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Comprehensive Framework of Firearm Violence Survivor CareA Review

To identify the key insights or developments described in this article

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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Article Information

Accepted for Publication: December 4, 2022.

Published Online: March 22, 2023. doi:10.1001/jamasurg.2022.8149

Corresponding Author: Sydney Timmer-Murillo, PhD, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226 (stimmer@mcw.edu).

Author Contributions: Dr Timmer-Murillo had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Timmer-Murillo, Schroeder, Trevino, Schramm, Hargarten, Milia, deRoon-Cassini.

Acquisition, analysis, or interpretation of data: Timmer-Murillo, Geier, Brandolino, Holena, de Moya.

Drafting of the manuscript: Timmer-Murillo, Schroeder, Trevino, Milia, deRoon-Cassini.

Critical revision of the manuscript for important intellectual content: Timmer-Murillo, Geier, Schramm, Brandolino, Hargarten, Holena, de Moya, Milia.

Administrative, technical, or material support: Timmer-Murillo, Schroeder, Trevino, Brandolino, Holena, Milia, deRoon-Cassini.

Supervision: Geier, Schramm, Hargarten, de Moya, deRoon-Cassini

Conflict of Interest Disclosures: None reported.

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