Maheswari Ekambaram

is a pediatrics resident at Einstein Medical Center

In the middle of a routine well-child visit, my 4-year-old patient started creating a ruckus in the exam room. Johnny systematically opened all the cabinets, pulled out any loose bits of paper he could find, and tore them up. He then got on the exam table, picked up my expensive ophthalmoscope, and almost took a dive to the floor before his dad stopped him.

Knowing that unintentional injuries are the leading cause of death among children, I used this opportunity to educate Johnny's parents about safety at home. Do you have your medicine cabinet locked? Are detergent bottles kept in the top shelf? Do you have working fire alarms? Do you have guns in your home?

While a routine part of well-child checkups, that last question has come under scrutiny lately. Why do I ask?

The data are clear: Gun violence is a public-health threat to children. According to the Centers for Disease Control and Prevention, firearm-related deaths are one of the top three causes of death in American youth, causing twice as many deaths among them as cancer, five times as many as heart disease, and 15 times as many as infections.

Studies show that, among gun-owning Americans with children under 18 years of age, 21.7 percent stored a gun loaded, 31.5 percent stored a gun unlocked, and 8.3 percent stored at least one gun unlocked and loaded.

So what happens when an inquisitive, energetic 4-year-old has access to a loaded, unlocked gun? The answer is, sadly, all over the news:

"5-year-old shoots 2-year-old sister in Kentucky" (Washington Post, May 1).

"Two 4-year-olds, two guns, two fatal shootings" (NBC, April 9).

"New Jersey police: 6-year-old dies a day after being shot - by a 4-year-old" (CNN, April 10).

And the list goes on.

I don't want to see 4-year-old Johnny featured in such a headline. That is why I ask.

And it makes a difference when we do. A recent national trial demonstrated that physician counseling directed at parents, combined with a distribution of gun locks, can be effective in promoting safer storage of guns in homes with children. Another recent trial found that a gun-safe distribution was both feasible and effective at limiting exposure to unlocked and loaded guns.

The American Academy of Pediatrics advises parents that the best preventive measure against firearm injuries and deaths is to not own a gun. However, if parents do have firearms in the home, there are safety steps they should follow, including never allowing children access to guns, never keeping a loaded gun in the house or the car, and locking up guns and ammunition safely in separate locations.

In the exam room, questions about guns in the home are not political. They are preventive. They are part of routine pediatric care, and keep children safe. That is why I ask.