According to Daniel Guzman, M.D., a pediatric emergency medicine physician with Cook Children’s Health Care System, children are treated in emergency departments every year for fireworks-related injuries, including burns, eye trauma and hand injuries. While many families associate these injuries with the person lighting the fireworks, children and other bystanders can also be at risk.

Although fireworks are a beloved Fourt of July tradition, Cook Children’s Health Care System, encourages families to celebrate safely and understand the risks fireworks can pose to children.

What type of fireworks injuries do children often experience?

Fireworks can cause serious injuries in a matter of seconds. Even legal consumer fireworks can burn at temperatures high enough to cause severe skin damage.

Some of the most common fireworks-related injuries include:

• Burns to the hands, fingers and face
• Eye injuries that can threaten vision
• Cuts and lacerations
• Hearing damage from loud explosions
• Falls or other injuries while running away from fireworks

Sparklers aren’t as safe as they seem

Sparklers are often considered a safer option for young children, but they can be surprisingly dangerous.

 “Many parents feel that sparklers are safe because they don’t explode, however, the risk for burns is significant because they can reach 2000˚F (1093˚C) which is hot enough to melt some metals and cause severe burns.” said Dr. Guzman.

 Young children may accidentally touch the hot wire, wave sparklers near others, or drop them onto bare feet. Using glow sticks instead of sparklers is a safer, brighter, and more fun way to celebrate.

Fireworks safety tips for families

The safest way for children to enjoy fireworks is by attending a professional public display rather than using fireworks at home according to Dr. Guzman.

If your family chooses to use legal consumer fireworks, help reduce the risk by following these safety tips:

• Never allow young children to handle or light fireworks.
• Keep children and pets a safe distance away from fireworks.
• Ensure a sober adult supervises all fireworks.
• Read and follow all instructions on the packaging.
• Never relight a firework that doesn’t ignite properly.
• Keep a bucket of water or a garden hose nearby.
• Never point or throw fireworks toward another person or pet.
• Never carry fireworks in your pocket.
• Soak used fireworks in water before throwing them away.
• Avoid homemade or illegal fireworks.

What should you do if a child is injured?

If a child is burned by fireworks, move them away from the source of the injury. Cool the burn with cool water as soon as possible, remove clothing from the burned areas and apply a gauze bandage or clean, soft cloth. Seek medical care attention right away, especially for burns involving the face, hands, feet, joints or large areas of skin.

If a child has an eye injury, “do not rub the eye or attempt to wash it out; call 911 or go to the nearest emergency department,” said Dr. Guzman.

Other Fourth of July safety reminders

Fireworks aren’t the only risk during Independence Day celebrations. Parents can also help keep children safe by:

• Never leaving children unattended near pools, lakes or other bodies of water.
• Making sure children wear properly fitted life jackets when appropriate.
• Keeping kids hydrated, especially during extreme heat.
• Taking frequent breaks from outdoor activities.
• Applying and reapplying sunscreen throughout the day.
• Grilling outdoors only, keeping children at least 3 feet away from hot grills.
• Keeping matches, lighters and lighter fluid out of children’s reach.

The safest celebration is a prepared one

The Fourth of July should be remembered for time with family, not a trip to the emergency department. Choosing professional fireworks displays, supervising children and practicing simple safety precautions can help families enjoy a fun and memorable holiday while reducing the risk of serious injuries.

Related Stories:

• Big Game, Big Responsibility: Water Safety

• Expert Tips for a Safe Spring Break: Aim for Safety

• Big Game, Big Safety: Preventing Hot Car Tragedies

The Fourth of July is a time for celebration and getting together with family and friends. Cook Children’s experts are sharing safety tips and information to remember as people gather this weekend. Keep in mind that drowning is the leading threat for children, especially during the Fourth of July holiday.

In the emergency room, drowning patients are seen the most frequently and drownings most often lead to fatal outcomes, said Corwin Warmink, M.D., medical director of Cook Children’s Emergency Department.

