If a firecracker explodes in your hand - how to administer first aid

Nobody wants to spend the New Year as a patient in the emergency room. But sometimes New Year's Eve rockets and firecrackers don't ignite where they should; injuries of all kinds can occur, such as severed fingers. Dirt tattoos can also occur. Important knowledge for emergencies.

The firework battery remains silent after being lit. Bend over the box for a quick look? This can literally backfire if the first shot does ignite. "In such situations, injuries are often so severe that the eyesight cannot be saved," says Luisa Backhaus, a trauma surgeon at Unfallkrankenhaus Berlin.

Treacherous: If fireworks explode too close to the body, there is usually more than just one injury. For example, if a rocket flies into someone's hood and sets their hair on fire. "A tail of fire can form, leading to devastating burns in the head and neck area," says Backhaus.

Dirt tattoo caused by firecracker particles

It is quite possible that a so-called dirt tattoo may also occur. "When a firecracker detonates on the body, particles penetrate into the deeper layers of the skin - just like a tattoo," explains Luisa Backhaus. Hearing or even the eyes can also be severely damaged in such an accident.

These are injuries that quickly become complicated to treat. Scars and limitations often accompany those affected for the rest of their lives - not only physically, but also psychologically.

First aid for a severed finger

Another typical case: the firecracker has exploded in the hand - or very close to it. Those who are lucky get off lightly. Those who are unlucky have to fear for a finger or even parts of the hand because they have been blown off.

Can the amputation, as the severed body part is called in medicine, be saved? Only the professionals can judge that. So if you make your way to the hospital, the severed finger must also go with you, "if you were able to find it in the dark," says Andreas Ruecker. He is Head Physician at the Clinic for Trauma Surgery and Reconstructive Surgery at the Schön Klinik Rendsburg.

"The finger has to be transported dry," says trauma surgeon Backhaus. Ideally, this works like this: the amputation is wrapped in a clean cloth and placed in a plastic bag, which is then sealed tightly. This bag is then placed in a second bag filled with water and ice, which is also sealed for transportation.

According to Backhaus, the wound on the hand should be covered with clean bandages. If this is not to hand, a clean cloth handkerchief will also do.

There is a chance of preserving the severed finger if the doctors can find arteries, veins and nerves on both the stump and the amputation - and reconnect them. However, according to Andreas Ruecker, this is rarely the case: "The edges of the wound are usually burnt and so torn by the pressure of the explosion that reconstruction is not possible. Unlike with a smooth cut, such as with an axe."

For burns: do not cool too much

And what if the rocket has hit your arm? For small burns: "It's better not to cool with ice-cold water or a cold pack, but with water at around 20 degrees. And only for a maximum of five minutes," says Luisa Backhaus. Then cover the burn cleanly and take it to hospital.

And in the case of extensive burns, i.e. if an entire arm or chest is affected? "Then you shouldn't think about giving the person a cool shower," warns Luisa Backhaus. "It's better to wrap them in a rescue blanket from the first aid kit." The reason: the skin is a protective layer that surrounds us. If it is damaged over a large area, the body is less able to retain heat. There is a risk of hypothermia, especially on cold winter nights.

Speaking of wrapping up: First aiders should not spend too much time and effort wrapping up burn wounds in the event of extensive burns, advises Backhaus. This is because the medics still need to look at the wounds anyway.

Incidentally, the following applies to eye and ear injuries: cover them, preferably with a sterile compress, such as those contained in emergency kits or first aid kits. "And then drive to the clinic," says Ruecker.

Just go to sleep? Usually not a good idea

Many firework accidents are emergencies that need to be treated as quickly as possible. However, not everyone who needs to go to hospital immediately makes their way there or calls 112. "We often see patients who are injured on New Year's Eve but are so drunk that they lie down in bed and go to sleep," says Andreas Ruecker. And then realize when they wake up: Wait, something is wrong here. "The second wave of patients arrives around 11 o'clock on New Year's morning."

The problem with this is that when injuries are sometimes many hours old, they become more difficult to treat. According to the emergency physician, lacerations can no longer be sutured without further ado if they are more than six hours old - the risk of infection is too high.

Safe handling of fireworks

How can you prevent such injuries from occurring in the first place? Of course, the best protection is to avoid using rockets and firecrackers. But not everyone wants to stay at a safe distance from the action on the sofa just after midnight.

If you want to set off fireworks, you should make sure that they have a CE mark and a BAM test number - then they have been tested. Illegal or self-assembled fireworks, on the other hand, have an explosive power that cannot be predicted - and can be many times stronger. Experts therefore recommend keeping your hands off them.

Another way to increase safety when setting off fireworks is to use fireworks that do not have to be ignited in the hand - rockets, for example. However, if the bottle is not stable as a starting block, the rocket can whizz into crowds of people. Ruecker's tip is therefore to place the bottle in a drinks crate or bury it slightly.

Another safety rule: "Don't carry fireworks on your body, so don't stuff your jacket pockets with them," warns Andreas Ruecker. And of course: don't try again with firecrackers and rockets that have not ignited - and make children and young people aware of this. "There are often injuries on New Year's Day because children set fireworks off," reports Luisa Backhaus.

Alcohol as a risk factor

Of course, a glass of sparkling wine at midnight is a must for many people. But if you want to set off fireworks responsibly, you shouldn't look too deeply into your glass on New Year's Eve. "Alcohol leads to disinhibition and often also to people being more careless with explosives. You would actually have to say: if someone has been drinking, then he or she should stay away from fireworks," says Backhaus.

Especially as alcohol can also play a decisive role in other emergencies on New Year's Eve - for example if you fall down the stairs on your way out at midnight.