More people visit U.S. emergency departments on July 4 and 5 than on any other days of the year, according to data from Pew Research Center. And this year, the heat wave affecting much of the United States may make everything worse.
So E.R. doctors are bracing themselves.
“That’s our bread-and-butter holiday,” said Dr. Lauren Siewny, medical director of the Duke University Hospital Emergency Department. “It’s just this concoction of heat, alcohol, water sports, being outside, fireworks and travel.”
What also sets this weekend apart, Dr. Siewny added, is that “many of the injuries we see on July 4 are preventable, compared to some other things we see in the emergency department.”
So let’s prepare ourselves. We’ve published our tips for staying safe in the heat. And for the rest, I asked emergency room doctors for advice on how to stay safe this weekend.
Don’t approach a ‘dud’ firework
All the E.R. physicians suggested leaving fireworks displays to the professionals. According to the Consumer Product Safety Commission, about 13,000 Americans were injured by fireworks last year.
If you insist on setting off fireworks yourself, wear heat-resistant gloves and eye protection and have a bucket of water nearby to douse the fireworks after use, said Dr. Bernice Fokum, an emergency medicine physician at UChicago Medicine.
And never try to relight or pick up fireworks that did not fully ignite, which can lead to serious injuries such as amputations or permanent vision loss, Dr. Fokum added. “People love to go back and reinspect the firework, put their face right over it, put their hand on it, try to relight it,” she said. Then she sees them in the emergency department.
Be cautious with sparklers
Some people assume that sparklers are relatively harmless toys, Dr. Siewny said.
But according to the Consumer Product Safety Commission, sparklers burn at about 2,000 degrees Fahrenheit. “That’s enough to cause a serious burn, which we have seen in the emergency department,” Dr. Siewny said.
“I’ve seen a number of kids with burned feet from stepping on sparklers,” said Dr. Benjamin Abella, chair of emergency medicine for the Mount Sinai Health System.
Several experts recommended holding sparklers at arm’s length, supervising small children and keeping that large bucket of water close.
If you’re near water, appoint a lifeguard
Assign a watcher to keep an eye on the kids (and adults) if you’re celebrating near a body of water, said Dr. Torben Becker, an emergency medicine physician at University of Florida Health. Drowning is the leading cause of death among children ages 1 to 4, according to the Centers for Disease Control and Prevention.
“Typically, when people drown, it’s not like in the movies, where somebody is sort of screaming and waving and slowly going in under the water and coming back up,” Dr. Becker said. “A lot of times, it’s quiet.”
You can take shifts watching the water, Dr. Fokum said. And the watcher shouldn’t be looking at a phone, she added, “unless they’re taking pictures of the kids.”
Replace that heirloom wire grill brush
If you have an old grill brush with wire bristles, those wires can break off and end up in your food, Dr. Siewny explained.
If you swallow them, they can perforate your gastrointestinal tract, she said, which could lead to an infection and sometimes surgical intervention. It’s a “lesser-known injury,” Dr. Siewny said, but it’s “something that we do see in cookout weather.”
So if you have a wire grill brush, replace it after a few years, Dr. Abella said. Pulling out the “half-rotted grill brush” that you’ve had for decades is “probably not the move,” he explained. Or you can get a model made from wood, he said.
And if you’re using a charcoal grill, add lighter fluid to coals before you light them, said Dr. Samuel Luber, professor and chair of emergency medicine at UTHealth Houston. Injuries from lighter fluid accounted for over a quarter of grill-related burns, according to a 2025 study from The Journal of Burn Care & Research.
Designate (and celebrate) a driver
Several doctors told me they often see an influx of traffic accidents on Fourth of July weekend — and many involve alcohol.
So if you’re drinking — even one drink, which can affect your ability to perform two tasks at once — do not get behind the wheel. “From a medical perspective, we know that there is not a safe dose of alcohol,” Dr. Becker said.
A good strategy, Dr. Becker said, is to establish a transportation plan ahead of time, whether it’s a designated driver or an Uber or taxi. Or you can pool money for a van driver to take everyone home, he said.
If you appoint a sober driver, give the person special treatment for keeping you safe, Dr. Becker said. When a friend of mine has parties, she gives the designated driver a gift card and toasts the person at dinner.
And if you’re in a car, even for a short distance, always wear your seatbelt, Dr. Abella said. “I’ve been an emergency doc for 25 years, and I cannot remember ever seeing a fatality from a car crash where there was a seatbelt worn,” he said. “They may have been injured, but they lived.”
I’ll think of Dr. Abella’s words on the Fourth. I’m a teetotaler, so I’m often a designated driver. I’m always happy to do it, but I wouldn’t turn down a gift card.
Happy Fourth, everyone — stay cool and stay safe!
A dangerous ‘heat dome’ is settling over parts of the United States.
Emergency room doctors are prepping for a double whammy: the typical surge of patients they’ll see this holiday weekend and a second influx of people suffering from extreme heat. Here are their tips for weathering the heat wave.
Read the article: How to Stay Safe in a ‘Heat Dome’
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