Kids and Fireworks: A 4th of July Injury I’ll Never Forget.

Most of my guy friends have childhood memories that involve fireworks or backyard explosives. I’m being blunt but we’ve all been there. So now, teenage hat off, pediatrician hat on, I am aware of two things: fireworks are insanely dangerous, can cause severe burns, disfigurement, or even death AND children absolutely love them.

I’m willing to bet most kids know exactly what these are.
One of my most gut-wrenching doctor tales involves home-explosive-fun-gone-awry. I was a resident in Seattle, on-call on the 4th of July, two years ago, when it all went down:

My pager went off, reading: “firework-injury to hand” so I stopped in my tracks and immediately headed to the emergency department. The majority of fireworks injuries I had seen involved burns, often from those stupid-sparklers (that can burn at 1000°F), so I thought to myself “here we go again.”

Lying and patiently waiting for care, was a teenage boy, with visibly seared eyebrows and a right hand hastily bundled in a t-shirt. The calming touch of morphine left him almost lackadaisical about the current situation.  I skipped the usual small-talk and asked the boy and his friend what exactly had happened.

“Well, we got some fireworks and stuff. I had this one in my hand, lit the fuse, and then I went to throw it, underhand, and it, like, blew up before the fuse went down. There was a huge flash, then I grabbed my hand and wrapped it in a t-shirt.”

“Can you describe the explosive to me?” I realized this was not a usual sparkler burn.

I dunno, it was silver, had a fuse, and was like the size of my hand.

(Really?! You don’t even know what you were lighting? Wait, I’m not surprised.)

I paged an orthopedic surgeon to accompany me during a brief exam. We examined the boy’s superficial facial and arm burns and then began negotiating the hand bandage. We unwrapped it carefully, dreading what lied beneath. The last layer of the dressing finally came off and at that moment the surgeon whispered in my ear: 

Oh #@!$

Pardon my descriptive language but the majority of the boys hand was missing. What was left was his thumb and severely disfigured flesh where is palm once was. As my heart broke, he looked over to us, still drunk from opioids, and asked: “How bad is it?”

We both did our best to objectively describe the next steps to the boy and his family members. But how do you reassure an ailing mother who just found out her high school football-star son lost his throwing hand? The surgeon and I walked away, bonding in mutual sorrow and ironic empathy; we both played with fireworks in our youth.

Face it: things that go boom are exciting. I remember aimlessly firing “Roman Candles”, strapping unfortunate GI-JOE action figures to M80’s, and delicately placing bottle-rockets in almost everything except actual bottles. And this definitely was not a 90’s-only phenomenon; thousands of fireworks-related injuries occur each year with nearly 50% of them occurring in children younger than 15 years. Remember that jackass neighbor from Toy Story who blew all his toys up?

We ALL had a friend like that – not a Pixar fallacy. Primal fascination with fire and destruction trumps teenage common sense.

You can find “Class C” fireworks, deemed “safe and sane”, at your local grocery stores and while these appear harmless, they’re still capable of starting fires, burning hands, or even causing severe corneal abrasions. Parental supervision is absolutely key. Without it and who knows what experiments your child will conduct.  And then there are your “silver and pretty big” explosives that are not hard to find.

Simple awareness about the nasty side-effects from unpredictable fuses may be the best start. I can’t help but wonder if this teenager would still be playing football had someone shared a similar story with him.