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With fireworks sales underway and larger crowds expected to celebrate America’s 250th anniversary, emergency physicians are reminding everyone to put safety first. Dr. Josh Miller, president of Nebraska Emergency Medicine, says emergency rooms see a noticeable increase in serious injuries around the Fourth of July,  with burns and traumatic injuries the most common.

“The stuff that we typically see is going to mostly be injuries to the hands and fingers and then we also often see some facial or ocular injuries as well,” Miller says. “And that just has to do with the proximity that folks have to the fireworks that they’re using.”

Miller says injuries often happen when fireworks don’t perform as expected. His advice is to light fireworks, move a safe distance away, and never approach one that fails to ignite. Instead, soak it with water and leave it alone.

While children are often involved in fireworks accidents, Miller says patients of all ages end up in the emergency room. Even sparklers, which many consider harmless, can cause severe burns. Miller says Independence Day itself is by far the busiest day for fireworks-related injuries, some of which result in permanent disability or the loss of fingers.

His message is simple: enjoy the holiday, but remember that a few seconds of carelessness can lead to life-changing injuries.