“Keep a close eye on your child any time there is water nearby,” Dr. Warmink said. “People are often in large groups and let down their guard thinking that someone else is watching the kids in or around the water. They should identify an official Water Watcher who is responsible for keeping track of everyone.”

DROWNINGS

In June 2022, there were 19 drownings treated at Cook Children’s, none were fatal. Seventeen of those children were 5 years old and under.

• In June 2021, there were 22 drownings, one was fatal.
• In June 2020, there were 8 drownings.
• In June 2019, there were 13 drownings.
• In June 2018, there were 16 drownings. Three were fatal.

While most patients survived these incidents, drowning injuries can result in severe effects, especially on a child’s brain development.

Many of the drownings so far in 2022 have occurred during unplanned swim time. This is when parents didn’t expect their child to be in or around the water.

Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger.

Drownings can occur even with many adults present. When there are children around water, always designate a Water Watcher, an adult who is in charge of watching all children without any distractions.

Drownings on July 3 and 4:

• 2018: one drowning on July 3 and two on July 4
• 2019: four drownings on July 3
• 2020: one drowning on July 4
• 2021: one drowning on July 3 and one drowning on July 4

None of these drownings listed above were fatal, but parents and caregivers must remain vigilant.

Parents can also put barriers in place to help prevent a child from accessing the water or make it more difficult to access when an adult is not present. Barriers – such as locks, alarms and fencing – can help keep unsupervised young children from getting into swimming pools.

For more information and resource, including Water Watcher tags, visit: LifeguardYourChild.org

HEAT SAFETY

There are other threats during the Fourth of July holiday that can lead to severe injuries.

“Boating, jet ski and watercraft accidents are very frequent and often very tragic injuries. Burns from fireworks and cookouts are also very common,” Dr. Warmink said. “Snake bites and other bites are also common because a lot of people are outdoors along with very severe sunburns and heat exhaustion.” 

With the highs in the upper 90s and triple-digits, be sure to keep these heat safety tips in mind.

“Sunscreen is important and it should be reapplied every few hours. Drinking plenty of water and hydrating drinks throughout the day,” Dr. Warmink said.

Wear appropriate clothing: Choose lightweight, light-colored, loose-fitting clothes. Wear a hat to shield yourself from the sun, until you feel yourself getting warm. Then remove any items covering your head that can trap heat close to the body.

Schedule outdoor activities carefully: Heatstroke can occur in less than an hour when you are participating in a strenuous activity on a hot day. Try to limit outdoor activity to when it’s coolest, like morning and evening hours. Rest often in shady areas so your child’s body has a chance to recover.

Hydrate: Drink plenty of water during the day, especially if you are engaged in any strenuous activity. Be sure to drink water or a sports drink before, during and after any strenuous activity.

Wear sunscreen: If you got outside, use sunscreen, wear a wide-brimmed hat, and sunglasses, and put on sunscreen of SPF 15 or higher 30 minutes before going outside. Continue to reapply according to the package directions.

FIREWORKS

Severe injuries from fireworks can be harmful and painful to a child. Even sparklers can heat up to more than 1,200 degrees and are dangerous for young children.

“Kids should not shoot off fireworks and they should be shot off in a ‘kid-free’ zone," Dr. Warmink said. "Keep kids away from grills and bonfires also.”

ATV SAFETY

Though often thrilling for children, off-road motorized vehicles — including all-terrain vehicles (ATVs), ATV mules, go-karts, and even golf carts — can be extremely dangerous for them to ride, especially if they don’t use safety measures once they get on board.

To prevent such injuries among children, the American Academy of Pediatrics (AAP) recommends children under 16 do not drive or ride as passengers in two- and four-wheeled off-road vehicles.

