Implementing means restriction education in urban EDs.

This study evaluated the impact of a mail information campaign on emergency department (ED) professionals' knowledge about the lethal role of firearms in suicide, knowledge of appropriate strategies for warning caregivers of adolescents who have attempted suicide about firearms, and practices with respect to the delivery of such warnings. Responses obtained from physicians and nurses working in ED sites within the targeted city (Chicago) were compared with responses from ED professionals employed in a comparison city (Detroit). In Chicago, the percentage of respondents recommending firearm removal strategies increased from 60% at pretest to 76% at posttest. Individual reports of caregiver warnings per adolescent suicide exposure showed a significant decline in Chicago and a marginally significant decline in Detroit. Gains in knowledge about firearm warning strategies persisted in multivariate analyses controlling for subject demographic characteristics. The pattern of results suggests that the intervention may have effected changes in knowledge while having little impact on behavior. More intensive, interactive educational strategies may be needed to effect behavioral changes among ED professionals.

Child and adolescent suicide attempts: an opportunity for emergency departments to provide injury prevention education.

The study objectives were to ascertain whether caretakers of suicidal children and adolescents received emergency department (ED) injury prevention education and to determine if injury prevention education and the medical outcome after a drug overdose are associated with caretakers restricting access to means of suicide. Participants were adult caretakers of children and adolescents who deliberately ingested a drug and received ED evaluation. Information was obtained by poison center chart review and phone interview. Fourteen percent of caretaker reported receiving injury prevention education concerning restriction of access to potential means of suicide at home. ED injury prevention education is significantly associated with caretakers restricting access to suicidal means, even when controlling for medical outcome from the attempt. Because parents are less likely to restrict access to means of suicide without education, injury prevention education about restricting access to means of suicide should be given in the ED.