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16 Things Emergency Room Doctors Never Do on Fourth of July

Follow ER doctors' lead this July Fourth (especially during COVID-19) to avoid fireworks injuries and other common causes of ER visits.

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What ER doctors avoid to stay safe on July Fourth

Emergency room (ER) doctors have seen it all when it comes to Independence Day-related accidents and injuries, like severe sunburns, fireworks injuries, and more. In the days surrounding the Fourth of July, an estimated 180 people go to the ER every day with fireworks-related injuries, according to the U.S. Consumer Product Safety Commission (CPSC). So, how can you lower your risk and avoid becoming another Fourth of July ER statistic?

Whether you’re watching a fireworks display, enjoying a barbecue, or just having fun, following a doctor’s lead will help keep you and your loved ones safe this July Fourth (especially during the COVID-19 pandemic). We asked doctors to reveal the things they would never do during this holiday weekend. Make sure to check out the ways you can have a good Fourth of July without leaving town.

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Drink alcohol and shoot off fireworks

This is such a dangerous combination, says Robert Glatter, MD, an emergency physician with Lenox Hill Hospital, New York City. “Many patients we see are impaired or distracted when they make the decision to set off a dangerous explosive device. This is a recipe for disaster,” he says. “Drinking alcohol makes people do things they wouldn’t normally do and these risk-taking behaviors can result in serious injuries to eyes, hands, fingers, the face, as well as the legs when fireworks are involved.” So this 4th of July, you might want to stick to these other uses for alcohol besides drinking it.

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Use fireworks without protective eyewear

If you are going to shoot fireworks (and this should not be a decision entered into lightly if you are not a pro), wear goggles to protect your eyes, Dr. Glatter says. “Eye injuries are one of the most feared complications of setting off fireworks,” he says. “Fireworks contain sulfur, charcoal, and gunpowder, and their red-hot fragments⁠—which can reach over 1,300 degrees Fahrenheit⁠—may cause burns, tears, and lacerations of the eyes, which can ultimately lead to blindness.” (Protective eyewear can also keep you safe at protests or rallies should they suddenly turn violent.)

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Not take every possible precaution before using fireworks

This starts with knowing whether fireworks are even legal in your area. If they are, and you are using fireworks, don’t place any part of your body directly over the device when lighting the fuse, Dr. Glatter says. “Back up to a safe distance immediately after lighting a firework and have a pail of water or standard garden hose connected to a water source in case of a fire.” Don’t pick up or try to light firecrackers that have not fully ignited, he says.

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Let small children hold sparklers

Sparklers may seem safer than traditional fireworks, and kids are naturally drawn to their color and twinkle, but they should not hold or touch them, says Steven Sandoval, MD, associate professor of surgery and medical director of the Suffolk County Volunteer Firefighters Burn Center at Stony Brook University Hospital in Stony Brook, New York. “Sparklers can reach as high as 2,000 to 3,000 degrees, and kids may run around with them or hold them too close to their faces or throw them if they get scared.”

variety of fireworksMichael Smith/Getty Images

Buy or use fireworks sold in brown paper bags

These types of fireworks are often for professionals only, Dr. Glatter says. Not all fireworks are created equal, he explains; while all of them can be dangerous, some are much more dangerous than others. “Sparklers and firecrackers account for the bulk of injuries, but we also see injuries from bottle rockets and Roman candles.” (Bottle rockets are firecrackers attached to a stick to control their launch. Roman candles eject stars or exploding shells.) Some of the worst offenders are homemade firecrackers, says Dr. Sandoval. They require black powder and gun powder, the latter of which can explode rapidly when it comes in contact with sparks or any flames, he says. Here’s why we set off fireworks on the Fourth of July.

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Not dress appropriately for any firework display

It’s not just the people who are shooting fireworks that may find themselves in harm’s way, Dr. Glatter says. “Bystanders may also be at significant risk from metal fragments, chemicals or dust released by the fireworks,” he explains. “It’s important to wear a light jacket or long sleeves with a sweat-wicking material to protect yourself.” If you have asthma or an underlying lung condition, make sure you have your inhaler handy as dust from the fireworks could potentially trigger an asthma attack.

firework sparkler close upMichael Dittel/EyeEm/Getty Images

Carry unlit fireworks in their pocket

Bad move, cautions Dr. Glatter. Don’t place fireworks in your pockets or on your body since there is always the potential that a nearby spark can cause them to go off. “This can cause devastating injuries to your extremities and genital organs.”

