Epidemiology and Clinical Characteristics of Fireworks-Related Injuries in Los Angeles County Trauma Centers

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Fireworks-related injuries (FWIs) remain a public health concern during festivities, affecting mainly adolescents and young adults. This study evaluates the epidemiology, demographics, and clinical features of FWIs at trauma centers in Los Angeles County Methods . A retrospective review of the Los Angeles County Trauma Registry identified all FWI patients treated at 12 trauma centers (2015–2022). Collected data included demographics, injury characteristics , and outcomes. Injury severity was measured by AIS and ISS. Incidence rates used U.S. Census intercensal estimates. Results . A total of 244 FWI patients (0.31/100,000) presented, rising from 0.19 to 0.47/100,000 (peak 0.66 in 2021). Patients were predominantly male (92.6%) and aged 15–34 (67.6%). Hispanics comprised 66% of cases; African Americans had the highest per capita rate. July accounted for 57.4% of injuries, especially July 4–5 (41.8%). Extremity injuries occurred in 86.9%, with 62.7% undergoing upper-limb amputations. Ocular injuries occurred in 31.1%; burns in 27%.Surgical intervention was needed in 79.1%. ICU admission occurred in 18.4% (median stay 3 days); median hospital stay was 4 days. No fatalities were reported. Conclusion . FWIs are increasing, causing significant extremity and ocular trauma; stronger prevention and enforcement are needed. Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction The use of fireworks during festive events is a widespread practice around the world. The use of pyrotechnic materials in civilian settings, whether legal or illegal, is associated with blast injuries and burns. In the United States, an estimated 10,163 fireworks-related injuries (FWI) occurred in 2022, with 251 cases requiring emergency department treatment, marking a 17% increase since 2012[1]. The most commonly reported injuries are burns and trauma to the hands and eyes[1–3]. Deep injuries involving internal organs are rare, and fatalities are exceedingly uncommon[4,5]. While the incidence of severe injuries is relatively low, these incidents tend to cluster around specific days of the year and often involve children or adolescents[6,7]. Therefore, understanding the epidemiology and characteristics of FWIs is essential. The aim of this study is to investigate the epidemiology and the clinical and demographic features of FWIs presenting to emergency departments in Los Angeles County from 2015 to 2022. Materials and Methods We conducted a retrospective study by extracting data from the Los Angeles County Trauma Registry. which includes data from all 12 trauma centers in the county. The study included all patients admitted with fireworks-related injuries (FWI). Data in this registry is entered prospectively by trained trauma registrars at each of 12 trauma centers in Los Angeles County. Extracted information included patient demographics (age, sex, ethnicity, and patient residence Zone Improvement Plan (ZIP) code) and injury details including date and time of admission; admission vital signs; Injury Severity Score (ISS); Abbreviated Injury Scale (AIS) for each body region (head, face/neck, chest, abdomen, and extremities); detailed description of injuries involving burns, fractures, amputations, and eye injuries; details of procedures performed; and outcomes. Ethnicity was stratified into five groups (African American, Asian, Caucasian, Hispanic, and Other). Age was divided into four subgroups: under 15 years, 15–34 years, 35–54 years, and over 55 years. Fireworks-related injury rates were calculated using the 2012–2022 US Census Bureau intercensal population estimates for Los Angeles County as denominators. Injuries were defined as severe if the Abbreviated Injury Scale (AIS) was greater than 2. Results From 2015 to 2022, a total of 244 patients with injuries secondary to fireworks were admitted in all the 12 trauma centers in Los Angeles County trauma system, corresponding to an overall incidence of 0.31 cases per 100,000 inhabitants. The incidence of FWI increased from 0.19 cases per 100,000 in 2015 to 0.47 cases per 100,000 in 2022, with a peak of 0.66 cases per 100,000 in 2021, with a net increase of 142.1% (Fig. 1 ). Of these patients, 226 (92.6%) were male. The month with the highest number of recorded cases was July, accounting for 140 cases (57.4%) (Fig. 2 ). Of these, 102 occurred between July 4th and 5th (41.8% of total cases), corresponding to the Independence Day holiday in the United States. The majority of FWI patients in absolute terms were Hispanic, accounting for 161 cases (66.0% of the total, 0.42/100,000) (Fig. 3 ), but when considering incidence per 100,000 inhabitants, African Americans are the most involved (0.66 cases per 100,000). Regarding age, 17 patients were under 15 years old (0.12/100,000), 165 were between 15 and 34 years old (0.71/100,000), 56 were between 35 and 54 years old (0.26/100,000), and 6 were over 55 years old (0.03/100,000) (Fig. 4 ). Geographically, residents of the neighbourhood with ZIP code 90003 (Southeast Los Angeles) had the highest number of FWI over the study period, with a total of 13 cases. Most cases (72.1%) occurred between 8 PM and 4 AM. Ten patients had a tourniquet applied in the field. Five patients required red blood cell (RBC) transfusions within the first 4 hours of admission. Patient epidemiological and admission clinical characteristics are summarized in Table 1. Out of 244 patients, the majority (86.9%) sustained extremity injuries, while 57.4% had facial injuries, 16.4% had chest injuries, 5.7% had abdominal injuries, and 4.5% had head injuries. Among those with extremity injuries, 133 (62.7%) patients suffered at least one upper-limb amputation—49.2% of these involved only the left limb, and 6.6% involved both limbs. In total, 227 fingers were amputated, with the index (29.1%) and thumb (26.4%) being most commonly affected. Bone fractures were observed in 134 hand cases and 12 forearm cases. Ocular injuriesoccurred in 31.1% of patients, and burns were documented in 66 patients; among those with burns, 25% were first-degree, 62.5% second-degree, and 12.5% third-degree (with one patient suffering burns over 50% of the body surface). Additionally, a few cases presented with severe head, chest, abdominal, or facial injuries. The median Injury Severity Score for the entire cohort was 5 (range 4–9). Details of the injuries are shown in Table 2. Regarding management, 51 patients (20.9%) were treated without invasive procedures, while 193 (79.1%) underwent surgery. Of these, 130 orthopedic procedures, 19 plastic surgery procedures, and 13 ophthalmologic procedures were performed, along with a few exploratory laparotomies, craniotomies, and vascular reconstructions (Table 3). Forty-five patients required ICU admission, with a median ICU stay of 3 days (range 2–4 days), and the overall median hospital length of stay was 4 days (range 1–6 days). No deaths were reported in this series. Discussion The use of fireworks, whether legal or illegal, is clearly associated with specific types of injuries, particularly when personal protective equipment is not used[8]. Consistent with previously published studies on the epidemiology of fireworks-related injuries (FWI) in the United States, Los Angeles County has experienced a marked increase in FWI cases in recent years, with a net increase of 142% and a peak in 2021 following the COVID-19 pandemic[1]. Other studies have confirmed a significant spike