Firearm Injury Prevention Series: Intervention in the Emergency Room
This episode of Michigan Minds is part of a special series from University of Michigan Public Engagement & Impact in collaboration with the Office of the Vice President for Research on firearm injury prevention.
Patrick Carter, MD, associate professor of emergency medicine, joined this special series of Michigan Minds focused on firearm injury prevention research to discuss his work on using the emergency department as a venue to intervene, decreasing injury outcomes and preventing risky firearm behaviors among youth.
He explains that as an emergency physician he sees a number of adolescents and young adults who are otherwise healthy come to the ER with an injury specifically related to firearms.
“One of the things I came to realize is that by the time they end up in the emergency department trauma bay, we’ve really failed at a societal level in terms of what we can do to prevent that from occurring. And so, my work really tries to focus on what we can do upstream of that event,” he says.
Carter received funding from the Centers for Disease Control and Prevention for a research project aiming to prevent risky firearm behaviors from occurring.
“The IntERact Project is really focused on identifying youth and young adults who come into the emergency department and report that they carry firearms on a regular basis, and intervening with them during that ED visit, as well as subsequent to their ED visit with a behavioral intervention to try and decrease the risky ways that they may be using firearms,” he says, giving as an example of risky behaviors carrying a firearm while intoxicated.
“It really focuses around supporting both their feelings of not feeling safe in their environment as well as addressing underlying issues around substance use and mental health issues,” he says. This is supplemented by a smartphone application that provides some of the intervention content in between therapy-based sessions.
Carter compares the intervention to a patient coming into the ER for chest pain. “If we evaluated you and you weren’t having a heart attack that day, but you were a smoker, you had high blood pressure, and you had all these other risk factors, we would address those things as part of your visit and we would make sure you got that care that you needed,” he says. “In the same way, if you come into the emergency department for abdominal pain or some other reason, but you’re actively carrying a firearm and there are a number of risks related to that, by addressing those risk factors, we’re doing the same thing we would do with the person who came in with chest pain. We’re decreasing their potential for those negative outcomes.”
Research informs advancements to solve problems, and that’s why the new U-M Institute for Firearm Injury Prevention is so important to the institution and also to our broader community, Carter says.
“There’s an opportunity when you bring together multiple disciplines and different perspectives to bear on an issue to identify new and innovative solutions to complex problems. Those types of innovative collaborations emerge when you have a singular multidisciplinary institute where people who have different perspectives can be brought together to focus on a complex problem.”