First Aid for Firework Injuries

The spectacular fireworks displays of Bonfire Night, or New Year’s Eve, are a high point of the year for many children, and for many adults too – just as they are in the United States with the annual 4th July celebrations.

Unfortunately, they are also a high point for injuries too. According to the NHS, 4506 people were treated for firework related injuries in England alone in the reporting year 2014/15. What’s more, these injuries are on the rise, with those figures up 111% on reported injuries in 2009/10.

In many of these cases, the people organising the display lacked basic first aid skills, or a firework first aid kit, and so called 999 immediately when they did not need to. On their busiest nights of the year, this puts extra strain on an already struggling service.

So how can you reduce fireworks injuries, what are the basic skills of first aid for fireworks and what should you keep handy in your fireworks first aid kit?

Reducing fireworks injuries

The best way to reduce the risk of fireworks injuries is to go to a well organised public display. More than half of all fireworks injuries occur at private parties, where inexperienced people are using fireworks in an enclosed space such as a backyard or garden. Public displays are professionally managed and the crowds are kept well away from any danger. You may not be in control, but you will usually get a far better display than you could ever afford at home.

If you decide to hold your own display, make sure you follow the fireworks code when dealing with fireworks. You should also ensure you have a well stocked fireworks first aid kit handy and that you understand fireworks first aid, including how to deal with burns, eye injuries and more serious incidents such as amputations and shock.

Fireworks first aid kit

Speed is of the essence when treating many firework related injuries, especially burns, so it is essential that you have a well stocked first aid kit handy ready to use in an emergency.

Your fireworks first aid kit should include:

  • Sterile saline
    – for washing out eyes and cleaning debris out of wounds
  • Lint free dressings
    – to cover wounds
  • Cotton wool pads
    – for protecting injured eyes
  • Cling film
    – for protecting large burns
  • Pain relief
    – burns and eye wounds can be extremely painful
  • Plenty of fresh water
    – for cooling burns
  • Blunt scissors
    – for cutting away clothing from burns victims
  • A fire blanket (or wool blanket)
    – for smothering flames and keeping victims warm until help arrives

Fireworks first aid – minor burns

Minor burns are the most common firework related injury, with a quarter of all fireworks injuries caused by sparklers. Sparklers burn at 2000°C and are often still very hot, even when they have gone out.

To treat a minor burn, hold the burned area under cold running water for at least 10 minutes, or if a tap is not available nearby, keep the injury immersed in water. The faster you treat a burn, the less damage it will do and the faster it will heal, so you must act fast.

Once you have cooled the burn, cover it with a specialist sterile burn dressing, or use cling film to cover the burn and protect it from infection. If in doubt, seek professional medical treatment by taking the victim to A&E or a minor injuries unit. Never burst blisters or rub the wound and do not apply creams or ointments. Avoid cloth bandages or cotton wool dressing pads when dressing the wound, as these will stick to the burn.

Fireworks first aid – major burns

A major burn is one that affects an area larger than the palm of the victim’s hand. Major burns do not hurt as much as minor burns, due to nerve damage, so extra care is needed to avoid causing further damage.

Once again, the affected area should be cooled as quickly as possible using clean, flowing water for at least ten minutes. Remove any clothing or jewellery adjacent to the burn, but do not try to remove anything stuck to the burn itself. While cooling the burn, get someone to call for an ambulance immediately, or if you do not have a signal, arrange to transport the victim to hospital yourself as quickly as possible.

Once the wound is cooled, cover the area with cling film to protect it. This should be used lengthways along the burn and never wrapped around a limb or torso. Try to keep the victim calm and reassured, as a major burn can lead to shock, and stress or panic will only make this worse.

Fireworks first aid – eye injuries

Exploding fireworks and popping bonfires often lead to eye injuries, either through impact with the eye area, or by introducing a foreign body into the eye. Eye injuries must be dealt with promptly to avoid the risk of scarring or infection that can permanently damage the eye.

If there is a loose foreign body in the eye, you should rinse this out carefully using sterile saline or fresh, clean water. Tilt the victim’s head and introduce water into the corner of the eye to flush it clean.

If there is an object embedded in the eye, do not try to remove it yourself. You should cover the eye with a protective pad and seek urgent specialist help. Do not let the victim rub their eye as this can cause significant damage. You should encourage them to keep their eyes still, reminding them that moving their uninjured eye will also make their injured eye move. The same procedure should be followed if the eye is cut, bruised or scratched.

Fireworks first aid – amputation

The explosive power of fireworks can occasionally lead to victims losing a finger in an accident. If this happens, sit or lay the victim down and raise the affected hand to slow the bleeding. Apply pressure to the wound until the bleeding stops then wrap it in a lint free dressing. If you can find the missing finger, wrap it in a clean, damp cloth and make sure it goes with them to the hospital. Do not place the finger in ice as this can damage the blood vessels and make it harder to reattach.

Fireworks first aid – shock

If the victim has experienced a major injury, you should be on the look out for signs of shock. This is not the emotional response of being shocked, but a physical reaction that can deprive the organs and the brain of vital blood supplies.

Patients in shock may be pale, cold and clammy, they may feel weak and disorientated, and they may have a fast weak pulse and display rapid, shallow breathing.

If you think a patient is in shock lay them down and raise their feet to encourage blood flow to the head, and loosen any clothing that may be restricting blood flow. Try to keep them warm and reassured until the ambulance arrives, checking their breathing and pulse regularly. Keep talking to them to ensure that they remain responsive and stay with you. Do not give them anything to eat or drink, as digestion will only divert further blood away fro their organs.

By learning how to treat fireworks injuries, and by having the correct first aid kit available at your event, you can not only provide prompt and essential treatment on site, you can also help to ease the burden on the emergency services on their busiest nights.