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Independence Day shouldn't mean a trip to the Emergency Department

Independence Day shouldn't mean a trip to the Emergency Department
Take alcohol, light fireworks and what do you have? Directions for a trip to the emergency department (ED).

But there are ways to celebrate our nation’s independence that don’t include driving to the ED or calling 9-1-1.

The Fourth of July, like many holidays, means increased travel and more alcohol consumption. That alone results in emergency medical services (EMS) response and ED treatments.

In addition, “The Fourth of July is unique among holidays in that it also adds varying grade explosives being used by novices,” Michael Smith, MD, FAEMS, medical director, Carle Regional EMS, said.

“Every year, most citizens have fun and enjoyable holidays,” Dr. Smith, also senior vice president and chief medical officer, Health Alliance, said. “A few are left with serious injuries, or worse.”

Common injuries from fireworks on and around the Fourth of July include injuries to the eyes, hands and face and burns to the hands, face and chest, Holly Cook, MSN, RN, director, Emergency Department, Carle Foundation Hospital, said.

“There is a high risk for infection in any skin or tissue that is burned,” Cook said. “You can also have vision changes or vision loss if there are injuries in or near the eyes that aren’t treated.”

This year, there is an additional wrinkle. Conditions remain more dry than usual, despite the recent rain in some areas.

“Honest advice is to skip the fireworks this year because the risk of fire spreading is extremely high throughout the region,” Dr. Smith said.

“Every year, our emergency services treat multiple injuries from fireworks,” Dr. Smith said. “While the large majority are minor, we have seen both loss of limb and loss of life events from novices using higher-grade fireworks. And every year, a few of our local fire departments end up battling structure fires ignited by fireworks.”

Never mix fireworks and alcohol, Dr. Smith advised. “Playing with fire is a bad idea while intoxicated,” he said.

John Sollars, NRP, CCEMTP, Arrow Ambulance operations manager-East Region, said “Overconsumption of alcohol is the biggest problem I see around Independence Day. If people would consume in moderation and act responsibly, there would be very few additional issues around this holiday.”

“The most common things we see are related to excessive alcohol consumption,” Sollars said. “Injuries from fireworks (usually burns), vehicle crashes and heat exhaustion are all more common around Independence Day.”

Fireworks that are legal in Illinois, such as sparklers and smoke bombs, typically cause mild to moderate burns. The state prohibits more complex fireworks that can explode in close proximity to the user, causing anything from burns that can get infected to loss of body parts and eyesight, even death, Sollars said.

“Leave fireworks to the professionals,” Sam York, BSN, RN, Emergency Department nurse manager, Carle Richland Memorial Hospital, said.

People who use fireworks shouldn’t let children set them off, shouldn’t hold the firework near their body, should light only one firework at a time following instructions, shouldn’t use alcohol or drugs while lighting fireworks, shouldn’t relight a firework that’s malfunctioning and shouldn’t throw a firework at anyone, Cook said. After using fireworks, soak them in water before throwing them out.

Anyone who experiences a burn from a firework should cool down the area by holding it under cool water for 10 minutes or applying a clean, cool, damp cloth, York said. Don’t use cold water or ice because they can cause more injury. Apply antibiotic ointment or aloe vera to the area and loosely cover with a bandage.

If redness or pain in the area gets worse after a couple days, if it looks too bad to treat at home or if you notice signs of infection, go to a Carle Convenient Care location or your primary care physician. A provider should evaluate any burn or injury around the eyes, nose, ears, fingers and feet.

Call 9-1-1 or go to an emergency department if you experience an injury from a fireworks explosion, if you inhale a lot of smoke, or if your burn results in charred skin, if the skin around the burn is white rather than red, if the burn goes around the arms, legs or trunk or if the burn covers a large area, especially of the face, neck or a major joint.

Fireworks-related injuries aren’t the only injuries and illness on and around Independence Day. What follows are other common mid-summer injuries and illnesses and how to prevent and treat them:

Heat exhaustion and heat stroke

Heat exhaustion happens when the body can’t cool itself through sweating. Symptoms include high body temperature, pale skin, muscle cramps, headache, dizziness, weakness and fatigue, rapid breathing and increased heart rate, nausea and vomiting.

If you experience heat exhaustion, get out of the heat, drink water and place ice packs to your neck, armpits and groin, York said.

Heat exhaustion can progress to heat stroke. Symptoms can include a body temperature of 104 degrees or higher, dry and red skin, inability to sweat, seizures, dizziness or fainting, slurred speech, hallucinations, confusion, aggression or agitation.

If you are experiencing any of those symptoms, call 9-1-1, York said. In extreme cases, heat stroke can lead to death.

People can reduce their risk of heat exhaustion and heat stroke by getting out of the sun and taking breaks inside, seeking shade and drinking water. Another strategy is don’t be alone outside, she said. When active outdoors, have a buddy with you so you can keep an eye on each other.


In addition to burns from fireworks, other common causes of burns this time of year are from people touching hot grills, from farmers working on their equipment and from people spending too long unprotected in the sun, York said.

Burns may be treated in the same way as burns from fireworks as described above.

People may reduce their risk of burns from overexposure to direct sunlight by limiting time in direct sunlight and by applying and reapplying sunscreen.

Reduce risk of burns from grills by keeping children away from grills.

As to burns from working on farming equipment, farmers may reduce their risk by always turning off equipment and letting it cool down before working on it, York said. Wearing protective gloves when working on equipment and when grilling also may reduce the risk of burns. Another piece of advice that applies to farming and grilling is to not rush.

“People know better but they get in a hurry,” York said.

Traffic crashes

Traffic crashes also keep EMS and ED staffs busy on and around the Fourth of July. Many of these are a result of alcohol consumption or illicit drug use.

“Don’t consume alcohol and get behind the wheel of a vehicle,” Sollars said.

This includes all-terrain vehicles and boats.

“We see an uptick of water-related injuries in general in the summertime,” he said.

People who wish to drink should have a designated driver, York said. In addition, drivers always should wear a seat belt and be aware of their surroundings.

Because idle children can cause some ATV and motorcycle crashes, parents should make sure that keys are where youth can’t find them, York said.

Categories: Staying Healthy

Tags: accidents, burns, emergency, fireworks, Fourth, heat, Independence, medicine, safety, summer