Journal
JAMA SURGERY
Volume 158, Issue 5, Pages 541-547Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/jamasurg.2022.8149
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Using research to guide a framework for trauma centers, this review emphasizes the importance of providing comprehensive care to survivors of firearm injury. The model presented highlights the need for patient-centered, trauma-informed care and integration of psychological services to address psychosocial needs. Incorporation of violence prevention programming is also crucial in addressing firearm injury as a public health concern.
Importance Firearm violence is a public health crisis placing significant burden on individuals, communities, and health care systems. After firearm injury, there is increased risk of poor health, disability, and psychopathology. The newest 2022 guidelines from the American College of Surgeons Committee on Trauma require that all trauma centers screen for risk of psychopathology and provide referral to intervention. Yet, implementing these guidelines in ways that are responsive to the unique needs of communities and specific patient populations, such as after firearm violence, is challenging. Observations The current review highlights important considerations and presents a model for trauma centers to provide comprehensive care to survivors of firearm injury. This model highlights the need to enhance standard practice to provide patient-centered, trauma-informed care, as well as integrate inpatient and outpatient psychological services to address psychosocial needs. Further, incorporation of violence prevention programming better addresses firearm injury as a public health concern. Conclusions and Relevance Using research to guide a framework for trauma centers in comprehensive care after firearm violence, we can prevent complications to physical and psychological recovery for this population. Health systems must acknowledge the socioecological context of firearm violence and provide more comprehensive care in the hospital and after discharge, to improve long-term recovery and serve as a means of tertiary prevention of firearm violence.
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