Emergency Physicians’ Familiarity with the Safe Handling of Firearms

Abstract

IntroductionEmergency physicians (EP) experience high rates of workplace violence, the risks of which increase with the presence of weapons. Up to 25% of trauma patients brought to the emergency department (ED) have been found to carry weapons. Given these risks, we conducted an educational needs assessment to characterize EPs’ knowledge of firearms, frequency of encountering firearms in the ED, and level of confidence with safely removing firearms from patient care settings.MethodsThis was a survey study of attending and resident EPs at two academic and four community hospitals in the Midwest and Northeast. A 26-item questionnaire was emailed to all EPs at the six institutions. Questions pertained to EPs’ knowledge of firearms, experience with handling firearms, and exposure to firearms while at work. We calculated response proportions and p-values.ResultsOf 243 recipients who received the survey, 149 (61.3%) completed it. Thirty-three respondents (22.0%) reported encountering firearms in the workplace, 91 (60.7%) reported never handling firearms, and 25 (16.7%) reported handling firearms at least once per year. Thirty-six respondents (24.0%) reported formal firearms training, and 63 (42.3%) reported no firearms training. There were no significant regional differences regarding firearms training or exposure. Residents from the Northeast were more likely to be moderately confident that they could safely handle a firearm prior to law enforcement involvement (p=0.043), while residents from the Midwest were more likely to be not at all confident (p=0.018).ConclusionThe majority of surveyed attending and resident EPs reported little experience with handling firearms. Among resident EPs, there was a regional difference in confidence in handling firearms prior to law enforcement involvement. Given the realities of workplace violence and the frequency with which firearms are encountered in the ED, further investigation is needed to evaluate provider competence in safely handling them. EPs may benefit from training on this topic.

Emergency Providers’ Familiarity with Firearms: A National Survey

“…Even more concerning in this context is our finding that the majority of respondents were unsure whether their hospital had a protocol regarding the handling and management of firearms found in patients’ possession. While this could simply be due to respondents’ never having received a thorough hospital orientation that included this element, it is alarming that this knowledge gap is widespread among many different health care systems, including EDs not staffed by USACS …”

“…This was a convenience sample survey study of EPs employed by US Acute Care Solutions (USACS). Our survey tool was developed using an iterative process in keeping with published best practices in survey design and piloted in a previous study . Briefly, the survey underwent three iterations prior to delivery to the study population: First, a literature review was conducted to identify relevant variables in EPs’ exposure to firearms, and survey items were developed based on the terminology and data present in the literature.…”

“…Our survey tool was developed using an iterative process in keeping with published best practices in survey design 18,19 and piloted in a previous study. 7 Briefly, the survey underwent three iterations prior to delivery to the study population: First, a literature review was conducted to identify relevant variables in EPs' exposure to firearms, and survey items were developed based on the terminology and data present in the literature. Second, survey content validity was assessed using local content expert review by emergency medicine (EM) faculty with experience in survey design methodology and EM faculty with formal training in handling firearms.…”

“…A preliminary survey showed a low level of firearm experience among emergency physicians in two hospital systems. 7 Twenty-two percent had personally encountered a firearm in the workplace; however, 60.7% had never handled a firearm, 76.0% had not received formal firearms training, and 42.7% had never received any kind of firearms training. These findings raise two concerns: First, EPs' lack of familiarity with firearms increases the risk of accidental injury to themselves or others should they be required to remove a firearm from a patient, visitor, or their belongings.…”

“…A preliminary survey showed a low level of firearm experience among emergency physicians in two hospital systems . Twenty‐two percent had personally encountered a firearm in the workplace; however, 60.7% had never handled a firearm, 76.0% had not received formal firearms training, and 42.7% had never received any kind of firearms training.…”