Many people associate July 4th with moms and apple pies, but sadly, emergency department physicians also think of injured hands and eyes.

Each year, firework accidents send about 50 people to the emergency departments of St. Luke’s University Health Network’s 11 acute care hospitals, said Adam Colombo, St. Luke’s Network Vice Chairman of Emergency Medicine. The most common injuries occur when someone holds on to an explosive too long and the firework explodes. Injuries range from minor burns to the loss of fingers or worse. Dangerous particles flying through the air also cause burns and eye injuries.

Grill fires are another common Independence Day accident, he said. Typically, they’re caused by fat from cooking that gets trapped on the underside of the grill, creating a thick black crust. The homeowner opens the lid and gets a flash burn. Usually, it only singes eyebrows, eyelashes, and hair, but can cause serious inhalation or burn injuries.

“People use their grills day after day, summer after summer, and never get the creosote (the black crust) out on the underside of the lid,” said Dr. Colombo, who is also the 1st Assistant Chief of the Upper Saucon Fire Department. “You’ve got to clean the machine or at some point the heat generated is going to set the entire grill on fire.”

During the holiday weekend, Dr. Colombo sometimes sees young children injured by falling and impaling themselves. Once, he treated a toddler who fell and the post of a small flag he was holding went through his open mouth and punctured the back of his throat.

“There was concern because of how close it was to the carotid artery, so we needed a surgical consultation,” he said. “In the end, the flag was removed with no significant bleeding and the child was fine.”

Water-related injuries are also common. During a party, it’s easy to get distracted, but never take your eyes off young children near pools or other bodies of water, he advised. Drowning accidents can occur in minutes. For older children and young adults, water injuries tend to be trauma-related. They slip while roughhousing or diving. Then, they hit the board, side of the pool, or rocks in the lake.

“A young gentleman was celebrating his 21st birthday,” Dr. Colombo recalled. “It was nighttime at one of the lakes. He dove into a shallow area and couldn’t move afterward. His friends knew he was injured but didn’t think it was too bad, so they pulled him out of the water, into their car, and drove him to the hospital. And here he had this devastating neck injury the entire time. He was paralyzed. He has mostly recovered but it’s been a very long road. Whenever there’s an accident, own up to it and call 911 immediately.”

Flash floods from summer storms are another water danger. Because of the location of South Mountain, Blue Mountain, and the Poconos, storms can stall and intensify so that one town gets a deluge while the next town over gets no rain. Sometimes motorists (illegally) cross barricaded roads, not understanding that it only takes about six inches of swift-moving water to cause a car to float and be swept away. A couple of years ago, a young woman drove around a barrier. Her car rolled and flipped several times. By the time it came to a rest, she had drowned.

Storms also cause lightning strikes that can occur miles away from rain and wind—the “bolt out of the blue.” If you’re struck and survive, you will likely recover without any lingering effects. Injuries treated in emergency departments tend to be caused by the secondary effects of lightning. An employee’s entire family was injured when lightning struck a tree, causing it to fall on their tent, Dr. Colombo said.

Fallen trees also cause accidents when they strike a vehicle directly or block a road. But a more common cause of vehicular collisions is excessive speed combined with reckless and impatient drivers, he said. Dr. Colombo’s friends in law enforcement attribute another cause of accidents to large speed differentials with the increase in large trucks associated with the area’s warehouses.

Finally, many accidents of all kinds are caused by people who are under the influence of drugs or alcohol, which never play a friendly part.

“My best advice for avoiding the emergency room this holiday weekend is: Don’t combine alcohol with dangerous things, whether it’s driving or fireworks or just showing off to your friends,” Dr. Colombo said. “You know one of those famous last lines is, ‘Hey guys, watch this,’ and then we see you in the emergency department.”