Staying Safe While Saving Lives: A Paramedic's Guide to the 4th of July & Firework Injuries

By Kinjal Shah

As the Fourth of July approaches, paramedics and first responders brace themselves for a predictable surge in firework-related injuries.  The U.S. Consumer Product Safety Commission reports a concerning statistic: a whopping 66% of these injuries occur in the weeks surrounding the holiday. Paramedics find themselves on the front lines, playing a vital role in immediate care and preventing complications for those who suffer these injuries.

Preparation is Key

Firework season is a time for EMS teams to ensure their kits are stocked with specific supplies to handle the unique challenges of burns, eye injuries, and shrapnel wounds.  These essential supplies include sterile dressings in various sizes, burn gel, cooling packs, and burn sheets.

For eye injuries, irrigating solutions (normal saline), eye patches, and portable eyewash stations are crucial. Wound care needs are met with non-adherent dressings, trauma dressings, bandages, and antiseptic wipes. Finally, pain medication, both oral and injectable within their scope of practice, allows paramedics to manage patient discomfort. Staying updated on the latest firework-related trauma management protocols ensures paramedics can deliver the best possible care.

Swift and Focused Action: The Rapid Assessment and Treatment Protocol

When encountering a firework injury, a swift and focused approach is essential.  The Rapid Assessment and Treatment (RAT) protocol provides a clear framework for paramedics.

The first step involves ensuring the scene is safe by checking for ongoing hazards like smoldering fireworks or unstable structures. Minimizing the number of bystanders around the injured person is also crucial. 

Next comes the primary assessment, focusing on life-threatening issues using the ABCDE approach: Airway (checking for patency and breathing difficulty), Breathing (assessing for respiratory distress), Circulation (controlling severe bleeding and checking for signs of shock), Disability (evaluating level of consciousness and signs of head injury), and Exposure (removing smoldering clothing or debris, checking for burns and their severity, cooling minor burns with copious water, and covering burns with sterile dressings).

For eye injuries, the protocol emphasizes the importance of not removing embedded objects, irrigating the eye with normal saline solution if available, and covering the injured eye with an eye patch. Pain management is also addressed, with paramedics administering pain medication within their scope of practice to manage moderate to severe pain.

Communication and Transport: Getting the Patients the Care They Need

Once the initial assessment and treatment are complete, clear communication with dispatch is vital. Paramedics need to relay the severity of the injuries and determine if advanced care at a burn center or ophthalmology department is necessary.  Finally, the patient is transported to the nearest appropriate medical facility to receive further treatment.

Prevention: The Most Powerful Tool

The most effective measure first responders can take is patient education. Partnering with local organizations to promote firework safety is key. This includes educating the public about safe handling practices and the dangers of improper firework use.  Empowering individuals with knowledge fosters responsible behavior.

The U.S. Consumer Product Safety Commission highlights a sobering fact: in 2023, 5 out of 8 firework-related deaths stemmed from misuse. By equipping individuals with knowledge, paramedics can play a vital role in creating safer celebrations and preventing unnecessary injuries during this festive time.