According to the latest available data (June 30), Cook Children’s has treated 29 patients for gunshot wounds in 2023. Two of those patients died from their injuries.

Findings from Cook Children’s 2021 Community Health Needs Assessment survey revealed:

• Of households with guns in Cook Children’s eight-county service area, 1 in 5 children live in a home with guns that are not always safely locked away (locking up the firearm and storing ammunition in a separate location).
• Ten percent of young children, 20% of 6–11 year olds and 30% of 12–17 year olds live in a home with a gun that is not always safely locked away.

“As a physician focused on injury prevention, I know local leaders are instrumental in educating children and families about the risks unlocked guns pose in the home,” said Daniel Guzman, M.D., emergency medicine physician and program director of the Aim for Safety program at Cook Children’s. “We’re grateful for the leadership Fort Worth has shown on this important issue.”

Partners in this proclamation included Lock Arms for Life, a Texas-based nonprofit that works every day to get all guns locked when not in use.

Cook Children’s Health Care System has treated 16 non-fatal firearm-related injuries so far from January through April of this year. Of those 16 injuries, 14 were unintentional, and two were assault injuries. There have been zero fatal firearm-related injuries  in 2022.

Since 2017, Cook Children’s has treated 344 firearm injuries, 16 of which were fatal.

Cook Children's Aim for Safety® initiative is designed to help reduce the number injuries we see every year among children through gun safety education. This is not about whether guns are right or wrong. It's about taking the necessary steps to protect our children.

Aim for Safety interactive kiosk

Cook Children’s Aim for Safety® program has a new way to educate families on gun safety through an interactive kiosk that teaches children what to do if they discover a firearm in a home — all while reinforcing safe-storage techniques for adult gun owners.

The mobile kiosk, which stands more than 7-feet high and resembles a giant smartphone, rolled out in December at Defender Outdoors, a sports shooting and outdoors equipment retailer in Fort Worth. As part of a first-time collaboration with Cook Children’s, the kiosk was placed near the check-out registers in hopes it attracts the attention of parents and children alike.

The Aim for Safety educational kiosk — activated by touch — uses advanced technology to engage and teach children as they progress through four levels, stumbling upon unsecured guns hidden in places such as cabinets and drawers while moving through a virtual home. If they find a gun, they must correctly answer questions on how to safely handle the situation in order to progress through the program. Other gun safety-related questions are asked as objects in the rooms are found and touched.

The kiosk is another way the hospital system can further its reach in the community and educate more families about the safe handling and storage of firearms, says Amy Johnson, program coordinator for the Center for Children’s Health (C4CH) and Safe Kids North Texas Coalition led by Cook Children’s.

Aim for Safety program

Gun awareness and gun safety is a passion for Dan Guzman, M.D., Medical Director of the Aim for Safety program at Cook Children’s. Dr. Guzman is asking gun owners to take action and store their firearms properly and to take personal responsibility for our children’s safety.

Dr. Guzman stressed that children are curious and impulsive which can be deadly when paired with a firearm. Storing a loaded firearm under the mattress, in a bedside table or a closet is placing your family at risk, Dr. Guzman added.

The most secure place for your firearm is in a safe with the ammunition stored separately. Unsecured firearms should always be in your possession. If you are unable to purchase a gun safe, then separating the ammunition from the firearm and using a cable or trigger lock will help reduce the risk of unintentional injury to your child.

“It’s important to assess and evaluate your home injury risk and find ways to reduce the hazards in your home whether it is related to firearms, water safety, poisonings or any other safety risks,” Dr. Guzman said. “Discussing with your children the importance of what to do when they encounter a firearm can help to reduce unintentional injury in your home."

Help your kids learn and follow the 3-step rules:

Safe storage: 

Parents and caretakers should always ensure safe storage in your own home and the homes you visit. Store firearms unloaded and in locked locations, out of reach of children.

• Use trigger locks and gun boxes.
• Secure ammunition separately.
• Hide gun safe and trigger lock keys.
• Keep unlocked guns in your possession.
• Make sure all guns are equipped with effective, child-resistant gun locks.
• If a visitor has a gun in a backpack, briefcase, handbag, or unlocked car, provide them with a locked place to keep it when in your home.

Safe children: 

If your child sees a real gun or sees someone aiming a toy gun at others, teach them to:

• Stop.
• Don't touch.
• Run away.
• Tell a grown up.

Safe play for non-powder guns:

• When non-powder guns are in use, there are a few things to remember to help prevent injury:
  • Never aim BB guns or pellet guns at another person
  • When using a paint ball gun, gel bead gun, water bead gun, or soft foam gun, players should be properly attired and wear safety glasses at all times.
• Ask the parents of your child's friends if they have guns in their homes and how they are being stored.
• If you are asked about your guns, don't be offended.
• Aim for Safety is for advocating gun safety and gun safety only.
• This information is to aid gun owners in protecting not only their own children, but also those that enter their home.

Dr. Guzman, pediatric emergency medicine physician and Medical Director of the Aim for Safety Program, says that the school-aged kids who dealt with the tragedy will "definitely have long-lasting effects," some of which will include "stress, anxiety [and] their comfort level with returning to school."