in FWI incidence during and immediately after the pandemic, suggesting that this may be due to a decrease in professional and public displays and increased sales of fireworks to non-professionals [9–11]. From an epidemiological perspective, males are predominantly affected by FWI (approximately 93% in our series), and the adolescent/young adult age group is at the highest risk (about 68% of all cases). This finding is in line with previous literature, which demonstrates a strong correlation between younger age and FWI[8,12,13]. In our series, only 7% of cases involved children, compared to a national 10-year average of 13%, most of whom were bystanders[1,14]. Our study found that most patients with FWI in Los Angeles County were of Hispanic ethnicity, reflecting the ethnic makeup of Los Angeles County. However, when considering incidence per 100,000 inhabitants, African Americans are the most involved (0.66 cases per 100,000). July is the month with the highest number of FWI cases, likely due to the celebration of Independence Day on July 4, when 102 cases (about 42% of the total) were recorded. Interestingly, only eight cases occurred during New Year’s Eve (December 31) throughout the study period. This date, however, represents the day most affected by fireworks-related injuries in other settings, such as in Europe[8]. Consistent with previous studies[7,10,15–18], most injuries involved the extremities (87% of cases). Among these, 133 cases resulted in partial or complete amputation of parts of the upper limb. The first two fingers were the most affected, in 25% and 27% of cases respectively. In 31% of cases, the eyes were involved, and 32% of these resulted in severe injuries such as avulsion, enucleation, or laceration. Sandvall et al. reported that over 80% of ocular injuries were severe enough to cause permanent vision loss, blindness, or enucleation of the eye[19]. The National Society for Prevention of Blindness stated in 1970 that more than half of fireworks-related ocular injuries resulted in partial or complete vision loss[20,21]. Furthermore, Smith et al. showed that rockets are more frequently associated with ocular injuries compared to other types of fireworks (OR = 6.7, p = 0.03). In our series, 27% of patients experienced burns, with 21% suffering third-degree burns. Other studies have indicated that burns of any degree are the most frequent FWI, representing around half of all cases[22]. Wegmann et al. demonstrated an inverse correlation between the likelihood of burns and weather conditions involving precipitation (OR 0.4, p = 0.004)[8]. Among hospitalized patients, the majority underwent some form of surgical intervention. Specifically, three patients underwent neurosurgical procedures for the evacuation of intracranial hematomas and cerebral edema, and one patient underwent an exploratory laparotomy for hepatic laceration due to non-penetrating trauma following FWI. The median hospital length of stay was 4 days, and no patients died. These findings align with the literature, which reports that severe visceral injuries and fatalities from FWI are very rare. Contributing to the rise in FWI cases is the lack of adherence to current regulations (illegal fireworks) or to behavioral and safety norms. Fireworks sales and usage are regulated by individual states in the United States[1,23]. It has been demonstrated that stricter regulations significantly reduce the number of FWIs. For instance, in the United States, the Hawaii islands have stricter laws, and in Europe, stricter legislation in Finland, the Netherlands, Italy, and Germany has reduced the number of FWIs[8,24–26]. Conversely, Minnesota experienced a 100% increase in FWI incidence following a relaxation of legislative restrictions[27]. In California, the law distinguishes between two types of fireworks. “Safe and Sane” devices are designed to prevent explosions or uncontrolled effects and are only authorized with the State Fire Marshal’s seal, provided they are used during specified periods and in designated areas (usually from late June to early July and with a minimum age of 16). In contrast, “dangerous” fireworks (such as rockets and roman candles) are banned for private use and can only be used by licensed professionals. In Los Angeles County, the situation differs from state legislation: in unincorporated areas, the Fire Code prohibits the sale and use of any fireworks without a permit, and some cities only authorize “safe and sane” fireworks during specific times and in designated areas. The City of Los Angeles, however, bans all forms of fireworks and enforces both criminal and administrative sanctions for possession or use[28]. Despite stringent regulations, there has been an increase in emergency department visits for FWI in recent years. This study had several limitations. First, the selection was limited to patients with FWI who were admitted in trauma centers. The trauma registry does not include patients treated and discharged from emergencies rooms, thereby underestimating the total number of injuries.Another limitation is the lack of detailed information on the types of fireworks involved, their illegal possession, and the relationship between the patient and the pyrotechnic agent (whether as a user or spectator).. Lastly, data on medium- and long-term follow-up for treated patients are not available. Conclusion The number of FWIs in Los Angeles County is increasing. Although there were no deaths and severe internal injuries were rare, FWIs often affect areas that are functionally and cosmetically important. Enhanced education, prevention, and stricter enforcement of regulations are necessary to prevent a further rise in such injuries. Declarations The authors declare that they have no conflicts of interest or disclosures and that they have received no funding. Ethics, Consent to Participate, and Consent to Publish declarations: not applicable. Author Contribution A.So. and D.D. contributed to the conception and design of the work;A.So., N.K., and J.T. participated in data collection;A.So. and A.Si. contributed to drafting the manuscript;D.D. participated in the final revision and editing of the work. References Winicki NM, Waldrop I, Orozco JV, Novak D, Sheets NW. The epidemiology of firework-related injuries in the US, 2012–2022. Inj Epidemiol. 2023;10:32. Serra López VM, Cheema AN, Gray BL, Pirruccio K, Kazmers NH. Epidemiology of Fireworks-Related Injuries to the Upper Extremity in the United States From 2011 to 2017. Journal of Hand Surgery Global Online. 2020;2:117–20. Moore JX, McGwin G, Griffin RL. The epidemiology of firework-related injuries in the United States: 2000–2010. Injury. 2014;45:1704–9. Vaghardoost R, Ghavami Y, Sobouti B, Mobayen MR. Mortality and morbidity of fireworks-related burns on the annual last wednesday of the year festival (charshanbeh soori) in iran: an 11-year study. Trauma Mon. 2013;18:81–5. Wang C, Zhao R, Du W-L, Ning F-G, Zhang G-A. Firework injuries at a major trauma and burn center: A five-year prospective study. Burns. 2014;40:305–10. Bitter CC, Zhang Z, Talbert AW, Weber AK, Hinyard L. Firework injuries are increasing in the United States: An analysis of the National Emergency Department Sample. JACEP Open. 2021;2:e12600. Jacobson L, Sandvall BK, Quistberg DA, Rowhani-Rahbar A, Vavilala MS, Friedrich JB, et al. Severe Fireworks-Related Injuries: Demographic Characteristics, Injury Patterns, and Firework Types in 294 Consecutive Patients. Pediatr Emer Care. 2021;37:e32–6. Wegmann H, Mayer S, Blankenburg N, Zimmermann P, Schulz T, Lacher M, et al. Firework injuries around New Year’s Eve - epidemiology, injury patterns and risk factors. Eur J Trauma Emerg Surg. 2025;51:106. Capitelli-McMahon H, Magness C, McCrossan S, Austin O. After freedom comes pain: Increasing firework injuries at a regional burns centre following the lifting of COVID-19 restrictions. