PubMed · 6827826
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M J Dewey. 1983. Child safety program.. https://pubmed.ncbi.nlm.nih.gov/6827826/
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OBJECTIVE: To describe the magnitude and characteristics of unintentional, nonfatal firearm-related injuries treated in US hospital emergency departments. DESIGN: Data were obtained from medical records for all firearm-related injury cases identified using the National Electronic Injury Surveillance System (NEISS) from June 1, 1992, through May 31, 1994. We report on cases classified as unintentional gunshot wounds. SETTING: NEISS comprises 91 hospitals that are a stratified probability sample of all hospitals in the United States and its territories that have at least 6 beds and provide 24-hour emergency service. MAIN OUTCOME MEASURES: Number of and population rates for unintentional, nonfatal firearm-related injuries. RESULTS: An estimated 34 485 (95% confidence interval [CI], 25 225-43 745) persons (6.7 per 100 000 population; 95% CI, 4.9-8.5) were treated for unintentional, nonfatal firearm-related injuries in US emergency departments during the 2-year study period. The majority of patients were male (87%) and aged 15 to 34 years (61%); 38% required hospitalization. Injuries were most often to an extremity (73%), were self-inflicted (70%), involved a handgun (57%), and resulted during common gun-related activities. CONCLUSIONS: Further development of effective interventions are needed to reduce the risk of injury from unintentional discharge of a firearm during routine gun-handling practices by those who own and use firearms. These injuries often occur during common gun-related activities such as gun cleaning, loading/unloading, hunting, target shooting, and showing, handling, or carrying. Studies are needed to evaluate the efficacy of existing gun safety training courses and assess the potential role of various gun safety devices (eg, trigger locks and loading indicators) in future prevention strategies.
Before a physician or a patient can decide whether a preventive program is worth while, each must understand the nature and degree of its benefits and the frequency and magnitude of its adverse effects. Preventive interventions can be divided into two major categories: those with infrequent or minor adverse effects and those with adverse effects that are frequent or serious. Accident prevention, avoidance of high-risk behaviour and healthy lifestyle choices such as breast-feeding and moderate exercise are associated with few adverse consequences. By contrast, screening populations for disease, risk classification for the purpose of selective preventive interventions, dietary intervention and prophylactic drug treatment may lead to more frequent and serious adverse effects. When assessing whether the benefits of a preventive intervention outweigh the harm, one must be aware that the methods used to report benefits of clinical trials may distort the reader's perception of their magnitude. The relative reduction of morbidity or mortality rate often grossly exaggerates benefits and should never be used as a basis for clinical decision making. More realistic ways of recording benefits are the absolute reduction of morbidity or mortality rate, the number of patients that need to be treated to avoid one adverse event, and the total cohort mortality rate.
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