Read the full story here.

As an emergency room physician, Dr. Guzman also knows the importance of gun safety.

Dr. Guzman has seen serious, even deadly consequences, as a result of a child shot with a BB or pellet gun.

From January 2016 to the end of November in 2019, 214 children have been seen at Cook Children’s because of firearm injuries.

During that time frame, 27 children were injured by a handgun, 10 from a rifle, shotgun or larger firearm and 177 others were harmed by “other or unspecified firearms, which includes airguns and BB guns.

Firearm Injuries by Calendar Year and Age Group

Over his 16-year emergency room career, Dr. Guzman has cared for three children who died from BB/pellet firearm injuries to the chest.

Dr. Guzman said that "basic BB guns like a Red Ryder can fire up to 450 feet/second, and pellet guns can fire up to 1300 feet/second, which is faster than most handguns."

Dr. Guzman stated, "that studies have shown that it only takes 331 feet/second to penetrate the skin, so it is easy to see why injuries and deaths can occur from such basic firearms. Teaching children to respect firearms is important. Still, more importantly, parental supervision is important, as well as appropriately storing all firearms is key to keeping our children safe from unintentional injuries."

Even some NERF guns can harm a child. Many of these guns are made to shoot from as far away as 100 feet. If a child holds the Nerf gun too close, the power of the dart could hurt a child.

"Many children have been harmed by what's called a 'toy gun,'" Dr. Guzman said. "If you are going to have guns in the house, it's important to teach children to respect the guns. It can save a life and teach children to have gun safety etiquette as they get older."

With the holidays and gift-giving right around the corner, Dr. Guzman wants to get the word out about gun safety as more firearms will find their way into people's homes.

Buying a Gun for Your Child

Giving guns as gifts, especially BB and pellet guns, is a common occurrence in states like Texas.

In fact, the vast majority of us grew up with these types of firearms and never would think of them as "deadly." But the truth is, they can cause severe injury and death.

Firearm Injuries by Calendar Year and Outcome

Unfortunately, Dr Guzman has seen many unintentional injuries related to BB and pellet guns. Within the last two years he has seen injuries to the face and eye causing debilitating injuries. One child lost vision in one eye from being accidentally shot by a friend with a BB gun.

“It is important to view these firearms as real threats to our children and be vigilant about safety when we have any type of firearm in the home,” Dr Guzman explains.

In Texas, minors can't buy guns. It's illegal to sell a long gun (rifles) to anyone under 18 and to sell handguns to anyone under 21.

However, it's not illegal to give a gun to a minor with parental permission.

"I know this is a divisive issue for many people," Dr. Guzman said. "But my main concern is the safety of children. If you do buy a gun for your younger child, make sure they are mature enough to handle the firearm. And, if you are taking the gun out for hunting or recreation, always travel with your child. Never let them go alone."

Some helpful tips for gun safety include:

• Start with a hunter's safety course for children to learn the basics of firearm handling.
• When you aren't using a gun, store the gun unloaded, and locked up. Lock up the bullets separately and keep control of the keys.
• Teach your child to assume a gun is always loaded.
• Never point a gun at someone or yourself.
• Set a good example with your own gun handling practices. For instance, don't leave a gun out in the open.

Steps to Protect Your Child

"It won't happen to us" is a common theme among children and accidental injuries such as gun shootings.

However, the numbers tell a different story. In 2017, there were at least 26 children ages 0-11 in the state of Texas alone that were accidentally killed because a gun was not safely locked away.

One out of every three homes with children in the U.S. has a gun. In Texas, 36% of adults have a household firearm, and over 199,000 children currently live with unlocked, loaded firearms in their homes.

Firearm Injuries by Calendar Year and Gun Type

Dr. Guzman encourages you to talk to the parents of your child's friends if they have guns in their homes and asked how they are stored. And if asked about your own guns, don't be offended.

Other tips from Dr. Guzman include:

Safe Children

• Ask the parents of your child’s friends if they have guns in their homes and how they are stored.
• If you are asked about your guns, don’t be offended.

Safe Play

If your child sees a gun, teach them to:

• Stop
• Don't touch
• Run away
• Tell a grownup

Safe Storage

• Store firearms unloaded in locked locations, out of reach of children.
• Use trigger locks and gun boxes.
• Secure ammunition separately.
• Hide gun safe and trigger lock keys.
• Keep unlocked guns in your possession.
• Make sure all guns are equipped with effective, child-resistant gun locks.
• If a visitor has a gun in a backpack, briefcase, handbag, or unlocked car, provide them with a locked place to keep it when your home.

Another way to easily remember and share with family and friends is what Dr. Guzman coined the "3T's of firearm safety and children.

Talk – to your family, friends, and neighbors about the importance of firearm safety to keep our children safe

Teach – your children how to respond if they encounter an unsecured firearm

Take – personal responsibility to store your firearms appropriately to keep ALL our children safe

And finally, Dr. Guzman emphasizes, "if you are going to purchase a firearm this Christmas- remember to purchase a storage device along with that firearm to keep it from being found and mishandled by our children, so we can keep our holiday fun, festive and SAFE!"

