Patterns of Firework-blast Injuries: A Descriptive Case Series

Fireworks are commonly used during holidays in the United States. Firework related injuries (FWRIs) have been rising throughout the country since 2012. Here, we describe injury trends and patterns in patients with FWRIs. The trauma registry at Desert Regional Medical Center's Level I Trauma Center was queried from July 2016 to August 2021. Injury patterns and procedures performed were reviewed. The data were reviewed, and a description of the most common injury types and the association between FWRIs and holiday celebrations, alcohol use, and toxicology results is presented. Ten patients were identified for inclusion during the study period. Fifty percent of the patients were found to be under the influence of alcohol, and 40% had other substances on board. The most common drug found was methamphetamine, accounting for 30% of patients. Ninety percent of patients suffered injuries to hands. Fifty percent of the injured patients presented around the time of either New Year's or Independence Day celebrations. Neither holiday and alcohol use nor toxicology results were associated with differences in Injury Severity Score. Patients with injuries related to fireworks are presenting to our nation's emergency rooms at an increasing rate. In this descriptive case series, we found that hand injuries are the most common, followed by face injuries. Most patients had either alcohol or drugs on board at the time of presentation. Findings from this paper will help trauma programs prepare for the presentation of these patients and design outreach programs and future research.