04 July 2009

Happy Fourth of July

But really, folks, be careful with the fireworks!

Photo credit: Surfactant on Flickr


  1. Good advice.

    Doesn't take a medical degree to see that doesn't look good. Owie.

    Happy 4th!

  2. It's kind of beautiful in a way, but I'm sure its owner isn't happy. :(

  3. Not the way to enjoy a holiday.

    May everyone have a more enjoyable Independence Day.

  4. From the source link, this was a "homemade explosive device" but we use it to talk about about fireworks. Maybe I should try to find those pictures of the guy who failed to sheath a katana correctly and we can use them to talk about kitchen knives.

    Don't get me wrong, fireworks safety is important, and now is a good time to bring it up. But there are lots of other types of safety which are also important.

  5. From the source link, this was a "homemade explosive device" but we use it to talk about about fireworks. Maybe I should try to find those pictures of the guy who failed to sheath a katana correctly and we can use them to talk about kitchen knives.

    Homemade explosive device is to fireworks as sword is to knife.

    That is not an accurate analogy. If this picture were from a war zone, I would agree. Those IEDs are designed to kill. However, you can easily buy a very destructive range of explosive devices. You do not need to be a chemist.

    The first or second American patient to receive a hand transplant is an example of even greater damage from plain old store bought fireworks.

    Would you say that Tylenol is not really a problem, because you can buy it over-the-counter? The reason the FDA committee is recommending that Percocet and Vicodin be banned is the Tylenol, not the opioid.

    An image of an ex-liver would not be inappropriate in making a point about Tylenol safety.

  6. Shadow- without violating any HIPPA rule- was this a patient you guys saw over the Holiday weekend. Glad I'm not taking hand ER call anymore...

  7. SPSoLU --

    No, it's a kind of famous image off the 'net -- I've seen it many times. The link's in the original post.

  8. Note to self: THROW the M80 after lighting the fuse.

    The subject of this photo may be a future Darwin Award winner.

  9. Regarding homemade explosive devices, analogies and so on. I think it really depends on the size and sort of homemade explosive device. I was once sufficiently curious about such things to read a wide range of sources on the subject.

    I once read an account by pyrotechnic hobbyist (very) carefully making a one pound batch of flashpowder, knowing full well that it would likely not be survivable if something went wrong. Talk about motivation to take static electricity precautions seriously.

    I also read about some not so bright gang banger type who made a pipebomb with black powder from a gun store and had it go off early, apparently because some powder got into the threads as he put an end cap on.

    I know people who remember when dynamite was relatively easy to buy as something for farmers to remove rocks and so on.

    I remember people in high school making "two liter bombs" using a plastic soda bottles and a few very common household products. I still believe it was reasonably safe if you stayed back and thought about where you set the thing. However, I heard of one kid who decided to make one out of a glass jar. Genius decided to shake it or something when it didn't immediately go off. He ended up with quite a few glass fragments in his body.

    I also heard a story about a group that was trying to manufacture gun powder, made a substitution and had it blow up on them, causing some long term disfigurement. They had done a library search and the university library, but the one book in the library that would have explained that the substitution was bad was removed on grounds of being dangerous.

    I guess I've rambled enough. The point I'm trying to make is that it is easy to vilify a product, but we don't know anything about this "homemade explosive device", and we don't know if it has any relationship to over the counter fireworks.

    Kinda like sex-ed I think that teaching how to do fun things safely is better than preaching abstinence. If you correctly explain what went wrong and why, you can turn nasty images into lessons about what not to do. But when you say "this guy lost his hand to store bought fireworks" you oversimplify to the point that it is impossible to tell what he actually did wrong.

    On a final note, skateboards, pogo sticks and slip n slides all injure people, but none of them take near the heat that fireworks do. Why is that?

  10. Anonymous,

    I do not disagree with education.

    The entire post, except for the image, is copied below:

    But really, folks, be careful with the fireworks!

    That is it. The entire post.

    Is this injury rare for store bought fireworks injuries that end up in the ED? No, unfortunately.

    I believe that people should be responsible for what they do. Punishing the responsible participants in any activity, just because of the misbehavior of some participants, is bad policy.

    I do not see where this post is an example of anything other than a reasonable warning. Even ordinary store bought fireworks can cause serious injuries.

    As a society we do focus on the wrong risks. We worry about airline crashes, which are insignificant compared to auto crashes. I could go on for a while on this.

    We do not understand risk management.

    I do not see this post as an example of that problem.

  11. Interesting picture. After reading your posting in the NY Times, I wonder if you think a primary care MD could solve this patient's problem.
    Take away the incentive to learn how to fix problems like this and you'll take away the opportunity to have them fixed.


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