Children should not be shot: Child access prevention laws are just as important as child restraint laws!

By Kiesha Fraser Doh

In 2019, there were 563 emergency department visits for unintentional shootings involving children and teens in Georgia. Early 2020 estimates show that a total of 22 children gained access to a gun and unintentionally shot themselves or someone else. The youngest child was two years old when he shot his father in the back and killed him

In 2020, there was an increase in firearm injuries and deaths of children nationwide. During the first six months, there was a 1.9 times increased risk of firearm injury in children under 12 and an 1.4 times increased risk of children under 12 shooting someone else with a gun compared to pre-COVID period.

There are numerous ways to secure firearms safely by utilizing cable locks, trigger locks, lockboxes, and gun safes. Public policy that encourages gun owners to secure their weapons could potentially reduce the impact of this injury, similar to the impact that child passenger restraint laws have had on our society.  In 1975, many kids died in motor vehicle collisions (MVCs) due to inadequate and less sophisticated car design and lack of child and passenger restraints. Since 1975, the rate of pediatric passenger motor vehicle deaths has decreased by 56%.  

In the early 1980s, only 14% of American adults used seat belts, and only 7% of American children were restrained in seat belts or car seats. Starting in the ’70s and ‘80s, numerous public safety campaigns promoted car restraints, and the National Highway Transportation Association pushed for improved car design. Since the first child restraint law was enacted in our neighboring state of Tennessee in 1985, child restraint laws have been enacted in all 50 states and DC; these laws have encouraged parents to restrain 90% of children nationwide. In fact, since the passage of Georgia’s seat belt restraint law, 97% of Georgians now wear a seat belt

Since 1963 the child and teen firearm fatality rate has increased by 72%. From March-December 2020, there was a 30% increase in unintended shooting deaths by kids. One-third of children in the US live in homes with guns, and 85% of fatal pediatric firearm deaths in children 12 and under occur in their own homes. In addition, a recent survey in Georgia found that 53% of parents report storing their firearms insecurely: unlocked, loaded, or not separate from ammunition. 

Fifteen states plus the District of Columbia have laws that make it illegal to store your firearm negligently (Child Access Prevention-CAP laws).  Just 4 of those states require some or all guns to be locked up, and only one state, Massachusetts, requires all firearms to be locked up. CAP laws that require gun owners to store their firearms safely have been shown to reduce suicide and unintentional death and injury by up to 54%. In addition, the CAP law in Massachusetts has potentially impacted the number of children killed by guns; for example: in 2019, 163 children and teens died from firearm injuries in Georgia, while Massachusetts had 18 deaths. Georgia’s CAP law is considered a negligence law as it states that it’s illegal to knowingly give a gun to a minor for an unlawful purpose but Ga has no law that makes it illegal for gun owners to store their firearms insecurely. 

Motor vehicle collisions used to be the number one cause of death in children and teens, but now firearms injury has surpassed MVCs as the leading cause of death. By utilizing similar injury prevention approaches to those that enabled us to reduce the frequency of MVCs as a preventable cause of death in children and teens, we can reduce the rate of firearm injury. Medical organizations, public health agencies, gun owners’ associations, and public safety personnel all support safe firearm storage practices in homes with children and youth

“What can healthcare workers and Georgians do?” 

   We can lead by example: securely storing firearms unloaded, locked up, and separate from ammunition.

   We can talk to children and teens in our lives about the dangers of unsecured firearms and what steps to take if they find an unsecured firearm: “STOP! Don’t touch. Leave the area. Tell an Adult.”  

   We can ask if any firearms in the home are stored, unloaded, and locked before sending our child to someone else’s home. 

   We can have respectful, informed conversations with patients, parents, and caregivers about the risk of unsecured firearms and how to reduce that risk.

   We can work collaboratively with lawmakers and stakeholders to craft thoughtful, evidenced-based CAP laws.

   We can partner with community partners, families, and gun owners to advocate for safe gun storage in our communities.

Georgia Stay SAFE! Georgia Stay SAFE is a coalition of healthcare workers involved in injury prevention who came together to form a partnership based on our shared interest in promoting the prevention of firearm injuries in children.Georgia Stay SAFE Coalition is excited to announce the launch of Georgia Stays SAFE campaign this current week from June 20th-June 25th.

Georgia Stays SAFE stands for:

1.     Secure Firearm Storage

2.     Ask Before Play

3.     Focus on Safety

4.     End Firearm Injury

Firearm Injury Prevention: The Importance of Safe Firearm Storage

Sofia Chaudhary

A 12-year-old boy with a gunshot wound (GSW) to the chest is wheeled into the trauma bay, unresponsive, pulseless and undergoing CPR and subsequently dies. The patient’s 6-year old brother found their father’s gun while playing and pointed it at him. The parents now face the shattering loss of their older son and also the psychological impacts for their younger son, the second victim. Tragedies such as this have become too familiar for emergency departments across the US as the number of pediatric firearm deaths continue to climb annually

Firearms are the second leading cause of pediatric death in the US taking the lives of over 1,700 and injuring more than 6,500 children and teens (ages 0-17) in 2019.1 Homicide accounted for a majority of these deaths, but 40% were from firearm-assisted suicide and 5% from unintentional injuries. Middle schoolers and high schoolers in the US are now more likely to die from a gun than from any other cause, including motor vehicle collisions.2 Additionally, 4.6 million children in the US live in a home with at least one unlocked and loaded gun, double the rates of firearm exposure from a decade earlier.3 Access to an improperly stored firearm in the home increases the risk of both pediatric unintentional firearm injury and firearm assisted-suicide (by 2-5x).4-7

Asking Saves Kids

Kiesha Fraser Doh, MD


As of June 14th there have been 23 school shootings this year!  A total of 1,392 children have been killed or injured by firearms. In comparison during the influenza season from October 2017 to May 2018 a total of 172 children died. [1]This year of 2018 has been especially deadly for children, with 547 firearm deaths this year. [2]Thus more children died from firearm injuries this year compared to influenza deaths despite frequent media reports about influenza death compared to firearm injuries.

