Flare guns and trauma: Patterns, severity, and clinical implications from case and national surveillance data

Flare guns are pyrotechnic devices capable of causing serious injury due to high-temperature combustion and projectile discharge. Though intended for signaling in maritime or wilderness settings, improper use can result in trauma patterns distinct from those seen with typical burns or fireworks. Despite their severity, flare gun injuries remain underreported and poorly characterized. We conducted a scoping review of PubMed, Scopus, and Ovid to identify 12 case reports involving 13 patients, and reviewed US National Electronic Injury Surveillance System records from 2015 to 2024, identifying 18 flare gun-specific injuries for a combined total of 31 injuries. Demographic, injury mechanism, body region, hospitalization, and fatality data were extracted and compared across sources using R. Most case report patients were male with head, neck, or torso injuries; hospitalization occurred in 92 % of cases with two fatalities. National surveillance data showed a broader age range, with 39 % under 18 years. Burns were the most common injury type in both sources; case reports also described vascular injury, airway burns, and organ damage. Fatal injuries were typically linked to moderate-range discharge, while close-range incidents caused severe nonfatal trauma. Flare gun injuries, though rare, span a wide spectrum of severity and disproportionately affect pediatric and adolescent populations. These findings support the need for improved injury surveillance, targeted prevention efforts, and increased clinical awareness of flare guns as a distinct mechanism of burns and trauma.