The pinnacle of summertime fun and folly in the United States, the Fourth of July holiday weekend, often also means a peak in traffic to the emergency room.

Take the ‘Wear It’ pledge

With more than 500 drownings in 2008 (Coast Guard) because of recreational boating accidents, the National Safe Boating Council urges boaters to use extra caution during the busy Fourth of July holiday.

“For some people, July 4th celebrations may be the only time they get on a boat the entire summer,” said Virgil Chambers, executive director of the National Safe Boating Council, a lead organization for the campaign. “Whether you’re an experienced or new boater, always boat responsibly and wear a life jacket.”

Last week, the council launched a campaign, “Wear It!” encouraging boaters to take a safety pledge at


The warm weather and sunshine combine with alcohol use, boating and fireworks to dramatically raise risks of getting injured.

Fireworks facts

The U.S. Consumer Prod- uct Safety Commission recently released a report on fireworks-related deaths and injuries between June 22 and July 22, 2012 and found the following statistics, which were conservative estimates:

There were an estimated 5,200 fireworks-related injuries, or 60 percent of the total estimated fireworks-related injuries for the year, during the one-month special study period.

Of the fireworks-related injuries, 74 percent were to males and 26 percent were to females.

Children younger than 15 years of age accounted for about 30 percent of the injuries.

There were an estimated 1,200 emergency department-treated injuries associated with firecrackers.

There were an estimated 600 emergency department-treated injuries associated with sparklers and 400 with bottle rockets.

Most often injured were hands and fingers (41 percent); head, face, and ears (19 percent); legs (13 percent); and eyes (12 percent).

Source: 2012 Fireworks Annual Report, U.S. Consumer Product Safety Commission

Three top emergency room physicians at the Medical University of South Carolina, Roper St. Francis Healthcare and Trident Health System attest to the perils of the patriotic holiday and urge just an extra dose of vigilance to ease some of those risks.

“The safest way for you and your family to enjoy the fireworks and the Fourth is to put on lots of sunscreen, wear your PFD (personal flotation device) when you take your boat out into the harbor and wear your helmet when your ride your bicycle to a local waterfront park for the fireworks show,” says Dr. Preston Wendell, director of Emergency Medicine at Trident’s Summerville Medical Center.

Dr. John Frederick Walters of Roper Emergency Physicians says having multiple beaches in the Charleston, as well as an influx of tourists, ratchets up the injury count in Charleston-area ERs.

“People from out of town may not know that walking out on the rocks at Folly Beach is risky because they can slip or get knocked over by a wave and either break a bone or get cut,” says Walters.

Dr. Edward Jauch, director of the Medical University of South Carolina’s emergency medicine division, and the others mentioned the heightened risks of fireworks, particularly to male juveniles and young adults.

Jauch strongly urged that parents and guardians not allow children to handle fireworks, even sparklers, and that no one hold or try to throw fireworks.

“People should not underestimate the power of fireworks that the average person can purchase,” says Jauch. “Surprisingly the most common firework that injures people during the Fourth of July season are sparklers, and (they) can cause serious burns and eye injuries.”

The following is a compilation of hazards the emergency room doctors say are common in the Charleston area.

Alcohol use

The use and abuse of alcohol increases risky behavior, such as drunk driving, impaired operation of boats and all-terrain vehicles, Jauch says, as well as contributes to dehydration, falls and drownings, and even sunburns.

Cuts, broken bones

Because of the warm weather and time off from work, Walters says that more people are just outside doing activities that expose them to cuts that require stitches and/or tetanus shots and broken bones.


According to the U.S. Consumer Product Safety Commission’s recently released 2012 Fireworks Annual Report, an estimated 8,700 injuries needing treatment in U.S. hospitals in 2012 involved fireworks. Of those, an estimated 5,200 took place between June 22 and July 22.

“Our biggest injuries are to the hands, eyes and then general burns,” Jauch says. He urges the following precautions:

Children should not handle fireworks.

No one should hold fireworks in their hands nor try to throw them.

No one should look down the barrel of aerial shells, especially if they don’t go off at first.

Don’t approach unexploded fireworks.

Don’t point Roman candles, and similar firing fireworks, toward people.

Sparklers can burn and catch things on fire.

Don’t set fireworks near combustible items.

And don’t make your own fireworks. Jauch adds, “Trust me, I have no hair on my hands for a reason.”


While being sun safe is important in Charleston almost year-round, it’s even more important on July 4th.

“Severe sunburn is the easiest way to ruin a holiday weekend,” says Trident’s Wendell. “Wear sunscreen with an SPF of at least 15 or higher and reapply often especially when swimming. Stay out of the sun during peak hours and use protective clothing such as hats, swim shirts, and UV-protected sunglasses.”

Other burns

Another popular activity over the Independence Day holiday is grilling out.

Wendell says, “Grills should always be properly inspected prior to use; propane and lighter fluid handled only by adults; and cooking should occur in an open area away from flammable material and children.”


In addition to sunburn, Wendell says prolonged exposure outside can lead to heat exhaustion and heat stroke. Infants and the elderly are particularly at risk.

He urges everyone to drink plenty of water, seek shade outdoors and take breaks from the heat.

Swimming, boating

Of course, one way to beat the heat is to hit the water, but swimming and boating also carry inherent risk, particularly in places where boats gather.

“Whether you are swimming in a marsh creek, at the beach, or in your own backyard pool, it is important to enjoy the water safely,” says Wendell.

“You should always wear an appropriate personal flotation device when you are boating, kayaking or sailing. Understand your surroundings and know the swimming capabilities of you and your family members to avoid being caught in a swift incoming tide or rough water that you are not prepared to handle,” says Wendell.

“When swimming with children, always keep them at arms-length by practicing ‘touch supervision’ and never leave them alone, even for a moment. And keep home pools properly gated and fenced and if you are routinely supervising children in the water, you should know basic CPR.”

Wear a helmet

Warm weather and the Fourth of July draw more people out on bicycles and kids on skateboard and scooters.

“It’s a great way to get around in the summer, but falls and accidents can really lead to serious injury,” says Wendell. “Helmets, helmets, helmets along with other activity-appropriate protective gear can be the difference between a mild tumble and a life-changing accident.

“Helmets need to be worn at all times and by all members of the family regardless of the terrain, location, or distance being traveled.”

Don’t worry

And yet, sometimes even if you take every preventive measure, bad stuff still happens, says Roper’s Walters.

“When it comes to people getting hurt, sometimes it’s just bad luck,” he says. “A lot of innocent bystanders get caught up in other people’s bad luck.”