hargarten, Stephen W.; Sakran, Joseph V.; Rivara, Frederick P.; James, Thea; Lamis, Dorian A.; Timmerman, Gary; Rogers, Selwyn O.; Choucair, Bechara; Stewart, Ronald M.

doi:10.1016/j.jamcollsurg.2019.05.018

Cited by 103 publications

(76 citation statements)

References 77 publications

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“…The only difference between BH and ED providers was that the former were more likely to believe that patients would be accepting of counseling—possibly reflecting their own experiences. Our findings highlight a need for training and continuing education for providers about firearm storage and lethal means access; currently available resources include CALM training for suicide prevention (SPRC, 2009) and general training related to firearm safety (including suicide prevention) (Bulger, Kuhls, Campbell, Bonne, Cunningham et al, 2019; Pallin, Spitzer et al, 2019). Further examination of the effects of training, and the best methods for dissemination, is urgently needed.…”

Section: Discussionmentioning

confidence: 92%

“…At the same time, our findings should not discourage engagement of firearm‐owning providers as critical partners for development and delivery of firearm safety messaging. These providers might help inform their non‐firearm‐owning peers about firearm culture and the best way to engage with patients in a “culturally competent” manner (Betz & Wintemute, 2015), and their insights could aid in development of materials and interventions (Bulger, Kuhls, Campbell, Bonne, Cunningham et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

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Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms

Diurba

Johnson

Siry-Bove

et al. 2020

Suicide & Life Threat Behav

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This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home. Methods: Emergency department providers (physicians and mid-level practitioners) and behavioral health (BH) providers at four Colorado EDs completed an anonymous, web-based survey. Results: Fewer ED providers (35%) than BH providers (81%) felt confident in their ability to counsel patients about lethal means (p < .001). In multivariable analysis, the only clinical or provider factor associated with often or almost always asking patients about firearm access was provider type, with BH providers more likely than ED providers to ask in all scenarios (OR: 5.58, 95% CI 1.68-18.6). Behaviors and attitudes about lethal means counseling did not vary by whether the provider had firearms at home. Almost all providers said that additional training and

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms

Diurba

Johnson

Siry-Bove

et al. 2020

Suicide & Life Threat Behav

Self Cite

View full text Add to dashboard Cite

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“…In concert with 45 medical and injury prevention organizations, including EAST, the ACS stated that a broad, national approach to firearm violence is warranted. 16 17 18 …”

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confidence: 99%

Eastern Association for the Surgery of Trauma Statement on Structural Racism, and the Deaths of George Floyd, Ahmaud Arbery, and Breonna Taylor

et al. 2020

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“…In 2017, there were 39,773 firearm-related deaths in the United States. 4 Gunshots rank among the top 2 most common causes of penetrating cranial wounds in the United States, next to stabbings. 8 Mortality rates of gunshot wounds to the head (GWH) are extremely high, with an estimated 90% of cases being fatal.…”

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confidence: 99%

Gunshot wounds to the head: racial disparities in inpatient management and outcomes

Chiu¹,

Fuentes²,

Mehta³

2019

Neurosurgical Focus

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OBJECTIVESeveral studies have indicated that racial disparities may exist in the management and outcomes of acute trauma care. One segment of trauma care that has not been as extensively investigated, however, is that of cranial trauma care. The goal of this study was to determine whether significant differences exist among racial and ethnic groups in various measures of inpatient management and outcomes after gunshot wounds to the head (GWH).METHODSIn this study, the authors used the Nationwide (National) Inpatient Sample (NIS) to investigate all-cause mortality, receipt of surgery, days from admission to initial intervention, discharge disposition, length of hospital stay, and total hospital charges of those with GWH from 2012 to 2016. A 1:1 propensity score–matched analysis was conducted to evaluate the effect of race on these endpoints, while controlling for baseline demographics and comorbidities.RESULTSA total of 333 patients met the inclusion and exclusion criteria: 148 (44.44%) white/Caucasian, 123 (36.94%) black/African American, 54 (16.22%) Hispanic/Latinx, and 8 (2.40%) Asian. African American patients were sent to immediate care and rehabilitation significantly less often than Caucasian patients (RR 0.17 [95% CI 0.04–0.71]). There were no significant differences in mortality, length of stay, rates of surgical intervention, or total hospital charges among any of the racial groups.CONCLUSIONSThe authors’ findings suggest that racial disparities in inpatient cranial trauma care and outcomes may not be as prevalent as previously thought. In fact, the disparities seen were only in disposition. More research is needed to further elucidate and address disparities within this population, particularly those that may exist prior to, and after, hospitalization.

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Proceedings from the Medical Summit on Firearm Injury Prevention: A Public Health Approach to Reduce Death and Disability in the US

Cited by 103 publications

References 77 publications

Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms

Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms

Eastern Association for the Surgery of Trauma Statement on Structural Racism, and the Deaths of George Floyd, Ahmaud Arbery, and Breonna Taylor

Gunshot wounds to the head: racial disparities in inpatient management and outcomes

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