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Kids shooting kids: Today’s reality and empowering parents with the ASK campaign


by Sofia Chaudhary

A 2-year old child has wandered into his parent’s bedroom and found an unlocked, loaded gun hidden in the top nightstand drawer.  Seconds later a shot is fired and the parent runs into the room to find their child lifeless.  As pediatricians we have all heard or encountered a similar story- all involving a child having access to an unlocked, loaded firearm.  According to the American Academy of Pediatrics, around 40% of homes with children in the US have a gun with an average of one child under age 10 being killed or disabled by a gun every other day (Pediatrics 2016-1).  In 2014 firearm injury was the 2nd leading cause of injury death in ages 15-19, 4th leading cause for ages 5-9 and 10-14, and 8th leading cause for ages 1-4 (CDC-2016-2).  Although mortality rates are high there is a larger rapid rise of unintentional pediatric injuries from firearms.  In a study reviewing an 8-month period of US pediatric firearm related injuries in 2014: two thirds were non-fatal, 50% of the victims were younger than 13 years of age, 25.3% younger than age 7, 84.3% were the child victims themselves or a family member/friend.  Of note 77% of events took place at the residence and 68% of the families  were the gun owners (J. Trauma Acute Care Surg. 2015-3).

Perhaps the most chilling recent headline from the Washington Post stated “Toddlers have shot at least 23 people this year.” Georgia was the top state with 8 listed self-inflicted shooting, with children ages 2 to 3 with hand guns all found within the home, parental purse, or vehicle (Washington Post-2016-4).  Many non-gun owner caregivers are not aware that there is indeed an accessible and loaded firearm in their home. In 2000, a study in Pediatrics found that in gun-owning homes with children, non-gun owners (87% women) reported significantly lower rates of a gun being stored loaded (7%) and unlocked (2%) in comparison to gun owners (21% loaded, 9% unlocked).  Those with a handgun were more likely to store it loaded and unlocked (Pediatrics-1999-5).  Parental perception of their child’s potential behavior around a firearm is also misleading.  In a survey published in Pediatrics 52% of the parent gun owners stored their firearms loaded or unlocked of which 75% believed that their 4 to 12-year-old child would be able to tell the difference between a toy gun and a real gun, and 23% thought that their child could be trusted with a loaded gun (Brady Center 2016-6)

In the US today 1.7 million children and teens live in a home with a loaded and unlocked gun (AAP-2016-7). One in every 25 admissions to pediatric trauma centers is due to a gunshot wound with major urban trauma centers reporting an increase of 300 percent in the number of pediatric gunshot wounds treated (AAP-2016-8).  Despite this national public health crises, in 2004 Congress banned the CDC from continuing gun violence related research and in 2011 the state of Florida passed a Privacy of Firearm Owners Act prohibiting pediatricians from asking patients and families about firearms in the home-this is currently under review and being appealed later this month.  As pediatricians our first priority is in providing developmentally appropriate advice on how parents can keep their child healthy and safe.  These safety measures include keeping medications out of reach, using appropriate car passenger seats according to age, vaccinating their children, wearing protective helmets when riding wheeled objects, and keeping guns locked and out of reach with the ammunition stored separately.   An AAP policy statement from 2012 reiterates the safest measure to prevent firearm related injuries being the absence of guns from homes and that pediatrician counseling on safe gun storage practices has shown significant reduction in injury. On June 21st the AAP is joining the Brady Campaign and asking parents to ASK (Asking Saves Kids) to save lives.  This campaign is asking parents to ask if there is an unlocked gun where their child plays.  It is encouraging parents to ask these questions as they would discuss other topics for a playdate such as supervision, TV/internet access, or food allergies.  I encourage each and every one of you to not only continue to ASK your patient’s families about firearm storage practices in their homes but also that they in turn ASK their kid’s playmates.

For more information for parents on firearm safety please visit:



  1. American Academy of Pediatrics. Reduce the Risk of Gun Injury. Available at: Accessed: April 27, 2016.
  2. WISQARS. Center for Disease Control. Injury Prevention and Control: National Center for Health Statistics (NCHS), National Vital Statistics System. 10 Leading Causes of Injury Deaths by Age Group Highlighting Violence- Related Injury Deaths, United States- 2014. Available at: Accessed: June 1, 2016.
  3.  Faulkenberry J, Schaechter J. Reporting on pediatric unintentional firearm injury-Who’s responsible.  J. Trauma Acute Care Surg. 2015 79 (3): S2-S8.
  4. The Washington Post. Toddlers have shot at least 23 people this year. Posted May 1, 2016. Available at:  Accessed: May 27, 2016.Azrael D, Miller M, Hemenway D.  Are Household Firearms Stored Safely? It Depends on Whom You Ask. Pediatrics. 2000; 106 (3).
  5. Farah M, Simon H, Kellerman A. Firearm in the Home: Parental Perceptions. Pediatrics. 1999; 104 (5): 1059-1063.
  6. Brady Center to Prevent Gun Violence. Keeping Kids and Families Safe. Available at: Accessed: March 27, 2016. 
  7. American Academy of Pediatrics. Handguns in the Home. Available at Accessed: May 27, 2016.
  8. American Academy of Pediatrics. Council on Injury, Violence, and Poison Prevention Executive Committee. AAP policy statement.  Firearm-related injuries affecting the pediatric population. November 2012; 130 (5)