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2022;75:1765–79. Herzog LN, Daley DN. Devastating Independence Day fireworks hand injuries of 2020: a retrospective case series examining dramatic increase secondary to COVID-19 restrictions. Current Orthopaedic Practice [Internet]. 2022 [cited 2025 Apr 16]; Available from: https://journals.lww.com/10.1097/BCO.0000000000001124 Maassel N, Saccary A, Solomon D, Stitelman D, Xu Y, Li F, et al. Firework-related injuries treated at emergency departments in the United States during the COVID-19 pandemic in 2020 compared to 2018–2019. Inj Epidemiol. 2021;8:65. Chang IT, Prendes MA, Tarbet KJ, Amadi AJ, Chang S-H, Shaftel SS. Ocular injuries from fireworks: the 11-year experience of a US level I trauma center. Eye (Lond). 2016;30:1324–30. Demmer W, Mesas Aranda I, Jimenez-Frohn M, Esser T, Oeckenpöhler S, Lauer H, et al. Verbot von Feuerwerkskörpern reduziert schwere Handverletzungen an Silvester: Eine deutschlandweite Multicenter-Studie des Pyrotechnikverbots im Rahmen der Covid-19-Maßnahmen. Handchir Mikrochir Plast Chir. 2024;56:308–15. Witsaman RJ, Comstock RD, Smith GA. Pediatric Fireworks-Related Injuries in the United States: 1990–2003. Pediatrics. 2006;118:296–303. Sandvall BK, Keys KA, Friedrich JB. Severe Hand Injuries From Fireworks: Injury Patterns, Outcomes, and Fireworks Types. The Journal of Hand Surgery. 2017;42:385.e1-385.e8. Gordon AM, Malik AT, Tamer R, Khan SN, Goyal KS. Firework Injuries to the Hand in the United States: An Epidemiological and Cost Analysis. Orthopedics. 2023;46:180–4. Van Yperen DT, Van Der Vlies CH, De Faber JTHN, Smit X, Polinder S, Penders CJM, et al. Epidemiology, treatment, costs, and long-term outcomes of patients with fireworks-related injuries (ROCKET); a multicenter prospective observational case series. Lumenta DB, editor. PLoS ONE. 2020;15:e0230382. Van Yperen DT, Van Lieshout EMM, Dijkshoorn JN, Van Der Vlies CH, Verhofstad MHJ. Injuries, treatment, and impairment caused by different types of fireworks; results of a 10 year multicenter retrospective cohort study. Scand J Trauma Resusc Emerg Med. 2021;29:11. Sandvall BK, Jacobson L, Miller EA, Dodge RE, Alex Quistberg D, Rowhani-Rahbar A, et al. Fireworks type, injury pattern, and permanent impairment following severe fireworks-related injuries. The American Journal of Emergency Medicine. 2017;35:1469–73. Berger LR, Kalishman S, Rivara FP. Injuries from Fireworks. Pediatrics. 1985;75:877–82. Wilson RS. Ocular Fireworks Injuries and Blindness. Ophthalmology. 1982;89:291–7. Read DJ, Bradbury R, Yeboah E. Firework‐related injury in the Top End: a 16‐year review. ANZ Journal of Surgery. 2017;87:1030–4. Puri V, Mahendru S, Rana R, Deshpande M. Firework injuries: a ten-year study. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2009;62:1103–11. D’Argenio P, Cafaro L, Santonastasi F, Taggi F, Binkin N. Capodanno Senza Danno: the effects of an intervention program on fireworks injuries in Naples. Am J Public Health. 1996;86:84–6. De Faber JT, Kivelä TT, Gabel-Pfisterer A. National studies from the Netherlands and Finland and the impact of regulations on incidences of fireworks-related eye injuries. Ophthalmologe. 2020;117:36–42. Sheller JP, Muchardt O, Jønsson B, Mikkelsen MB. Burn injuries caused by fireworks: effect of prophylaxis. Burns. 1995;21:50–3. Roesler JS, Day H. Sparklers, smoke bombs, and snakes, oh my! Effect of legislation on fireworks-related injuries in Minnesota, 1999-2005. Minn Med. 2007;90:46–7. Health and Safety Code - HSC; DIVISION 11. EXPLOSIVES [12000 - 12761] ( Division 11 enacted by Stats. 1939, Ch. 60. ); PART 2. FIREWORKS AND PYROTECHNIC DEVICES [12500 - 12728] ( Part 2 repealed and added by Stats. 1973, Ch. 1109. ) [Internet]. 1973 p. 12000–761. Available from: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=12505 Tables Table 1 : Patient characteristics. SBP: Systolic Blood Pressure; HR: Heart rate; GCS: Glasgow Coma Scale. N° - Median % - IQR Cases per 100.000 All 244 100.0% 0.31 Year 2015 19 7.8% 0.19 2016 13 5.3% 0.13 2017 16 6.6% 0.16 2018 22 9.0% 0.22 2019 15 6.1% 0.15 2020 48 19.7% 0.48 2021 65 26.6% 0.66 2022 46 18.9% 0.47 Month Jenuary 14 5,7% - February 3 1,2% - March 5 2,0% - April 4 1,6% - May 8 3,3% - June 39 16,0% - July 140 57,4% - August 8 3,3% - September 6 2,5% - October 6 2,5% - November 3 1,2% - December 8 3,3% - Hour 4am - 12 am 176 72.1% - 12 am - 20 pm 21 8.6% - 20 pm - 4 am 47 19.2% - Vital Parameters BP120 bpm 18 7.4% - GCS <13 0 0% - Sex Male 226 92.6% 0.57 Female 18 7.4% 0.04 Age 55 years 6 2.5% 0.03 Ethnicity Asian/Oceanian 8 3.3% 0.07 Afro American 42 17.2% 0.66 Caucasic 27 11.1% 0.13 Hispanic 161 66.0% 0.42 Other 6 2.5% 0.34 Table 2 : Injuries Characteristics and Frequencies. ISS: Injury Severity Score. Injury N° - Median % - IQR Head 11 4.5% Face 140 57.4% Chest 40 16.4% Abdomen 14 5.7% Extremity 212 86.9% Amputation 133 54.5% · I Finger 60 24.6% · II Finger 66 27.0% · III Finger 46 18.9% · IV Finger 30 12.3% · V Finger 16 6.6% · Finger Not Specified 9 3.7% · Hand. wrist level 19 7.8% · Hand. transemtacarpal 11 4.5% · Right hand involved 54 22.1% · Left hand involved 60 24.6% · Both hands involved 8 3.3% · Forearm amputation 2 0.8% · One finger involved 74 30.3% · Two Fingers Involved 13 5.3% · Three Fingers Involved 22 9.0% · Four or more Fingers Involved 17 7.0% Hand Fracture 134 54.9% Forearm fracture 12 4.9% Other 157 64.3% Eyes Injuries 76 31.1% · Avulsion / Rupture of eye 4 1.6% · Eye Laceration 21 8.6% · Eyelid Injuries 22 9.0% · Other 29 11.9% Burns 66 27.0% · Face 27 11.1% · Chest 23 9.4% · Abdomen 12 4.9% · Extremities 39 16.0% · Grade I 8 3.3% · Grade II 20 8.2% · Grade III 14 5.7% · Unknown Grade 24 9.8% AIS >2 Head Injuries · Subdural Hemorrhage 3 1.2% · Epidural Hemorrhage 1 0.4% · Brain Contusion 1 0.4% · Cerebral Hedema 1 0.4% AIS >2 Chest Injuries · Lung Contusion 2 0.8% AIS >2 Abdominal Injuries · Liver Laceration 1 0.4% ISS 5 4 - 9 Table 3 : Type of surgery and Hospitalization. NOM: Non-Operative Management; ICU: Intensive-Care Unit; ICU-LOS: Intensive-Care Unit Length of Stay; HLOS: Hospital Length of Stay. Procedure N° - Median % - IQR NOM 51 20.9% Surgery 193 79.1% · Orthopedic 130 53.3% · Plastic 19 7.8% · Ophthalmology 13 5.3% · Neurosurgery 3 1.2% · Vascular 3 1.2% · Abdominal 2 0.8% · Thoracic 2 0.8% · Other 33 13.5% No Hospitalization 29 11.9% ICU 45 18.4% ICU-LOS 3 2 - 4 HLOS 4 1 - 6 Mortality 0 0.0% Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 16 Feb, 2026 Read the published version in European Journal of Trauma and Emergency Surgery → Version 1 posted Editorial decision: Revision requested 19 Sep, 2025 Reviews received at journal 07 Sep, 2025 Reviewers agreed at journal 30 Aug, 2025 Reviews received at journal 21 Aug, 2025 Reviewers agreed at journal 07 Aug, 2025 Reviewers invited by journal 29 Jun, 2025 Editor assigned by journal 29 Jun, 2025 Submission checks completed at journal 24 Jun, 2025 First submitted to journal 14 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6895198","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":478032948,"identity":"ec389883-ac0f-4128-9e47-57828ffff679","order_by":0,"name":"Andrea