ATV Safety:

• Always wear protective gear such as:
• o Helmet
• o Eye Protection
• o Boots, gloves, long pants, jacket
• Do not ride an ATV at night
• Take an ATV safety course
• Never ride on public roads
• Perform ATV safety checks

I absolutely love fireworks, something about the smell of the burning punk, after eating a barbequed hamburger followed by homemade peach cobbler…. It’s just the best. Watching the beautiful fountains explode in an array of colors, and then hearing the large BOOM from the awesome reloadable shell fireworks, it’s classic Americana. This year, more people will be gathering for Fourth of July celebrations, so let’s make sure we make it a safe and enjoyable experience for all.

Firework-related injuries require trips to the ER 11,000 times per year. Sixty percent of injuries are burns. The hand and fingers are the most likely injured body part, followed by the head/ face, and eye. One third of eye injuries caused by fireworks result in blindness. Kids age 10-19 are the most likely age group to be injured by fireworks. Sparklers are the most likely firework to cause injury in a child less than 5 years old.

If you choose to shoot off fireworks at your home, follows these safety tips:

1. First check if fireworks are legal in your neighborhood, county and city. Do not light fireworks even if they are legal during a burn ban.
2. Light the fireworks at a safe distance from spectators, and over a piece of plywood instead of on top of dry grass.
3. Keep a water hose close.
4. Never re-light fireworks that failed.
5. Children should be under strict adult supervision, Remember, sparklers burn at 1,200 degrees and are one of the leading causes of fireworks injuries.
6. I should not have to say this, but do NOT shoot fireworks at your friends!
7. If you are injured, go to the ER immediately; firework injuries usually cannot be treated at home.

With fewer options for the Fourth of July weekend because of the COVID-19 pandemic, more people might try to create their own fireworks show this weekend. But experts warn those attempts to entertain at home could lead to a trip to the Emergency Department or even worse.

The Academy of Pediatrics (AAP) found that an average of 180 people go to the emergency room with fireworks-related injuries every day during this time of year. Fireworks resulted in at least 12 deaths and more than 10,000 injuries treated in U.S. hospital emergency departments in 2019, according to the Consumer Product Safety Commission.

The AAP is part of the Alliance to Stop Consumer Fireworks, “a group of health and safety organizations that urges the public to avoid the use of consumer fireworks and to only enjoy displays of fireworks conducted by trained professionals.”

“Our big fear right now is that with everyone staying home, we will have more 'do-it-yourself’ firework shows at people’s homes and that will mean more injuries,” said Sharon Evans, Trauma Injury Prevention Coordinator at Cook Children’s.

Firework-Related Injury Facts

• The types of fireworks that cause the most injuries are firecrackers, sparklers and bottle rockets. 
• The most frequently injured body parts are the hands, head/neck and eyes.
• Burns are the most common injury. Cuts, bumps and bruises are the most common injuries to the head.
• In addition to blindness, third degree burns and permanent scarring, fireworks can also cause life-threatening home and motor vehicle fires.

Who Is At Risk?

•  Boys are two times more likely than girls to be injured by fireworks.
• Children younger than 15 account for 1 out of 4 firework-related injuries.
• Most firework-related injuries occur around the 4th of July.

The AAP recommends that if you do go out to watch fireworks, to try to watch it from your home or somewhere you can safely follow social distancing rules. The safest option is to stay home and watch televised events. 

Related Links/Sources:

• Stay Safe this 4th of July (AAP)
• Fireworks Information Center (United States Consumer Product Safety Commission)
• Fireworks Public Education (National Fire Protection Association)
• Fireworks Safety Tips (National Fire Protection Association)
• Fireworks Safety 
• Fuegos artificiales y seguridad

As we have reported throughout multiple summers, drowning remains a leading threat to children during the holiday. Last year, two children were rushed to Cook Children’s after being pulled from that water at pool parties on the Fourth of July. One of those children died from their injuries. For the entire month of July in 2017 there were 27 drownings, with two deaths.

Cook Children’s safety experts remind parents and adults to watch children near water with the mindset of a lifeguard.

