It’s all fun and games on the Fourth — until someone gets hurt

July 4 may not have the same appeal in the acute and urgent care space as it has for providers in ambulatory/outpatient care whose organizations observe the holiday.

Why? It might have something to do with the 8,700 fireworks-related injuries that are treated in U.S. hospital emergency departments around Independence Day each year, according to U.S. Consumer Product Safety Commission (CPSC) analysis of non-occupational fireworks deaths and injuries in 2017.

This time of year (June 16 to July 16) accounts for about two-thirds of total estimated fireworks-related injuries for the full year — emergency departments treated an estimated 13,073 fireworks injuries in 2017, according to the USCPSC National Electronic Injury Surveillance System (NEISS) database.

And Americans are buying more fireworks year after year, which means ample opportunity for mishaps that lead to injuries or worse. Spending nationwide on consumer fireworks has grown by at least $60 million each year since 2015, growing from $695 million in 2014 to $885 million in 2017, according to the American Pyrotechnics Association’s industry revenue figures.

For those who don’t see acute and urgent care patients around the Fourth, the CPSC 2017 fireworks annual report yields these not-so-fun facts:

• 70% of patients treated for fireworks-related injuries are male, while 30% are female.
• Sparklers are responsible for an estimated 1,200 emergency department-treated injuries, compared to about 800 for firecrackers and 300 for bottle rockets.
• Children 10 to 14 years old had the highest estimated rate of fireworks-related injuries (5.9 injuries per 100,000 people), followed by young adults 20 to 24 years old (5.8 injuries per 100,000 people).
• The majority of fireworks-related treated injuries are burns (53%), followed by contusions and lacerations (26%). Another 3% come from fractures and sprains, while 19% are labeled “other.”
• Hands and fingers suffered the worst, constituting 31% of fireworks-related injuries, followed by head/faces/ears (22%), legs (17%), eyes (14%), abdominal area (10%) and arms (6%).
• A survey of hazard patterns in fireworks-related injuries found that 48% were related to misuse — such as holding fireworks in hand, improperly setting fireworks or throwing lit fireworks at someone — while 45% were the result of malfunction, including tipped-over fireworks, debris and errant flight paths.

Of course, ICD-10-CM has this covered for dealing with these injuries: The W39 codes cover discharge of firework, depending on encounter. However, this code only describes the circumstance causing an injury but not the nature of the injury, requiring further documentation and coding — such as a Y code — to add greater specificity.

MGMA wishes everyone a happy (and safe) Fourth of July holiday. In case these startling statistics put you out of a celebratory mood, consider checking out WalletHub’s much more pleasant compilation of Fourth of July factoids.

Learn more
Directory of state laws pertaining to fireworks (American Pyrotechnics Association)