Sozzi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIiWNgGAWjYHACAzjrwAcGBh4GZiCDaC0HZ8C0ENCD0MLMA7cPj3r+2c3bPnyoYbDn5z/+8LBt2x0Z3XYGxsMf8GiRuHOseOaMYwyJMxsOJBzObXvGY3aYkMNu5Bgz87AxJBgcbDgA1HKYsBZ5kJY//xjsDQ4zNhy2JEaLAUgLYxsD44ZjzAyHGYnRYngjrZixt08icWYPG8PBnnMgLYwNB87g0SJ3I3kzw49vNqAQe/zhR9lhe7Pzhw9/qMCjBQokkDmMDYQ1jIJRMApGwSjACwB76FHzxCpfHAAAAABJRU5ErkJggg==","orcid":"","institution":"University of Southern California","correspondingAuthor":true,"prefix":"","firstName":"Andrea","middleName":"","lastName":"Sozzi","suffix":""},{"id":478032949,"identity":"d9373e7c-9a6c-4c0b-98bd-697a9357c2a1","order_by":1,"name":"Anaar Siletz","email":"","orcid":"","institution":"University of Southern California","correspondingAuthor":false,"prefix":"","firstName":"Anaar","middleName":"","lastName":"Siletz","suffix":""},{"id":478032950,"identity":"469f36be-0461-4151-b23f-c3c46ca2ffa5","order_by":2,"name":"Negar Nekooei","email":"","orcid":"","institution":"University of Southern California","correspondingAuthor":false,"prefix":"","firstName":"Negar","middleName":"","lastName":"Nekooei","suffix":""},{"id":478032951,"identity":"a1861996-e1bb-49d6-b459-8fb417ea5b0d","order_by":3,"name":"Justin Tian","email":"","orcid":"","institution":"University of Southern California","correspondingAuthor":false,"prefix":"","firstName":"Justin","middleName":"","lastName":"Tian","suffix":""},{"id":478032952,"identity":"f9f4ac38-ea86-42a2-b85f-0851a3bcfd77","order_by":4,"name":"Demetrios Demetriades","email":"","orcid":"","institution":"University of Southern California","correspondingAuthor":false,"prefix":"","firstName":"Demetrios","middleName":"","lastName":"Demetriades","suffix":""}],"badges":[],"createdAt":"2025-06-14 17:23:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6895198/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6895198/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s00068-026-03090-y","type":"published","date":"2026-02-16T15:59:09+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":85885543,"identity":"78014fbe-2281-43e2-8c87-5ae1c9fd4a94","added_by":"auto","created_at":"2025-07-02 17:38:08","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":18491,"visible":true,"origin":"","legend":"\u003cp\u003eCases of FWI per 100000 inhabitants per year.\u003c/p\u003e","description":"","filename":"FIG1.png","url":"https://assets-eu.researchsquare.com/files/rs-6895198/v1/06cb474b59320f8e38f931f4.png"},{"id":85885536,"identity":"fffabe91-a747-46fa-851e-97ab169e4897","added_by":"auto","created_at":"2025-07-02 17:38:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":16923,"visible":true,"origin":"","legend":"\u003cp\u003eCases of FWI per month.\u003c/p\u003e","description":"","filename":"FIG3.png","url":"https://assets-eu.researchsquare.com/files/rs-6895198/v1/8231aa4b3e95fc2269842f69.png"},{"id":85885558,"identity":"c51252ed-b461-4896-9f1e-946285da31f7","added_by":"auto","created_at":"2025-07-02 17:38:08","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":14509,"visible":true,"origin":"","legend":"\u003cp\u003eEthnicity. Absolute number and cases per 100000 inhabitants. AO: Asian/Oceanian; AA: Afro American; C: Caucasic; H: Hispanic; O: Other.\u003c/p\u003e","description":"","filename":"FIG2.png","url":"https://assets-eu.researchsquare.com/files/rs-6895198/v1/0cea90d6157c6bf230a2d307.png"},{"id":85885567,"identity":"f3111d4c-7fda-4d4b-8eba-b569268bf662","added_by":"auto","created_at":"2025-07-02 17:38:08","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":18384,"visible":true,"origin":"","legend":"\u003cp\u003eAge. Absolute number and cases per 100000 inhabitants.\u003c/p\u003e","description":"","filename":"FIG4.png","url":"https://assets-eu.researchsquare.com/files/rs-6895198/v1/ef00fc0762af6869be265510.png"},{"id":103252399,"identity":"913253c8-9e47-4a3d-af90-9c76513576fc","added_by":"auto","created_at":"2026-02-23 16:14:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":814077,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6895198/v1/ec32b20a-49b1-4620-aebd-b80464cf9c01.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Epidemiology and Clinical Characteristics of Fireworks-Related Injuries in Los Angeles County Trauma Centers","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe use of fireworks during festive events is a widespread practice around the world. The use of pyrotechnic materials in civilian settings, whether legal or illegal, is associated with blast injuries and burns. In the United States, an estimated 10,163 fireworks-related injuries (FWI) occurred in 2022, with 251 cases requiring emergency department treatment, marking a 17% increase since 2012[1]. The most commonly reported injuries are burns and trauma to the hands and eyes[1\u0026ndash;3]. Deep injuries involving internal organs are rare, and fatalities are exceedingly uncommon[4,5]. While the incidence of severe injuries is relatively low, these incidents tend to cluster around specific days of the year and often involve children or adolescents[6,7]. Therefore, understanding the epidemiology and characteristics of FWIs is essential. The aim of this study is to investigate the epidemiology and the clinical and demographic features of FWIs presenting to emergency departments in Los Angeles County from 2015 to 2022.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eWe conducted a retrospective study by extracting data from the Los Angeles County Trauma Registry. which includes data from all 12 trauma centers in the county. The study included all patients admitted with fireworks-related injuries (FWI). Data in this registry is entered prospectively by trained trauma registrars at each of 12 trauma centers in Los Angeles County. Extracted information included patient demographics (age, sex, ethnicity, and patient residence Zone Improvement Plan (ZIP) code) and injury details including date and time of admission; admission vital signs; Injury Severity Score (ISS); Abbreviated Injury Scale (AIS) for each body region (head, face/neck, chest, abdomen, and extremities); detailed description of injuries involving burns, fractures, amputations, and eye injuries; details of procedures performed; and outcomes. Ethnicity was stratified into five groups (African American, Asian, Caucasian, Hispanic, and Other). Age was divided into four subgroups: under 15 years, 15\u0026ndash;34 years, 35\u0026ndash;54 years, and over 55 years. Fireworks-related injury rates were calculated using the 2012\u0026ndash;2022 US Census Bureau intercensal population estimates for Los Angeles County as denominators. Injuries were defined as severe if the Abbreviated Injury Scale (AIS) was greater than 2.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eFrom 2015 to 2022, a total of 244 patients with injuries secondary to fireworks were admitted in all the 12 trauma centers in Los Angeles County trauma system, corresponding to an overall incidence of 0.31 cases per 100,000 inhabitants. The incidence of FWI increased from 0.19 cases per 100,000 in 2015 to 0.47 cases per 100,000 in 2022, with a peak of 0.66 cases per 100,000 in 2021, with a net increase of 142.1% (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Of these patients, 226 (92.6%) were male. The month with the highest number of recorded cases was July, accounting for 140 cases (57.4%) (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Of these, 102 occurred between July 4th and 5th (41.8% of total cases), corresponding to the Independence Day holiday in the United States. The majority of FWI patients in absolute terms were Hispanic, accounting for 161 cases (66.0% of the total, 0.42/100,000) (Fig. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e), but when considering incidence per 100,000 inhabitants, African Americans are the most involved (0.66 cases per 100,000). Regarding age, 17 patients were under 15 years old (0.12/100,000), 165 were between 15 and 34 years old (0.71/100,000), 56 were between 35 and 54 years old (0.26/100,000), and 6 were over 55 years old (0.03/100,000) (Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Geographically, residents of the neighbourhood with ZIP code 90003 (Southeast Los Angeles) had the highest number of FWI over the study period, with a total of 13 cases. Most cases (72.1%) occurred between 8 PM and 4 AM. Ten patients had a tourniquet applied in the field. Five patients required red blood cell (RBC) transfusions within the first 4 hours of admission. Patient epidemiological and admission clinical characteristics are summarized in Table\u0026nbsp;1.\u003c/p\u003e\n\u003cp\u003eOut of 244 patients, the majority (86.9%) sustained extremity injuries, while 57.4% had facial injuries, 16.4% had chest injuries, 5.7% had abdominal injuries, and 4.5% had head injuries. Among those with extremity injuries, 133 (62.7%) patients suffered at least one upper-limb amputation\u0026mdash;49.2% of these involved only the left limb, and 6.6% involved both limbs. In total, 227 fingers were amputated, with the index (29.1%) and thumb (26.4%) being most commonly affected. Bone fractures were observed in 134 hand cases and 12 forearm cases. Ocular injuriesoccurred in 31.1% of patients, and burns were documented in 66 patients; among those with burns, 25% were first-degree, 62.5% second-degree, and 12.5% third-degree (with one patient suffering burns over 50% of the body surface). Additionally, a few cases presented with severe head, chest, abdominal, or facial injuries. The median Injury Severity Score for the entire cohort was 5 (range 4\u0026ndash;9). Details of the injuries are shown in Table 2.\u003c/p\u003e\n\u003cp\u003eRegarding management, 51 patients (20.9%) were treated without invasive procedures, while 193 (79.1%) underwent surgery. Of these, 130 orthopedic procedures, 19 plastic surgery procedures, and 13 ophthalmologic procedures were performed, along with a few exploratory laparotomies, craniotomies, and vascular reconstructions (Table\u0026nbsp;3). Forty-five patients required ICU admission, with a median ICU stay of 3 days (range 2\u0026ndash;4 days), and the overall median hospital length of stay was 4 days (range 1\u0026ndash;6 days). No deaths were reported in this series.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe use of fireworks, whether legal or illegal, is clearly associated with specific types of injuries, particularly when personal protective equipment is not used[8]. Consistent with previously published studies on the epidemiology of fireworks-related injuries (FWI) in the United States, Los Angeles County has experienced a marked increase in FWI cases in recent years, with a net increase of 142% and a peak in 2021 following the COVID-19 pandemic[1]. Other studies have confirmed a significant spike in FWI incidence during and immediately after the pandemic, suggesting that this may be due to a decrease in professional and public displays and increased sales of fireworks to non-professionals [9\u0026ndash;11].\u003c/p\u003e \u003cp\u003eFrom an epidemiological perspective, males are predominantly affected by FWI (approximately 93% in our series), and the adolescent/young adult age group is at the highest risk (about 68% of all cases). This finding is in line with previous literature, which demonstrates a strong correlation between younger age and FWI[8,12,13]. In our series, only 7% of cases involved children, compared to a national 10-year average of 13%, most of whom were bystanders[1,14]. Our study found that most patients with FWI in Los Angeles County were of Hispanic ethnicity, reflecting the ethnic makeup of Los Angeles County. However, when considering incidence per 100,000 inhabitants, African Americans are the most involved (0.66 cases per 100,000).\u003c/p\u003e \u003cp\u003eJuly is the month with the highest number of FWI cases, likely due to the celebration of Independence Day on July 4, when 102 cases (about 42% of the total) were recorded. Interestingly, only eight cases occurred during New Year\u0026rsquo;s Eve (December 31) throughout the study period. This date, however, represents the day most affected by fireworks-related injuries in other settings, such as in Europe[8].\u003c/p\u003e \u003cp\u003eConsistent with previous studies[7,10,15\u0026ndash;18], most injuries involved the extremities (87% of cases). Among these, 133 cases resulted in partial or complete amputation of parts of the upper limb. The first two fingers were the most affected, in 25% and 27% of cases respectively. In 31% of cases, the eyes were involved, and 32% of these resulted in severe injuries such as avulsion, enucleation, or laceration. Sandvall et al. reported that over 80% of ocular injuries were severe enough to cause permanent vision loss, blindness, or enucleation of the eye[19]. The National Society for Prevention of Blindness stated in 1970 that more than half of fireworks-related ocular injuries resulted in partial or complete vision loss[20,21]. Furthermore, Smith et al. showed that rockets are more frequently associated with ocular injuries compared to other types of fireworks (OR\u0026thinsp;=\u0026thinsp;6.7, p\u0026thinsp;=\u0026thinsp;0.03). In our series, 27% of patients experienced burns, with 21% suffering third-degree burns. Other studies have indicated that burns of any degree are the most frequent FWI, representing around half of all cases[22]. Wegmann et al. demonstrated an inverse correlation between the likelihood of burns and weather conditions involving precipitation (OR 0.4, p\u0026thinsp;=\u0026thinsp;0.004)[8].\u003c/p\u003e \u003cp\u003eAmong hospitalized patients, the majority underwent some form of surgical intervention. Specifically, three patients underwent neurosurgical procedures for the evacuation of intracranial hematomas and cerebral edema, and one patient underwent an exploratory laparotomy for hepatic laceration due to non-penetrating trauma following FWI. The median hospital length of stay was 4 days, and no patients died. These findings align with the literature, which reports that severe visceral injuries and fatalities from FWI are very rare.\u003c/p\u003e \u003cp\u003eContributing to the rise in FWI cases is the lack of adherence to current regulations (illegal fireworks) or to behavioral and safety norms. Fireworks sales and usage are regulated by individual states in the United States[1,23]. It has been demonstrated that stricter regulations significantly reduce the number of FWIs. For instance, in the United States, the Hawaii islands have stricter laws, and in Europe, stricter legislation in Finland, the Netherlands, Italy, and Germany has reduced the number of FWIs[8,24\u0026ndash;26]. Conversely, Minnesota experienced a 100% increase in FWI incidence following a relaxation of legislative restrictions[27]. In California, the law distinguishes between two types of fireworks. \u0026ldquo;Safe and Sane\u0026rdquo; devices are designed to prevent explosions or uncontrolled effects and are only authorized with the State Fire Marshal\u0026rsquo;s seal, provided they are used during specified periods and in designated areas (usually from late June to early July and with a minimum age of 16). In contrast, \u0026ldquo;dangerous\u0026rdquo; fireworks (such as rockets and roman candles) are banned for private use and can only be used by licensed professionals. In Los Angeles County, the situation differs from state legislation: in unincorporated areas, the Fire Code prohibits the sale and use of any fireworks without a permit, and some cities only authorize \u0026ldquo;safe and sane\u0026rdquo; fireworks during specific times and in designated areas. The City of Los Angeles, however, bans all forms of fireworks and enforces both criminal and administrative sanctions for possession or use[28]. Despite stringent regulations, there has been an increase in emergency department visits for FWI in recent years.