For most Americans, the 4th of July is marked by patriotic celebrations with family and friends — but for some, the festive holiday can end with an unplanned trip to the emergency room.
More than 45,000 people visit the ER on July 4 and 5 each year, according to the Pew Research Center — which means Independence Day has the year’s highest number of daily medical emergencies.
"This time of year, we see big increases in traumatic injuries and heat-related illness," Dr. Ryan Marino, M.D., an ER doctor and associate professor at Case Western Reserve University in Cleveland, Ohio.
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"While fireworks accidents and injuries get most of the attention, there are far more falls, broken bones, head injuries and car accidents, just to name a few."
As people are more likely to be outside and active during the holiday, that makes them more prone to accidents and injuries, Marino added.
Dr. Robert Biernbaum, an emergency medicine physician in Fairport, New York, who is also the chief medical officer at WellNow Urgent Care, echoed that July 4th is one of the busiest holidays for ERs across the country.
"We routinely see a sharp spike in preventable injuries and medical emergencies," he told Fox News Digital.
Several ER doctors shared the specific injuries that dominate emergency rooms during this holiday weekend.
Fireworks are "by far" the most frequent source of injury, according to Biernbaum.
"We see everything from minor hand and facial burns to severe trauma from fireworks exploding in close proximity," he said. "Improvised or illegal fireworks tend to cause the worst damage."
Dr. Betsy Koickel, chief medical officer of Memorial Hermann-GoHealth Urgent Care in Houston, Texas, echoed that fireworks can cause a wide variety of injuries, many of them severe.
"Eye injuries are particularly troubling, as they can include corneal burns, scratches or even permanent vision loss due to flying debris or sudden explosions," she told Fox News Digital.
"The loud blasts can also harm hearing, especially in young children, sometimes resulting in ringing in the ears (tinnitus) or even long-term hearing damage."
In more serious incidents, people have suffered deep lacerations, lost fingers or sustained facial injuries when fireworks exploded too close or malfunctioned, Koickel added.
With more people indulging in alcoholic beverages for the 4th, Dr. Ellana Stinson, a board-certified emergency medicine physician at Boston Medical Center, said she has seen everything from falls and cuts to vehicle accidents and alcohol poisoning.
"Impaired judgment is a leading cause behind many ER visits," she added.
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Biernbaum reiterated that intoxication leads to a range of emergencies, even contributing to assaults and drownings. "We often see head injuries or fractures in patients who’ve had too much to drink," he noted.
July is the peak month for grill fires, according to the National Fire Protection Association.
"Mishandling propane tanks or grills results in flash burns and cuts, particularly to the hands and arms," Biernbaum said.
"Many patients come in with heat exhaustion or heatstroke after prolonged outdoor activities without proper hydration," Biernbaum said.
This condition can be life-threatening, particularly for elderly people and children, the doctor cautioned.
Marino added, "The heat that we saw most recently not only caused problems like heat illness and heat stroke, but can put people at risk for things like dehydration and kidney damage if they aren’t careful about staying cool and staying hydrated."
"Unfortunately, holiday weekends can also bring an uptick in violence-related injuries or major trauma from boating or car accidents," Stinson cautioned.
She shared one example when she treated a young man who fell from a speeding boat after a few too many drinks. "He struck the water hard and was rushed in with a ruptured spleen and multiple fractures — we nearly lost him," she told Fox News Digital.
Biernbaum noted that lack of life jackets, speeding and alcohol all contribute to injuries, ranging from fractures to near-drownings.
July has the highest number of drowning deaths compared to all other months, according to the Centers for Disease Control and Prevention (CDC).
Children are particularly at risk, as drowning is the top cause of death for kids aged 1 to 4.
"I’ve cared for individuals pulled from the water unconscious after near drownings, often because no one was watching closely or due to alcohol-blurred judgment," Stinson said.
Experts agree that fireworks are best left to the professionals.
"But if you do participate in home fireworks, make sure there are designated adults who are in charge, alert and sober," Koikel advised. "Keep a bucket of water or fire extinguisher handy nearby."
Fireworks should only be set off in safe, open spaces that are far away from people, pets, buildings and grass or trees, according to the doctor.
"It’s crucial to closely supervise children if they’re around sparklers, and they should never handle sparklers or any type of fireworks on their own," Koikel said.
Anyone handling fireworks should wear protective eyewear to guard against flying sparks or debris, Koikel said. "It’s also wise to avoid loose clothing that could catch fire and to tie back long hair to reduce risk."
Those lighting fireworks should follow all local laws and safety guidelines, she added.
Additional fireworks safety guidelines can be found on the National Safety Council’s website at https://www.nsc.org/.
Many boating-related injuries occur on the feet, according to Dr. Jared L. Ross, emergency medicine physician and a professor at the University of Missouri.
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"Having a sturdy pair of water shoes both protects against injuries and makes slips and falls less likely," he told Fox News Digital.
"Life vests (PFDs) are a must for everyone on the water — even the best swimmer can’t stay afloat if they have been knocked unconscious by a head injury."
"It is crucial to stay well-hydrated, avoid the sun between noon and 2 p.m., apply sunscreen and wear a large-brimmed hat," Ross recommended.
All experts suggested taking breaks in the shade or air-conditioning, especially if consuming alcohol.
If you are going to partake, Ross said it’s important to moderate your consumption.
"The risks from alcohol greatly increase after three drinks per day," he said. "Never participate in potentially dangerous activities, like driving or boating, while you are impaired."
For those who consume alcohol, Marino emphasized the importance of staying away from dangers like fireworks and planning in advance for sober rides.
"Also, make sure to stay hydrated, since alcohol also causes dehydration," he added.
All experts emphasized this safety tip — particularly around grills, water and fireworks.
"The 4th of July should be a celebration, not a trip to the ER," Biernbaum said. "A little planning and caution go a long way."
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"If something does go wrong, don’t hesitate to seek care immediately — time is critical with burns, head injuries and heat-related illness."
It’s also wise to stay brushed up on basic first aid and to keep a well-stocked emergency kit on hand, Stinson added.
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