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Ice a burn

The notion that putting ice on a burn can help is an old wives’ tale, says Lisa A. Moreno, MD, president of the American Academy of Emergency Medicine and professor of emergency medicine, director of research and director of diversity for the section of emergency medicine at Louisiana State University Health Sciences Center New Orleans. “It actually causes your blood vessels to constrict so the heat will go deeper into your tissue,” she says. “Apply room-temperature water to your burn instead. Applying butter, lard, or oil will also make burns worse because the oil absorbs heat faster than water, so it keeps the area hotter and more uncomfortable. “If you get a blister with a burn, go to the ER,” she says. “Any burns to your face, neck, or hands should be seen too [because] if they aren’t treated properly, you may have problems down the road, including trouble moving your neck or fingers.” Here are some perfect Fourth of July desserts.

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Walk barefoot through the park

Independence Day picnics in parks and other public spaces are a popular way to celebrate this holiday, but kicking off your shoes—or letting children run barefoot—is risky, even if it’s a hot day, says Alan L. Nager, MD, director, division of emergency and transport medicine at Children’s Hospital Los Angeles.

“Sometimes people dump hot charcoal from a portable grill in the grass after a barbecue,” he says. “We see a fair share of foot burns each year when kids accidentally step on hot coals,” he says. There are other risks lurking in the grass too, including broken glass and bees just waiting to sting.

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Use wire bristle brushes to clean the grill

This is risky because the brush’s wire bristles can break off, remain on the grill grate and end up in your food and potentially get lodged in your stomach or intestines, causing serious problems. Instead, the CPSC advises people to clean their grills with a ball of aluminum foil or nylon brushes instead of wire grill brushes. Check out these delicious grill ideas for the best BBQ.

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Squirt lighter fluid on lit charcoal

If you don’t think your charcoal is hot enough to start grilling, the worst thing you can do is squirt lighter fluid on it. “There will be a big flame,” says Dr. Moreno. “Each year people lose their eyebrows or burn their faces and hair or have their clothing set on fire when they do this.” Give the charcoal time to heat up, she suggests.

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Go too long without drinking water

It’s easy to get dehydrated under the sun, and alcohol can make it even easier, says Dr. Sandoval. “Drink water or another hydrating liquid drink for every alcoholic one,” he says. Make sure your kids are drinking water too. Here’s the best place to spend Fourth of July in every state.

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Let children jump on a trampoline without helmets

This may be a tough sell, but getting your kids to wear a helmet while jumping on a trampoline could save their lives, Dr. Nager says. “Trampolines are extraordinarily dangerous and can result in sprains and fractures in the arms or legs as well as head and neck injuries from improper landing,” he explains. There were more than 300,000 medically treated trampoline injuries in 2018, according to the American Academy of Orthopedic Surgeons. Supervision is also important, he says. “There should be a designated adult who is not drinking or reading a newspaper that is supervising every second a child is jumping on a trampoline.”

cocktail by the pool with towel and sunglasses overheadWestend61/Getty Images

Swim while intoxicated or alone

These are big no-no’s, warns Dr. Moreno. “I wouldn’t swim alone or let kids swim alone,” she says. “You should always have a partner in the water with you, and there should always be an adult supervising a child in the water.” Swimming while under the influence of drugs or alcohol can make you more likely to take risks and do stupid things such as diving into shallow water, she says. Check out these vintage photos of Fourth of July celebrations.

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Spend time outside without SPF

Using sunscreen is a good idea 365 days a year. The American Academy of Dermatology recommends using a broad-spectrum sunscreen with an SPF of 30 or higher that is water-resistant, and reapplying it frequently.

family celebrating fourth of july with face masks on to protect against coronavirusfranckreporter/Getty Images

Forget that COVID-19 is still spreading

This July Fourth has its own set of risks due to the spread of COVID-19, Dr. Nager says. Remember to wear a mask and practice social distancing to protect yourself and those around you, particularly those more vulnerable to infection with the coronavirus, SARS-CoV-2.  “If there is a fireworks display, sit in your car so you are protected from burns and crowds,” he says. “COVID-19 numbers are going up, and people are careless about [face] masks.” Next, check out the things you didn’t know about the Fourth of July.

Denise Mann, MS
Denise Mann is a freelance health writer in New York. Her articles regularly appear in WebMD,, and other consumer health portals.