\u003c/p\u003e \u003cp\u003eThis study had several limitations. First, the selection was limited to patients with FWI who were admitted in trauma centers. The trauma registry does not include patients treated and discharged from emergencies rooms, thereby underestimating the total number of injuries.Another limitation is the lack of detailed information on the types of fireworks involved, their illegal possession, and the relationship between the patient and the pyrotechnic agent (whether as a user or spectator).. Lastly, data on medium- and long-term follow-up for treated patients are not available.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe number of FWIs in Los Angeles County is increasing. Although there were no deaths and severe internal injuries were rare, FWIs often affect areas that are functionally and cosmetically important. Enhanced education, prevention, and stricter enforcement of regulations are necessary to prevent a further rise in such injuries.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe authors declare that they have no conflicts of interest or disclosures and that they have received no funding.\u003c/p\u003e\n\u003cp\u003eEthics, Consent to Participate, and Consent to Publish declarations: not applicable.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eA.So. and D.D. contributed to the conception and design of the work;A.So., N.K., and J.T. participated in data collection;A.So. and A.Si. contributed to drafting the manuscript;D.D. participated in the final revision and editing of the work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWinicki NM, Waldrop I, Orozco JV, Novak D, Sheets NW. The epidemiology of firework-related injuries in the US, 2012\u0026ndash;2022. Inj Epidemiol. 2023;10:32. \u003c/li\u003e\n\u003cli\u003eSerra L\u0026oacute;pez VM, Cheema AN, Gray BL, Pirruccio K, Kazmers NH. Epidemiology of Fireworks-Related Injuries to the Upper Extremity in the United States From 2011 to 2017. Journal of Hand Surgery Global Online. 2020;2:117\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eMoore JX, McGwin G, Griffin RL. The epidemiology of firework-related injuries in the United States: 2000\u0026ndash;2010. Injury. 2014;45:1704\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eVaghardoost R, Ghavami Y, Sobouti B, Mobayen MR. Mortality and morbidity of fireworks-related burns on the annual last wednesday of the year festival (charshanbeh soori) in iran: an 11-year study. Trauma Mon. 2013;18:81\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eWang C, Zhao R, Du W-L, Ning F-G, Zhang G-A. Firework injuries at a major trauma and burn center: A five-year prospective study. Burns. 2014;40:305\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eBitter CC, Zhang Z, Talbert AW, Weber AK, Hinyard L. Firework injuries are increasing in the United States: An analysis of the National Emergency Department Sample. JACEP Open. 2021;2:e12600. \u003c/li\u003e\n\u003cli\u003eJacobson L, Sandvall BK, Quistberg DA, Rowhani-Rahbar A, Vavilala MS, Friedrich JB, et al. Severe Fireworks-Related Injuries: Demographic Characteristics, Injury Patterns, and Firework Types in 294 Consecutive Patients. Pediatr Emer Care. 2021;37:e32\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eWegmann H, Mayer S, Blankenburg N, Zimmermann P, Schulz T, Lacher M, et al. Firework injuries around New Year\u0026rsquo;s Eve - epidemiology, injury patterns and risk factors. Eur J Trauma Emerg Surg. 2025;51:106. \u003c/li\u003e\n\u003cli\u003eCapitelli-McMahon H, Magness C, McCrossan S, Austin O. After freedom comes pain: Increasing firework injuries at a regional burns centre following the lifting of COVID-19 restrictions. Journal of Plastic, Reconstructive \u0026amp; Aesthetic Surgery. 2022;75:1765\u0026ndash;79. \u003c/li\u003e\n\u003cli\u003eHerzog LN, Daley DN. Devastating Independence Day fireworks hand injuries of 2020: a retrospective case series examining dramatic increase secondary to COVID-19 restrictions. Current Orthopaedic Practice [Internet]. 2022 [cited 2025 Apr 16]; Available from: https://journals.lww.com/10.1097/BCO.0000000000001124\u003c/li\u003e\n\u003cli\u003eMaassel N, Saccary A, Solomon D, Stitelman D, Xu Y, Li F, et al. Firework-related injuries treated at emergency departments in the United States during the COVID-19 pandemic in 2020 compared to 2018\u0026ndash;2019. Inj Epidemiol. 2021;8:65. \u003c/li\u003e\n\u003cli\u003eChang IT, Prendes MA, Tarbet KJ, Amadi AJ, Chang S-H, Shaftel SS. Ocular injuries from fireworks: the 11-year experience of a US level I trauma center. Eye (Lond). 2016;30:1324\u0026ndash;30. \u003c/li\u003e\n\u003cli\u003eDemmer W, Mesas Aranda I, Jimenez-Frohn M, Esser T, Oeckenp\u0026ouml;hler S, Lauer H, et al. Verbot von Feuerwerksk\u0026ouml;rpern reduziert schwere Handverletzungen an Silvester: Eine deutschlandweite Multicenter-Studie des Pyrotechnikverbots im Rahmen der Covid-19-Ma\u0026szlig;nahmen. Handchir Mikrochir Plast Chir. 2024;56:308\u0026ndash;15. \u003c/li\u003e\n\u003cli\u003eWitsaman RJ, Comstock RD, Smith GA. Pediatric Fireworks-Related Injuries in the United States: 1990\u0026ndash;2003. Pediatrics. 2006;118:296\u0026ndash;303. \u003c/li\u003e\n\u003cli\u003eSandvall BK, Keys KA, Friedrich JB. Severe Hand Injuries From Fireworks: Injury Patterns, Outcomes, and Fireworks Types. The Journal of Hand Surgery. 2017;42:385.e1-385.e8. \u003c/li\u003e\n\u003cli\u003eGordon AM, Malik AT, Tamer R, Khan SN, Goyal KS. Firework Injuries to the Hand in the United States: An Epidemiological and Cost Analysis. Orthopedics. 2023;46:180\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003eVan Yperen DT, Van Der Vlies CH, De Faber JTHN, Smit X, Polinder S, Penders CJM, et al. Epidemiology, treatment, costs, and long-term outcomes of patients with fireworks-related injuries (ROCKET); a multicenter prospective observational case series. Lumenta DB, editor. PLoS ONE. 2020;15:e0230382. \u003c/li\u003e\n\u003cli\u003eVan Yperen DT, Van Lieshout EMM, Dijkshoorn JN, Van Der Vlies CH, Verhofstad MHJ. Injuries, treatment, and impairment caused by different types of fireworks; results of a 10 year multicenter retrospective cohort study. Scand J Trauma Resusc Emerg Med. 2021;29:11. \u003c/li\u003e\n\u003cli\u003eSandvall BK, Jacobson L, Miller EA, Dodge RE, Alex Quistberg D, Rowhani-Rahbar A, et al. Fireworks type, injury pattern, and permanent impairment following severe fireworks-related injuries. The American Journal of Emergency Medicine. 2017;35:1469\u0026ndash;73. \u003c/li\u003e\n\u003cli\u003eBerger LR, Kalishman S, Rivara FP. Injuries from Fireworks. Pediatrics. 1985;75:877\u0026ndash;82. \u003c/li\u003e\n\u003cli\u003eWilson RS. Ocular Fireworks Injuries and Blindness. Ophthalmology. 1982;89:291\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eRead DJ, Bradbury R, Yeboah E. Firework‐related injury in the Top End: a 16‐year review. ANZ Journal of Surgery. 