The Medical Minute: Practice fireworks safety this Independence Day

Independence Day celebrations almost always include fireworks of some kind. The Prevent Blindness America organization recommends attending professionally organized fireworks displays rather than buying and setting off your own. This view is echoed by the United States Consumer Product Safety Commission (CPSC), which collects and reports data on fireworks-related injuries every year. They report that 7,000 emergency room visits from fireworks-related injuries occurred during 2008, including seven deaths. In 2007, there were 11 deaths and 9,800 emergency room visits from fireworks-related injury.

Injuries from fireworks can be diverse and devastating. They occur not only to people using the devices, but also to bystanders. The area of injury can encompass the entire body, but the most common site of injury includes the eye, the face and the hands. The most common type of injury is burn-related, followed by lacerations (cuts), contusions (bruises), and abrasions (scrapes). Amputations, although uncommon, did occur in 14 reported cases in one year. Eye injuries can be especially devastating, and include mild injuries requiring ointment therapy to injuries that are so severe that they require removal of the injured eye. Trauma is one of the most common causes of monocular blindness in children. Twenty-two percent of pediatric eye injuries recently reported were in bystanders. These facts underscore the importance of safety from fireworks even when only in the general vicinity of a display.

Children are especially prone to fireworks-related injuries. More than 40 percent of such injuries occur in children younger than 15 years. These injuries include use of “safe and sane fireworks,” in which category sparklers and other such devices reside. Such devices have been quoted as causing 10 to 17 percent of injuries. Sparklers can burn at up to 1,800 degrees Celsius (for reference, boiling water is 100 degrees Celsius). Bottle rockets and other aerial devices can misdirect and instead head towards both the handler and a bystander. Roman candles/fountains can send off a shower of miniscule, hot sparks that cause major skin and ocular burns.

The American Academy of Pediatrics officially recommends only attending professional fireworks displays. They also support efforts to curtail the availability of alternative devices and recommend especially that these devices be used and kept at a distance from children.

What to do if injury occurs:

If a serious burn to the hands or face occurs:

  • You may place cool compress over the area before heading to the emergency room.
  • Never place ointment on a burn site – this confines the burn and causes more injury to the affected tissue.
  • Never place ice cubes or ice cold water onto the site – this may cause an increase in injury.

2. If specks from a sparkler or Roman Candle get into the eye:

  • Do not rub the eye.
    • You may try lifting the upper eyelid carefully and down over the lower lid to try and let tears naturally wash the particle away.
  • Do not attempt to rinse the eye; this may cause greater damage.
    • Do prevent a child from rubbing by placing a protective guard over the affected eye; this can be anything from a cup taped over the eye to sports goggles.

3. If there is a cut or object in the eye:

  • Do not try to remove an object in the eye; this must be done by a medical professional.
  • Protect the eye with a guard, as described above.
  • Go directly to the emergency room or call 911 for assistance.

Jordana M. Smith is a resident in ophthalmology, Penn State Hershey Eye Center, Penn State Milton S. Hershey Medical Center.

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Last Updated November 18, 2010