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Riley Trauma Team and Plastic Surgeons: ‘Watch Those Tiny Hands This July 4’

Blog Riley Trauma Team and Plastic Surgeons: ‘Watch Those Tiny Hands This July 4’

Did you know sparklers can reach temperatures of up to 2,000 degrees – hot enough to melt some metals? Did you know adults drinking alcohol can lead to less supervision of children, resulting in accidents? The experts at Riley know. And they want to help you have a safe and happy Fourth of July.


The quickest way to take the sparkle out of a Fourth of July celebration is to have an accident.

The experts at Riley Hospital for Children know that better than just about anyone. Through the years, they have seen horrific injuries involving fireworks inside the hospital’s Level I pediatric trauma center. Plastic surgeons have operated on tiny hands with missing fingers and severe burns.

Ahead of the July 4 holiday, we asked three Riley experts for their insight and advice for parents.

Cory Showalter, M.D., Medical Director of Pediatric Emergency Medicine

“Finger and eye injuries, minor burns are the most common,” says Dr. Showalter. “More severe burns and extremity injuries also occur, but are more rare.”

“Kids should not be lighting fireworks,” he says. “The best fireworks are at professional shows. If you’re going to buy and light fireworks, have kids supervised and safely kept at a distance.”

Those supposed kid-friendly sparklers? “Even sparklers are extremely dangerous,” says Dr. Showalter. They burn at a temperature of 2,000 degrees, which is hot enough to melt some metals.

Beyond fireworks, Dr. Showalter cautions, “It’s likely going to be very hot this week, so be careful with dehydration and sun exposure.”

Joshua Adkinson, M.D., Pediatric Plastic Surgeon

The most common upper extremity injuries from fireworks are hand burns and severe soft tissue and bony injuries. This also includes partial or total finger or hand amputations, says Dr. Adkinson. Together, these accounted for nearly a third of all fireworks-related injuries in 2017, more than 13,000.

“These injuries are potentially devastating as they have long-lasting personal and economic costs,” he says. “They also can substantially change the patient’s ability to participate in sports and affect what they ultimately choose as a career.”

Patients with hand injuries from fireworks nearly always require multiple surgeries, sometimes spanning over the course of months with, in rare cases, up to a year of hand therapy, Dr. Adkinson says. Also, in devastating hand injuries, the children and families sometimes require therapy related to post traumatic stress disorder.

Dawn Daniels, CNS, Program Manager of Injury Prevention and Trauma Services

Inside Riley this week, much more than fireworks injuries will be treated, says Daniels. With the increased number of people traveling for the holiday, the hospital will see more patients involved in motor vehicle crashes.

With children playing outside, there will be pedestrians struck by cars. The hot weather will cause water injuries and even drownings, she says.

“Throw in the mixture of alcohol for the adults, an increased number of people having a good time -- which sometimes leads to decreased supervision -- and it is usually a busy holiday for us,” Daniels says.

-- By Dana Benbow, Senior Journalist at IU Health.
   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

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