# Experiences with and perspectives on firearm injury prevention among emergency medical services clinicians

## TL;DR

This study explores how emergency medical services (EMS) clinicians in the U.S. can help prevent firearm injuries, finding that many have encountered risky situations but lack proper training.

## Contribution

The study provides insights into EMS clinicians' experiences and training needs in firearm injury prevention, offering actionable recommendations for future training programs.

## Key findings

- Most EMS clinicians encountered patients at risk of firearm injury but rarely asked about firearm access or provided counseling.
- Many EMS clinicians reported being worried about firearm-related injuries on duty and had experienced firearm threats.
- A significant portion of EMS clinicians expressed interest in training on firearm injury prevention despite limited current education.

## Abstract

Firearm-related injury is a significant public health problem in the United States. Emergency medical services (EMS) personnel are uniquely positioned to recognize and counsel individuals at risk, but little is known about their firearm screening and counseling practices, experience with firearms, and training needs. To address these knowledge gaps and inform training efforts, this study examined the current and potential role of EMS clinicians in firearm injury prevention.

A 22-item survey was e-mailed to EMS agencies, predominantly in California and Nevada. EMS clinicians who had worked 5 + shifts in the previous three months were eligible to participate. Question topics included: participant characteristics, recent encounters with at-risk patients, career exposure to firearm risk situations, experience with firearms, and training on firearm injury prevention. Descriptive statistics were calculated, and write-in responses were analyzed thematically.

Among 234 participants, 75% reported that at least some of their calls in the past three months involved someone at risk of firearm-related injury. Among those who responded to at-risk patients, 47% reported that they never asked these patients about firearm access and 88% said that they did not provide them with education/counseling on firearm injury prevention. 76% were at least somewhat worried about being injured by a firearm while on duty, and 19% reported having had a firearm drawn on or used against them during a call. Participants reported being on duty without law enforcement when firearms were accessible to suicidal patients (70%), to children (47%), and in domestic violence situations (49%). Approximately 70% reported current or previous firearm ownership, and 82% felt comfortable handling firearms. More than one-third had not received medical education on firearm injury prevention, and 85% expressed interest in future training.

As the sole health care providers for many patients and given their unique prehospital perspective, with additional training, EMS clinicians can expand their role in firearm injury prevention. Training should: respect the right to own firearms; prioritize a risk-based approach to firearms screening; highlight interventions for reducing firearm injury risk; address the increased risk of firearm injury among EMS clinicians; and align with local policies, including those involving law enforcement.

Not applicable.

The online version contains supplementary material available at 10.1186/s12873-025-01241-9.