Remember, remember, the burns in November
The U.K.’s annual uptick in fireworks injuries demonstrates the danger of recreational explosives
Every November, A&E doctors prepare for a surge of patients with severe injuries. Fireworks land 1,000 people in the A&E in the four weeks surrounding Bonfire Night, according to The Royal Society for the Prevention of Accidents. The common theme of these injuries: young people (half of them under 18) attending private parties.
On Figure 1, our case-sharing platform for healthcare professionals, practitioners discuss these accidents and their complicated repairs. Based on their cases and in order of severity, here are three ways that fireworks can land you in the A&E.
1. Skin is burned
When someone presents to the A&E after fireworks, it is most likely due to a burn. In the case above, the patient suffered a full thickness burn, damaging both layers of skin on the hand. This wound is relatively minor and will likely heal on its own, as long as it is kept clean and dry and monitored for infection.
2. An explosion damages the hand
According to the U.S.’s National Fire Protection Agency (NFPA), fireworks most commonly injure the hands. Accidents can occur when a person is holding a lit firework that explodes. The flame and debris tear through the flesh, causing a traumatic amputation of the fingers on the patient’s dominant hand.
On Figure 1, a plastic surgeon shared his repair of a hand injury with extensive nerve damage from homemade fireworks. After a seven-hour microsurgery, he was able to salvage all of the patient’s fingers. He noted that the patient will still require extensive follow-up with physiotherapy and occupational therapy to regain mobility in the hand.
3. The face is hit
In one case shared by a radiology technician, an artillery shell firework unexpectedly went off next to a patient’s head. The result was an injury to the right cheek.
Upon seeing the X-ray, a radiology resident noted multiple fractures to the facial bones on the right side. Luckily, the accident did not impact the patient’s eyes, brain, or neck. This case will involve an extensive surgical repair that will also impact the patient’s facial appearance.
A little caution goes a long way
All of the cases shown here are relatively minor and were specifically selected to be shared with the public. The reality of fireworks injuries is often much, much more severe.
What can we learn from accidents like these? Healthcare professionals on Figure 1 say it’s important to use fireworks carefully. Always purchase them from approved retailers, and don’t try to light them while intoxicated. Make sure you set them up a safe distance away from yourself and others. Above all else, never hold a firework while it’s going off.
And ideally, leave the pyrotechnics to the professionals.
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