Oh God, it burns!

Blowing stuff up is kind of fun, but going blind, deaf, or being maimed is not. Two doctors share their experiences with Fourth of July-related injuries.


What has been your experience with fireworks injuries?

My mother was a pediatric nurse and one of the family stories was that she was giving a tour of Doernbecher Hospital; it was a hospital for children to some state legislators. There was a kid who soaked a cherry bomb with gasoline and lit it in the family kitchen. The flash was so hot that he got terribly burned, and it caramelized sugar in a kitchen cupboard.



That’s why the state of Oregon put together, early on, fairly restrictive measures against fireworks, whereas in Washington and its various municipalities you can get all kinds of dangerous materials, while Oregon has had fairly tight restrictions.


So that’s why you have to drive up to Blackjack to get the “good stuff.”



As a resident what was your first Fourth of July experience?

Well, that’s kind of interesting because my first month as a resident was from June 21 to July 21, of course that was a Fourth of July weekend when I was working. I remember a three-year-old kid came in. He had grabbed a sparkler and he had a pretty good second-degree burn on his hand. You know, fireworks can cause hearing damage, vision problems, of course burns – if something goes off near some sensitive tissue it can really cause significant tissue disruption.


Did you see any people come in with hearing damage?

No, but it does occur because of the loud explosion. I mean, you have this thing called a “threshold shift.” People come in and talk about “some fireworks went off and my ear was ringing for weeks afterwards.” That’s called “tinnitus.” Later on they’ll have some hearing loss, sometimes it’s temporary, sometimes it’s more permanent. The same thing happens with gunfire too close to your ear, same principle, the loud explosion.


Did you ever encounter war veterans suffering from some sort of anxiety attack due to post-traumatic stress?

Well, I’ve heard from several veterans that they don’t like the fireworks and get flashbacks.


What was the worst Fourth of July accident you’ve seen?

Well, I think it’s the little kids who get injured because they don’t understand why they’re hurting and in pain. Older children and adults know they’re being stupid. There are all kinds of stories. There’s a terrible one where a guy threw an M-80 out of a car window and it bounced on the door window and he reached under his seat to throw it out and it exploded in his hand and he lost his hand.


Have you seen people messing around with hand grenades or something like that?

No, there’s stories where you can go up to some of those reservations and they’re illegally selling quarter-sticks of dynamite with a fuse in it. It’s just people doing it in too confined an area. Of course the other issue is if it’s a dry area they set off wildfires.


Have you encountered people who have suffered burn injuries due to fires caused by fireworks?

There’s plenty of incidents where there’s house fires caused by fireworks, there’s plenty of house fires caused by cigarette smoking, it just crescendos right around this time of year. The thing is fireworks are going to be here no matter what, so use common sense, be very careful around children, and in crowds, and do everything in a controlled fashion.


Doctor 2


What’s the most traumatic firework injury that you’ve had to deal with?

I worked in the emergency department for 20 years. The worst firework injury I saw was a guy that made a homemade firework out of a pipe and he blew off his thumb and index finger. That was the worst one. A lot of what we see are like burns, kids getting burned by sparklers and fireworks going off in people’s hands. Usually if it goes off in the hand it causes the hand to go numb and maybe burns it, but it recovers. There’s stuff in the eyes where you get an explosion with a short fuse and then it blows some debris up into the eye. But I personally have never seen a really serious eye injury. Most of them are burns: first- andsecond-degree burns. First degree is like a sunburn, second degree is like a sunburn where you have blistering, that kind of thing, and a third-degree burn is where you burn all the way through the layers of the skin. I think I have seen a minor third-degree burn, but that’s normally what you see. It’s certainly possible that you have worse. They had one where these kids had lit some fireworks off that were the children of the owners of the fireworks stand, they were lighting, the stand caught on fire and some things started going off and they tried to get some of the fireworks out of there, one of the children was burned. I personally haven’t seen anything more serious than that but it’s entirely possible.


Are injuries from homemade fireworks common?

They’re quite common. Basically people take the powder out of other fireworks and put them into another container and put a wick on it and put it underneath something they can blow up and that’s the source of a lot of the more serious injuries. I’m from the old days when they had the cherry bombs and the silver bullets. I used to buy cases of that stuff and I might have blown off a few of my fingers as well.


Have you seen people come in with tinnitus?

Temporarily, yes; it could actually cause permanent hearing loss as well. In the ER you see them once and then refer them to the family doctor, but I have seen it.


Are respiratory problems common this time of year?

Asthma, yeah, you see a lot of it kicked off by seasonal allergies, grass and pollen, that kind of thing.


So it all kind of combines with the firework smoke?

It all kind of combines, yeah.


Besides burns what other injuries do you see around this time of year?

The volume of injuries goes way up. Any time there’s nice weather, everybody gets their boats out, they go horseback riding, they work on their houses on ladders, and we see all that. I don’t know what the volume goes up, around 25 percent. It may be more than that, that’s just a very broad generalization, but it very substantially goes up on nice weather and holidays. Also camping fires and people burning themselves – I had one injury where kids were running around on the beach after they put out a fire and they ran over to this huge fire where they used seawater to put it out and they didn’t realize that the rocks were still really hot and they had second-degree burns by the time they got out of that area.
But there’s just all kinds of accidents that go way up, motorcycle accidents, drinking and driving, it’s just phenomenal.


What part of the body is most common in firework injury?



I’ve also read that it’s most often children who get hurt.

Absolutely, adults are a little more mature and know how to be safe, whereas kids don’t and tend to take more chances.


What advice would you give to people setting off fireworks?

First of all, use legal fireworks. Second of all, have children well supervised, and always be aware of wind and the direction of wind, because that can blow whatever is burning into a burnable area.