Sharon Evans, Trauma Injury Prevention coordinator at Cook Children’s, says adults should be within arms reach of child swimmers.

“Don’t let your child out of your sight and be there to grab children out of the water at any sign of trouble,” Evans said.

Drowning prevention around the pool begins with adult supervision, but there are other steps parents can take at home to help protect their children from drowning.

Use these safety techniques and layers of protection whenever children are around the pool:

• Require adult Water Watchers to stay close and actively watch children in water. Water Watchers must be sober, stay off cell phones and not talk to other guests during their 15 minutes shift.
• If you are alone with your child, stay with your child. Get in the water with your child and be in arm's reach. If you have to get out of the water for any reason or leave the pool, take your child or children with you.
• Swim with U.S. Coast Guard-approved life vests. Don't use floaties filled with air.
• Learn to swim at any age.
• Learn CPR.
• Install a fence on all sides of a backyard pool or spa. Secure the fence with a self-latching gate.
• Use alarms that can be put on children's wrists. Also, install alarms in pools and on doors that lead to pools.
• Update pool/spa drain covers.
• Follow pool rules and signs.
• A fence with a locking gate should surround the pool.

Although drowning remains at the top of our mind throughout the summer, our Trauma department saw falls, car crashes, dog bites and snake bites from July 2 through July 8 2017.

The Trauma registry reports during that time frame:

• 19 Falls
• 7 Car Crashes
• 4 Blunt Mechanism Injuries (Finger smashed in the door type injuries)
• 3 Dog Bites
• 3 Snake Bites
• 2 Motorcyles or Dirt Bike Crashes

Rounding out the injury lists were ATV crashes, bike crashes and trampoline injuries with one each during the holiday week.

The safety experts at Cook Children’s remind parents to take the extra time to make sure their kids are safe during the holidays. History shows the most severe injuries seen during Fourth of July remain ATV/4Wheeler accidents and motor vehicle crashes. For the entire month of July last year, there were 27 motor vehicle crashes and 12 ATV accidents.

"If it can accelerate your body, it can injure you," said Corwin Warmink, M.D., medical director of Emergency Services at Cook Children's. "Vehicular accidents, including boats, ATVs, cars, scooters and bikes are all too common on holiday weekends during the summer."

For more information on this topic

• Drowning Prevention
• Vehicle/Car Safety
• Bicyle Safety
• Child Safety Center

The Emergency Department at Cook Children’s sees eye and face injuries from projectiles (fireworks that launch or that have parts that explode off), hand and finger injuries from holding items while they explode and burns of every type, especially when children are running around barefoot.

U.S. Consumer Product Safety Commission (CPSC)’s annual death and injury report on fireworks incidents indicates that nearly half of these injuries occurred to children younger than 15 years of age. The culprits? Firecrackers, bottle rockets and sparklers – yes, sparklers.

Sparklers are considered by many to be the “safe” firework. But even an innocent looking sparkler can get as hot as the flame on some blow torches and can easily ignite clothing?

“Every firework has its dangers and there simply isn’t one that I would consider completely safe,” said Justin Smith, M.D., a pediatrician in Lewisville. “Parents would be safest to take their children to an event and watch fireworks. You will have a good time and can view from a distance.”

Remind your friends and neighbors, before they touch a flame to any fireworks, to make sure it’s legal to do so where they live.

Prevent the Tragedies

If fireworks can be used legally where you live and you do want to use them, here are a few guidelines CPSC recommends they follow:

1. Never allow young children to play with or ignite fireworks. Adults should always supervise fireworks activities.
2. Never try to re-light or pick up fireworks that fizzle and don’t go off.
3. Never point or throw fireworks at another person.
4. Keep a bucket of water or a garden hose handy in case of fire or other mishap. After fireworks fully complete their functioning, douse the spent device with plenty of water from a bucket or hose before discarding to prevent a fire.

More guidelines are at CPSC’s Fireworks Information Center.