The Fourth of July- A Time to Be Careful and Cautious By Dr. Kurt Belk FACEP, Medical Director, The Urgency Room

This Fourth of July and while many people in the Twin Cities are entertained by the boom, crackle and exploding color of fireworks displays, ER doctors like myself are left to deal with the dark side of this tradition including patients with severe burns or even missing fingers. These are devastating lifelong injuries and a constant reminder of the need be careful and cautious when it comes to fireworks.

According to the Consumer Product Safety Commission (CPSC), nearly 10,000, Americans suffer firework related injuries every year and nearly half of those injured are children. Most of these injuries occur during what is referred to as the “high season” of fireworks, from June 19 to July 19.

It is interesting to note that sparklers are the top firework offender and what many consider the most innocent. After all, so many people allow their children to handle sparklers. But, according to the National Fire Protection Association (NFPA), the tip of a firework or sparkler can burn as hot as 1,200 degrees – hotter than boiling water, burning wood, hot enough to melt glass, and hot enough to cause third degree burns. Bottle rockets are also a major cause of firework-related visits to the ER.

The most common injuries we see at The Urgency Room resulting from fireworks are:

·         Eye damage

·         Burns to the body and face

·         Poisoning from children ingesting materials

·         Hand and foot wounds

Assessing Eye Damage

Corneal tears are the most common eye injuries from fireworks. Researchers have found these injuries occur from tiny shards of unspent explosive debris sprayed onto the eye. Those injured in this way should not rub the eye. Doing so can cause chemical burns or a foreign object to spread or injure the eye even further. If after inspection there appears to be a foreign body in the eye, do not try to remove it. Instead, come see us at the Urgency Room to have it properly and safely removed.

If there does not appear to be an object in the eye, flushing it is the best immediate treatment. In the case of a spark from a sparkler, the amount of foreign material from this type of injury is small. Over-the-counter eye care products designed to soothe irritation can help.

Burn Treatment

First, determine the severity of the burn. If the burn is not deep and smaller than the size of your palm it is possible to be treated at home. However, if the burn is on your face, genitals or major joints, you should see a doctor. You’ll also need to determine the type of burn:

• Superficial or first degree burns result in reddened skin without blisters. These types of burns can be treated at home.

• Partial thickness or second degree burns cause reddened skin with blisters. It’s best to have a doctor assess this type of burn.
• Full thickness or third degree burns are characterized by white or charred skin. The area loses sensation to pain and touch. This type of burn often needs a skin graft to prevent bad scarring.

Again, the level of care depends on the size and location of the burn. If you are unsure, check with your doctor or come to the Urgency Room. Before coming in, cover the burn with a sterile dressing or clean washcloth or towel.

Fireworks are toxic

Fireworks contain toxic chemicals such as potassium nitrate, white phosphorus, barium chlorate, and arsenic. It doesn’t help that fireworks come in pretty, colorful packages that can look like candy to a child. Because swallowing any amount of fireworks can be harmful, they should be kept out of the reach of children and animals.

If your child ingests a firework, call Minnesota poison control immediately at 1-800-222-1222 to determine immediate steps including a potential trip to the emergency room.

Hand and Foot Wounds

These are the most common firework injuries and happen when a firework goes off while being lit or in cases where someone lights a firework while it is in their hand. Treatment for these types of wounds includes:

• Apply direct pressure until bleeding stops.

• Clean area with warm water and soap.

• Apply antibiotic ointment and a sterile bandage.

• Apply ice and elevate hand or foot to reduce swelling.

• If a finger or part of a finger, for example, has been severed, collect all parts and tissue and place in a plastic bag on ice for transport to the hospital with the person.

• Come see us right away for a deep cut or scrape that you cannot get clean or if the cut shows signs of infection.

Most methods of firework injury-prevention are common sense.  Unfortunately alcohol and a “festive” attitude can get in the way of important safety guidelines when it comes to enjoying fireworks. In a perfect world, we would leave the firework displays up to the professionals. But for those who insist on lighting off fireworks at their home, here are important precautions:

·         Never use illegal fireworks. There is a reason they are illegal.

• Never allow young children to play with or ignite fireworks. Also keep children far away when fireworks are being lit.
• If the fireworks are packaged in brown paper… stay away. This can be a sign that the fireworks were made for professional displays and that they could pose a danger to consumers.
• Never place any part of your body directly over a fireworks device when lighting the fuse. Light one at a time and always back up to a safe distance immediately after lighting fireworks.
• Keep a bucket of water handy in case of fire or other mishap.
• Never try to relight or handle malfunctioning fireworks. Instead, soak them with water and throw them away.
• Keep fireworks in a safe place away from children.

Essentially, the 4th of July holiday is about celebrating our independence while relaxing with family and friends. If fireworks are part of your holiday tradition, be sure to play it safe.