2017;87:1030\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003ePuri V, Mahendru S, Rana R, Deshpande M. Firework injuries: a ten-year study. Journal of Plastic, Reconstructive \u0026amp; Aesthetic Surgery. 2009;62:1103\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eD\u0026rsquo;Argenio P, Cafaro L, Santonastasi F, Taggi F, Binkin N. Capodanno Senza Danno: the effects of an intervention program on fireworks injuries in Naples. Am J Public Health. 1996;86:84\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eDe Faber JT, Kivel\u0026auml; TT, Gabel-Pfisterer A. National studies from the Netherlands and Finland and the impact of regulations on incidences of fireworks-related eye injuries. Ophthalmologe. 2020;117:36\u0026ndash;42. \u003c/li\u003e\n\u003cli\u003eSheller JP, Muchardt O, J\u0026oslash;nsson B, Mikkelsen MB. Burn injuries caused by fireworks: effect of prophylaxis. Burns. 1995;21:50\u0026ndash;3. \u003c/li\u003e\n\u003cli\u003eRoesler JS, Day H. Sparklers, smoke bombs, and snakes, oh my! Effect of legislation on fireworks-related injuries in Minnesota, 1999-2005. Minn Med. 2007;90:46\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eHealth and Safety Code - HSC; DIVISION 11. EXPLOSIVES [12000 - 12761] ( Division 11 enacted by Stats. 1939, Ch. 60. ); PART 2. FIREWORKS AND PYROTECHNIC DEVICES [12500 - 12728] ( Part 2 repealed and added by Stats. 1973, Ch. 1109. ) [Internet]. 1973 p. 12000\u0026ndash;761. Available from: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC\u0026amp;sectionNum=12505\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e: Patient characteristics. SBP: Systolic Blood Pressure; HR: Heart rate; GCS: Glasgow Coma Scale.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"484\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u0026deg; - Median\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e% - IQR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCases per 100.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e100.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e7.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e5.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e6.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e9.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e6.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e19.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e26.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e18.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eJenuary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e5,7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFebruary\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e1,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarch\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e2,0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eApril\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e1,6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMay\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e3,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eJune\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e16,0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eJuly\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e57,4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAugust\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e3,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSeptember\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e2,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOctober\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e2,5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNovember\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e1,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDecember\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 0px;\"\u003e\n \u003cp\u003e3,3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHour\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e4am - 12 am\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e72.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e12 am - 20 pm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e8.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e20 pm - 4 am\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e19.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVital Parameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eBP\u0026lt;90 mmHg\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eHR\u0026gt;120 bpm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e7.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eGCS \u0026lt;13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e226\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e92.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e7.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u0026lt;15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e7.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e15 - 34 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e67.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e35 - 54 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e23.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u0026gt;55 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e2.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eAsian/Oceanian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eAfro American\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e17.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eCaucasic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e11.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eHispanic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e66.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 141px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\n \u003cp\u003e2.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e: Injuries Characteristics and Frequencies. ISS: Injury Severity Score.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"416\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInjury\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u0026deg; - Median\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e% - IQR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHead\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e4.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFace\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e57.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChest\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e16.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbdomen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e5.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExtremity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e86.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmputation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e54.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp;I Finger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e24.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp;II Finger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e27.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp;III Finger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e18.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp;IV Finger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e12.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp;V Finger\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e6.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Finger Not Specified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e3.