Statement of purpose To assess feasibility and caregiver acceptability of providing firearm safety education and free safe-storage devices in the ED.

Methods/Approach Prospective feasibility study of caregivers in a pediatric ED. Participants completed electronic surveys on firearm safe-storage knowledge and practices, and received video-based firearm-safety education. We offered those with firearm access free cable locks and device education. We contacted subjects two weeks post-ED visit to assess firearm safety practices, cable lock use, and acceptability of the intervention.

Results We enrolled 307 participants. 43 participants (14%) reported a firearm in the home at some point during the week. 16/43 (37%) of families with guns had never received safe-storage information prior to this ED visit. Among those with handguns, 17% reported not using a safety device and 17% reported storing the gun loaded. 47 (15%) of all participants received one or more cable locks from the study team. 240 (78%) subjects completed the 2-week follow-up survey. 182 (75%) participants had shared the firearm-safety information they received with others, 213 (89%) felt the ED was an appropriate place to discuss firearm safety, and two participants had removed a firearm from their home. Of the 163 participants who had the opportunity to ask about firearms in the homes where their children visit, 111 (68%) did ask, compared to only 61/163 (37%) at time of ED intervention, (p<0.01). Amongst those with guns, 31/43 (89%) reported using a safe storage device for their firearm.

Conclusions It is feasible to provide firearm-safety education and cable locks to caretakers in the ED. Caretakers considered these practices acceptable and appropriate. The education and device distribution led to a change in intended and actual practices of firearm safety.

Significance Providing firearm safety education in the ED can lead to improved firearm safety practices.