Kaboom Nation: Enjoy The Fireworks But Beware — Especially Boys



Everyone loves fireworks, and I hate to be a whiner, but parents should be mindful as we enter into high-pyrotechnics season. Apparently, parents of school-age boys should be most wary, based on statistics from Boston Children’s Hospital:

–Approximately 58 percent of all fireworks-related injuries are burns that usually occur to the hands, head, and eyes. The majority of fireworks-related injuries (75 percent) occur during July 4 celebrations.

–Boys, especially between the ages 10 and 14, are at the highest risk of fireworks-related injuries. Children ages 4 and under are at the highest risk for sparkler-related injuries.

–The most common causes of product-related thermal burn injuries among children ages 14 and under are hair curlers, curling irons, room heaters, ovens and ranges, irons, gasoline, and fireworks.

Indeed, according to a study of fireworks-related injuries in children 19 and under from 1990-2003, published in the medical journal Pediatrics, the demographic most at-risk is a 10-year-old biy:

An estimated 85,800 pediatric fireworks-related injuries were treated in US emergency departments during the 14-year study period. Injured children had a mean age of 10.8 years, and 77.9% were male.

Fireworks users accounted for 49.5% of the injuries, whereas 22.2% of the injuries were to bystanders; however, user status could not be determined in 28.3% of cases.

The overall fireworks-related injury rate decreased significantly during the study period, but subgroup analysis did not indicate consistent declines among all ages and types of fireworks.

Injuries were most commonly caused by firecrackers (29.6%), sparklers/novelty devices (20.5%), and aerial devices (17.6%). The most commonly injured body sites were the eyeball (20.8%), face (20.0%), and hands (19.8%), and the most common injury type was burns (60.3%). Approximately 91.6% of all children with fireworks-related injuries were treated and released from hospital emergency departments, 5.3% were admitted, and 2.3% were transferred to another institution. Bystanders accounted for 13.3% of admitted cases and 20.6% of transferred cases.

CONCLUSIONS. Consumer fireworks cause serious preventable injuries among pediatric fireworks users and bystanders in the United States. Parents should be advised to take their children to safer public fireworks displays rather than allowing consumer fireworks to be used by or near their children. A national restriction of consumer fireworks, in accordance with the policy recommendations of the American Academy of Pediatrics, should be implemented to reduce the burden of fireworks-related injuries among children.

With that in mind, Happy Independence Day!

Doctors Recall Station Fire Victims, Envision Future Of Burn Care

Jason Zubee and his wife, Robin Zubee, stand together near makeshift memorials on the site of The Station nightclub fire on Sunday. Zubee lost her cousin William Christopher Bonardi III in the 2003 blaze at the nightclub that killed 100 people. (Steven Senne/AP)

Jason Zubee and his wife, Robin Zubee, stand together near makeshift memorials on the site of The Station nightclub fire on Sunday. Zubee lost her cousin William Christopher Bonardi III in the 2003 blaze at the nightclub that killed 100 people. (Steven Senne/AP)

By Jeffrey C. Schneider, MD and Colleen M. Ryan, MD FACS
Guest Contributors

The Cocoanut Grove Nightclub Fire shook Boston and the medical community in 1942. Four hundred and ninety-two merrymakers perished in the fire and hundreds more were injured. The fire safety and treatment advances born in that fire a generation ago have had wide-reaching impact on building codes, triage, disaster management, burn resuscitation and the treatment of wounds, smoke inhalation and infections. The tragedy of those days was an engine for research and innovation that has since saved many more lives than lost, and is, in part, a fitting memorial to those whose lives were lost or heavily impacted by this devastating event.

We, as a burn surgeon and a rehabilitation physician who cared for some of the patients and families of the Rhode Island Station Nightclub Fire during the dark days after the fire and the ten years since deeply hope that our continued work studying this disaster and its impact will serve as a living memorial to those who lost their lives that day. This event has provided important lessons in burn disaster management, fluid resuscitation, and pain management of the critically ill patient. Innovative surgical techniques have been advanced because of this disaster. One of the important advances, driven by the grace and determination of survivors, is the development of resources and research into long-termrecovery. As doctors, we listened to their stories and we are now growing old with our patients, and still listening. There are little data on the long-term outcome from burn injury, not surprising since survival from massive burn injury was not commonplace until the mid-1980’s. We are trying to make headway in this area.



We recently published a study, “The Long-Term Impact of Physical and Emotional Trauma: The Station Nightclub Fire” in the journal PLOS One. The study involved over 100 survivors of the Station Fire and looked at the multi-dimensional long-term effects of this catastrophic event. We assessed the differences in outcomes between survivors with and without physical injury. This was the first study to investigate the long-term effects of a large fire on its survivor population that included survivors with and without burn injuries. Among the main findings of the paper were that survivors experienced significant life disruption, including occupational, psychological and quality of life sequelae.

Furthermore, quality of life, depression and post-traumatic stress outcomes were related to emotional trauma, not just physical injury.
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‘Planet Money’ Warning: Instant Soup Burns Kids

I’m not exactly sure why the “Planet Money” crew are writing about soup burns, but it’s definitely soup season and they’re great at explaining just about anything.

By the sound of it, steaming instant soup causes bad burn injuries far more often than you might expect, particularly to children, and the risk varies by brand because of cup design. Listen to or read their full segment, “Why burn doctors hate instant soup,” here. It begins:

Instant cups of soup — the kind that often come in a Styrofoam cup full of noodles — send children to the hospital every day.

“I don’t have them in my house,” says Dr. Warren Garner, director of the burn unit at University of Southern California’s County Hospital in Los Angeles. “I would say that we see at least two to three patients a week who’ve been injured by these products.”

These soups are dangerous because of the way the cups are designed. The cups are tall, lightweight, and have an unstable base that makes them tip over easily. At Garner’s unit, the most common cases are small children, often toddlers, accidentally tipping the cup over on to themselves.

And Garner’s unit is no exception:

Through calls to a dozen burn units at hospitals across the country, we learned that this is a common phenomenon, with children being the most frequent victims. Eight of the 12 hospitals said they see the injury several times a week. One hospital located in Washington D.C. says they regularly see 5-6 patients a week with the injury, especially during the colder months.

New Tool To Ease Burn Victims Pain: Virtual Reality Game, SnowWorld

The pain of a serious burn is one of the most excruciating types of pain a person can experience. And, to make matters worse, the treatment itself — cleaning and dressing the wounds — adds even more agony and distress. But here, the BBC reports that a new tool is being used to minimize the intense pain of burn victims: SnowWorld, a virtual reality game set in an icy 3D canyon, which apparently so envelopes the player in mental distraction that he becomes distanced from his own physical pain.

“Because pain has such a strong psychological component to it, psychological treatments can be used to counteract the pain,” said Professor Hunter Hoffman, who developed the interactive program with Professor David Patterson at the University of Washington Harborview Burn Centre in Seattle. Being immersed in SnowWorld puts a “curtain between the patient and reality,” he explains. “Snow is the opposite of fire.”

Patients wear a helmet hooked up to the virtual world and wear noise cancelling headphones, cutting off all the sights and sounds associated with the painful treatment. It is a fairly simple computer game. Patients can throw snowballs at various objects, including snowmen, igloos, mammoths, and penguins.