June 30, 2023 – Ryan Katz, MD, a hand surgeon at the Curtis Hand Center at MedStar Union Memorial Hospital in Baltimore, has a patient who was seriously injured by fireworks.
“My patient — I’ll call him ‘John’ because he doesn’t want his real name used — is a 23-year-old man based in Maryland,” Katz said. “He was lighting fireworks with his friends. He was holding a mortar – an explosive projectile designed to be launched from a tube – and the device exploded in his hand, knocking his thumb away from his index finger.
John is still living through the trauma of the accident, so he didn’t want to tell the story himself. But was happy that Katz shared her story so others could stay safe during the upcoming 4th of July holiday.
John needed a delicate and complicated operation that takes 4-6 hours.
“The skin on his index finger was completely gone, so the index finger had to be amputated,” Katz said. “The soft, supple, fleshy space between his thumb and index finger had also disappeared, so we resurfaced that web space with the skin of his thigh, creating a free flap.”
Fireworks injuries: common but preventable
Fireworks-related injuries are common, according to a Report of the Consumer Product Safety Commission in 2022. The agency reviewed deaths and injuries related to non-occupational fireworks from 2021 and gathered information from news clippings and estimates of injuries treated in emergency rooms across hospitals, drawn from its national electronic injury surveillance system.
Commission staff particularly focused on the period between June 18 and July 18, 2021 and found that approximately 74% of annual fireworks-related injuries treated in emergency rooms occurred this that month.
According to the CPSC report, in 2021:
- There have been nine fireworks-related deaths.
- Fireworks have been implicated in approximately 11,500 injuries treated in US hospital emergency rooms.
- Fireworks-related injuries have increased since 2006 by about 274 per year.
- More injuries occurred in men than in women (59% versus 41%).
- The highest percentage of injuries occurred among adults aged 25-44 (32%). Children under 15 followed closely with 29%.
- Young adults had the highest estimated rate of injuries treated in the emergency room, followed by children aged 5 to 9.
These injuries are preventable, Katz said, if you follow a few simple but important precautions.
Are people following fireworks safety measures?
Unfortunately, according to a new 2023 report released by MedStar Health, a health care system that serves Maryland, Virginia, and Washington, DC, many people are unaware of the precautions to take when using fires. ‘artifice. Prior to July 4, MedStar Health surveyed 1,000 people living in the Washington/Baltimore area to learn about their vacation plans and their knowledge of fireworks safety.
Some disturbing findings have emerged. Although more than a third of respondents knew someone who had been injured by fireworks, three quarters said they planned to celebrate the holiday with fireworks; 66% said they planned to use firecrackers and 61% planned to use sparklers.
Forty percent of respondents said they planned to use fireworks at home, and 40% said they were unaware of local fireworks laws.
Perhaps most troubling, over a third (37%) let their children/grandchildren use sparklers, 29% allow them to use fireworks and 15% allow them to use firecrackers.
The #1 tip offered by Katz is not to try out fireworks at home. “Leave it to the professionals,” he recommends. “Where people get in trouble is that they don’t see these fireworks as a risk, so they let their guard down.”
What are the risks ?
According to Consumer Product Safety Commission estimates, the most commonly injured body parts were the hands and fingers (31%), followed by the head, face and ears (21%), legs (15%) , eyes (14%). ), trunk/other regions (10%) and arms (8%).
The most common injuries were burns, particularly to the hands and fingers, followed by lacerations and bruises to the head, face and ears.
“Eye trauma is very common,” says Katz. The same goes for burns to the arms and legs, face and trunk. “Most people don’t wear eye protection, and if they get too close to the device and it explodes, it can damage their eyes.”
Often, homemade launching devices like bottles turn the device into a mortar. “If it explodes, it can send shrapnel into the immediate area, causing all kinds of injuries.”
And when people wear open-toed shoes and use sparklers, “the showers of sparks that rain down can burn hands and toes.”
There are also other types of injuries. Although Katz does not specialize in treating the ears, he is aware of the potential danger to the ears from loud noises and explosions of fireworks if a person stands too close. “Explosions occur at significant decibel levels and can damage the eardrum,” he said.
Take reasonable precautions
“One of the biggest problems I’ve seen is when people try to pick up an explosive device that they ignited but didn’t detonate,” Katz said. “They are chasing it and wondering if it should be turned back on. But sometimes there is a delay in the fuse and it goes out when they hold it in their hands.
He encouraged people to bring earplugs for young children and toddlers to public fireworks shows, and perhaps swaddle babies securely so their ears are covered. .
Katz warned against drinking alcohol or any other mind-altering substance (like marijuana) around fireworks. “When alcohol is in the mix, we tend to see more injuries because people often take more risks.”
And try to buy fireworks from reputable manufacturers. John believes the mortar exploded in his hand because it malfunctioned. According to the commission’s report, approximately 31% of the products selected and tested contained fireworks that did not comply with federal hazardous substances law. The violations consisted of fuse problems, the presence of prohibited chemicals and an overload of pyrotechnic materials. A reputable manufacturer may not be a guarantee, but at least it’s a good start. More information can be found on the CPSC website.
Emotional hurt often accompanies physical injury from fireworks, Katz said. “Many people develop post-traumatic reactions, stress, anxiety and even depression.”
He encouraged people dealing with these types of injuries to seek professional trauma and anxiety help, if needed.
Not just fireworks
July 4 is often celebrated with barbecues and outdoor barbecues, but Katz also urged caution.
“Don’t assume you automatically know how to grill,” he said. Be sure to read the instructions before turning it on.
He said using an accelerant – like lighter fluid – is a “bad idea and very dangerous. Nor is it necessary if you know how to use the grill correctly, according to the manufacturer’s instructions.
If you are using a gas grill and you smell gas, you must check for a gas leak before lighting it, or the grill could explode.
Other areas of safety include monitoring children and toddlers around bodies of water such as swimming pools. According 2023 data published by Cook Children’s Healthcare System in Fort Worth, TX, drownings are very common among young children, especially around the 4th of July. And drownings can happen even when many adults are around, so it’s a good idea to appoint a ‘water watcher’ – an adult specifically tasked with supervising children without any distractions.
And make sure you and your children wear sunscreen or protective clothing when outdoors. according to the American Academy of Dermatology. Sunburn can increase the risk of developing skin cancer.
The 4th of July is a wonderful time to spend with family and friends. Taking basic safety precautions is the best way to ensure the day stays fun and festive and isn’t marred by preventable tragedies.