Americans across the United States are getting ready to light up the sky with dazzling firework displays in recognition of the Fourth of July. Emergency departments are preparing as well.

“The National Fire Protection Association reports that fireworks start over 19,000 fires and send more than 9,000 people to the ER each year,” says Corrina Repetto, MD, with IU Health Emergency Services.

Research from the U.S. Consumer Product Safety Commission shows about 74% of firework-related injuries happen in the weeks before and after July 4, and Repetto says they see the same trend in the emergency departments she works in.

She commonly sees patients with injuries to their eyes, hands, fingers, face and ears.

“Burns are the most common injuries, about 40%,” Dr. Repetto says.

The other 60% of injuries can include, but aren’t limited to:

• Temporary or permanent hearing loss and ear ringing due to the loud noise.
• Permanent vision loss due to the impact or debris from fireworks.
• Bone fractures from explosions or flying debris.
• Lacerations and bruises to soft tissues.

“Many of these injuries occur due to direct contact with the fireworks, mishandling or malfunctioning of fireworks, or even fireworks landing on individuals or their clothing,” says Dr. Repetto.

But these aren’t the only issues people deal with due to fireworks.

“People with post-traumatic stress, anxiety disorders, or sensory sensitivities can find fireworks very distressing,” says Dr. Repetto. “It’s important to be mindful of individuals in the community who may be adversely affected by fireworks and to consider alternative ways to celebrate without causing distress.”

Some may experience respiratory health issues due to firework smoke and other irritating airborne particulates. Other individuals may experience allergic reactions to the substances in firework smoke. Staying a safe distance from where fireworks are lit is very important for these people.

Other issues Dr. Repetto and her team see during this holiday include heat-related illnesses and skin issues from being outdoors without proper protection from the sun or insects, along with alcohol-related injuries.

Her tips for staying safe while enjoying the holiday are:

• Have a meet-up point or a plan in case someone—especially children—gets separated from your group.
• Keep children and pets away from grills and campfires.
• Never allow young children to handle fireworks, including sparklers.
• Keep pets indoors and in a secure environment during fireworks displays.
• Stay hydrated—drink plenty of water, even if you’re not feeling thirsty
• Never use fireworks while impaired by drugs or alcohol.
• Anyone using fireworks or standing nearby should wear protective eyewear.
• Never hold lit fireworks in your hands.
• Never light fireworks indoors.
• Keep a bucket of water nearby to fully extinguish fireworks that don’t go off or in case of fire.

Emergency departments are here to help anyone who has a medical emergency 24/7 365. Please call 911 or go to your nearest emergency department for emergency help.

“If you are unsure about the severity of a situation, it is always better to err on the side of caution and seek medical attention,” says Dr. Repetto.