July Fourth emergency room visits: Common injuries and causes

For most people, July Fourth conjures up images of food, fun and fireworks. But for busy doctors in Long Island’s emergency departments, the holiday brings burns, food poisoning and heat stroke.

Last year, about 14,700 people across the country were treated at emergency departments for fireworks-related injuries, according to the U.S. Consumer Product Safety Commission, a sharp increase from the estimated 9,700 in 2023. There were 11 deaths from fireworks, up from eight in 2023.

Most of those injuries are burns on a person’s hands, ears and face. Dr. Robert Schwaner, medical director of the department of emergency medicine at Stony Brook University Hospital, recalled a patient who came in with a very severe hand injury one year ago due to fireworks. It was so badly mangled, the hand could not be saved.

"Hand surgery every Fourth of July is a busy service," he said. "Ophthalmology as well ... we are always cringing about what kind of injuries we are going to see this year because we know we are going to see them, it’s just a matter of what."

Food dangers

Picnics and barbecues are the highlight of any July Fourth gathering. Grilled hot dogs, chicken and hamburgers are stacked next to heaps of potato salad and creamy pasta.

But if these dishes are not thoroughly cooked or are left to sit outside for too long, they can become a "hotbed" for bacteria to grow, said Dr. Sanjey Gupta, senior vice president and director of emergency medicine for Northwell Health.

"We see more gastrointestinal illnesses," he said. "People are coming in vomiting or people are coming in with diarrhea or abdominal pains. I would recommend that people make sure they are careful about what they are eating."

Undercooked chicken and sausage can especially problematic, said Dr. John Mathew, director of emergency medicine at St. Joseph Hospital in Bethpage. He also warned about cross-contamination.

"You don’t want to be prepping the meat in the same area where you are preparing salad, corn, things like that," he said. "That’s how you end up with food poisoning-related injuries."

He suggested people use food thermometers. The safe minimum internal temperature for poultry is 165 degrees Fahrenheit and for ground meat 160 degrees, according to the U.S. Food and Drug Administration.

Keeping cool

Heat- and sun-related injuries are another common July Fourth occurrence, experts said. Even if you are hanging out in the pool, sipping a drink, you could be at risk for dehydration and a painful sunburn.

"That’s something we actually see more commonly than you think," Gupta said. "Sunblock has to be reapplied, especially if you are in the water. Then we see people coming in the next day with bad, blistering sunburns and they feel sick."

A severe sunburn can cause inflammation and even flu-like symptoms such as chills and vomiting, he said. Wearing clothing with a sun protection factor built in is another way to protect yourself, Gupta said.

"The skin is our biggest organ," he said.

Lounging in the pool with an alcoholic drink can also be troublesome, Mathew said, especially because many people don’t drink enough water in the heat. Alcohol and sugary drinks can cause dehydration and cramping.

"These are heartbreaking stories — a party full of people and nobody realized that one person drowned in a pool," he said. "It’s quick and quiet. You get a cramp and you are really going down."

Heat exhaustion and heat stroke can also come on quickly for children and the elderly, going from excessive sweating to feeling lightheaded and then confusion.

Drinking lots of water, wearing head coverings and staying out of the heat can help, he said.

Leave fireworks to professionals

Roman candles, bottle rockets, M-80s and sparklers. Schwaner has seen all the injuries that illegal fireworks handled by nonprofessionals can cause.

"We see at least two or three eye injuries typically a year," he said. "That can include losing vision."

Sometimes people stand over a firework that appears to be a dud, only to have it blow up in their face, Schwaner said. Holding fireworks can sometimes mean the loss of fingers or even a hand.

"I love fireworks but fireworks for the novice, along with drinking and thinking you are invincible, is a bad combo," he said.

If you do suffer a hand injury from fireworks, wrap your hand in gauze and rush to the emergency room. Lost fingers have a better chance of being reattached if they are kept away from water and packed with gauze and kept on ice, Schwaner said.

"If the ice melts, make sure it doesn’t sit in water because there’s no chance for a potential reattachment in that scenario," he warned.

Even seemingly tame sparklers can be dangerous — especially for kids. The Consumer Product Safety Commission said sparklers were involved in an estimated 1,700 emergency room-treated injuries in 2024.

"They can be well beyond 2,000 degrees Fahrenheit," Mathew said. "Little kids see them and they may put their hands on them. We see a lot of burns to the hand. If you are letting a child hold a sparkler, make sure you are right there holding it with them."

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.