*Source for Cook Children's Stats: Cook Children's Medical Center Meditech and Epic Claims Data. Inclusion Criteria: Encounter with any ICD-10 External Cause Code of: U01.4, W32-W34, X72-X74, X93-X95, Y22-Y24, or Y35.0

Dan Guzman, M.D., a Cook Children’s emergency physician, called the day gut-wrenching for the victims, their families, and the medical staff that took care of the kids, ranging from ages 3 to 14.

Gun awareness and gun safety is a passion for Dr. Guzman. He is the medical director of the Aim for Safety program at Cook Children’s, which promotes firearm safety for children. The program is a multi-step interactive experience that provides parental awareness and teaches children the steps they should take when they encounter a firearm.

“I think most people think this ‘won’t happen to us’ because we’ve taught our kids to never touch guns,” Dr. Guzman said. “But if you aren’t taking the proper precautions as the adult and parent, it’s probably only a matter of when, not if, your life may be affected by an unintentional discharge involving someone you know, and maybe even your child.”

Firearm-related fatalities are a top 3 cause of death among children in the United States.

Dr. Guzman said before the weekend, the medical center staff sees about one child per week. Already in 2019, three gunshot wounds treated at the medical center have been fatal.

“Unfortunately, the tragedy of children falling victim to unsecured firearms continues to happen daily,” Dr. Guzman said. “These preventable incidents and the pain and suffering they inflict can be reduced by properly securing your firearms.”

As part of the program, Dr. Guzman offers these safety tips to follow:

The 3 Ts of firearm safety and children

Talk – This includes your family, neighbors and friends. When your child visits other homes, ask the owners if there are guns in their homes and how they are stored. Dr. Guzman said this question is not to be insulting, but to keep your children safe from unsecured firearms.

Teach – Have a conversation with your kids about what to do if they see a gun:

• Stop
• Don’t touch the gun
• Run away
• Tell someone

Take – Dr. Guzman is asking gun owners to take action and store their firearms properly. And, to take personal responsibility for our children’s safety.

Dr. Guzman stressed that children are curious and impulsive which can be deadly when paired with a firearm. Storing a loaded firearm under the mattress, in a bedside table or a closet is placing your family at risk, Dr. Guzman added.

The most secure place for your firearm is in a safe with the ammunition stored separately. Unsecured firearms should always be in your possession. If you are unable to purchase a gun safe, then separating the ammunition from the firearm and using a cable or trigger lock will help reduce the risk of unintentional injury to your child.

“It’s important to assess and evaluate your home injury risk and find ways to reduce the hazards in your home whether it is related to firearms, water safety, poisonings or any other safety risks,” Dr. Guzman said. “Discussing with your children the importance of what to do when they encounter a firearm can help to reduce unintentional injury in your home.

NBC 5 reports that a toddler was shot in the head at a Fort Worth home last week. Police said the child’s mother and father were at the house and twin 2-year-olds were present at the time. 

While few details have been released about the shooting, Dan Guzman, M.D., an emergency physician at Cook Children’s and a gun owner himself, wants to make gun safety a priority in family’s homes. According to a 2017 Pew study, 30 percent of Americans own guns. Last year, 24 children were treated for gunshot wounds at Cook Children’s.

“Unfortunately, the tragedy of children falling victim to unsecured firearms continues to happen daily,” Dr. Guzman said. “These preventable incidents, and the pain and suffering they inflict can be reduced by properly securing your firearms.”

Dr. Guzman began the new Aim for Safety program at Cook Children’s, which gives parents the real-time opportunity to see what they would do if they found a gun.

Dr. Guzman stressed that children are curious and impulsive which can be deadly when paired with a firearm. Storing a loaded firearm under the mattress, in a bedside table or in a closet is placing your family at risk, Dr. Guzman added.

The safest place for your firearm is in a safe with the ammunition stored separately. Unsecured firearms should always be in your possession. If you are unable to purchase a gun safe, then separating the ammunition from the firearm and using a cable or trigger lock will help reduce the risk of unintentional injury to your child.

“It’s important to assess and evaluate your home injury risk and find ways to reduce the hazards in your home whether it is related to firearms, water safety, poisonings or any other safety risks,” Dr Guzman said. “Discussing with your children the importance of what to do when they encounter a firearm can help to reduce unintentional injury in your home.”

Teaching children basic firearm safety tips can save a child’s life such as:

• Stop
• Don’t touch
• Run away
• Tell a grown up

In addition, when your children visit other homes ask the owners of the home – parents of your child’s friends, your children’s grandparents or other close family members – if there are guns in their homes and how they are stored. Dr. Guzman said this question is not to be insulting, but to keep your children safe around unsecured firearms.

Aim for Safety focuses on protecting children from firearms. The program can help to answer any questions about your child’s safety and help to direct you to any resources to find the appropriate storage device.

Aim for Safety will begin a new program soon to show parents what can happen when their children encounter a firearm. For more information, please visit aimforsafety.org.

For more on this topic:

• Aim for Safety
• Program Aims to Protect Children from Accidental Shootings