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Hand. wrist level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e7.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Hand. transemtacarpal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e4.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Right hand involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e22.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Left hand involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e24.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Both hands involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Forearm amputation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; One finger involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e30.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Two Fingers Involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e5.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Three Fingers Involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e9.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Four or more Fingers Involved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e7.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eHand Fracture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e54.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eForearm fracture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e4.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e64.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEyes Injuries\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e31.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Avulsion / Rupture of eye\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e1.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Eye Laceration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e8.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Eyelid Injuries\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e9.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e11.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBurns\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e27.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Face\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e11.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Chest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e9.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Abdomen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e4.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Extremities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e16.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Grade I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Grade II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e8.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Grade III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e5.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Unknown Grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e9.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAIS \u0026gt;2 Head Injuries\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Subdural Hemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e1.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Epidural Hemorrhage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Brain Contusion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp; Cerebral Hedema\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAIS \u0026gt;2 Chest Injuries\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Lung Contusion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 331px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAIS \u0026gt;2 Abdominal Injuries\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Liver Laceration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eISS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e4 - 9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e: Type of surgery and Hospitalization. NOM: Non-Operative Management; ICU: Intensive-Care Unit; ICU-LOS: Intensive-Care Unit Length of Stay; HLOS: Hospital Length of Stay.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"340\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProcedure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u0026deg; - Median\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e% - IQR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNOM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e20.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e79.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Orthopedic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e53.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Plastic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e7.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Ophthalmology\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e5.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Neurosurgery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Vascular\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Abdominal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Thoracic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026middot; \u0026nbsp; \u0026nbsp; \u0026nbsp;Other\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e13.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo Hospitalization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e11.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eICU\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e18.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eICU-LOS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e2 - 4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHLOS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1 - 6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMortality\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-trauma-and-emergency-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejot","sideBox":"Learn more about [European Journal of Trauma and Emergency Surgery](http://link.springer.com/journal/68)","snPcode":"68","submissionUrl":"https://submission.nature.com/new-submission/68/3","title":"European Journal of Trauma and Emergency Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6895198/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6895198/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e. \u003c/em\u003eFireworks-related injuries (FWIs) remain a public health concern during festivities, affecting mainly adolescents and young adults. This study evaluates the epidemiology, demographics, and clinical features of FWIs at trauma centers in Los Angeles County\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e. \u003c/em\u003eA retrospective review of the Los Angeles County Trauma Registry identified all FWI patients treated at 12 trauma centers (2015–2022). Collected data included demographics, injury characteristics , and outcomes. Injury severity was measured by AIS and ISS. Incidence rates used U.S. Census intercensal estimates.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e. \u003c/em\u003eA total of 244 FWI patients (0.31/100,000) presented, rising from 0.19 to 0.47/100,000 (peak 0.66 in 2021). Patients were predominantly male (92.6%) and aged 15–34 (67.6%). Hispanics comprised 66% of cases; African Americans had the highest per capita rate. July accounted for 57.4% of injuries, especially July 4–5 (41.8%). Extremity injuries occurred in 86.9%, with 62.7% undergoing upper-limb amputations. Ocular injuries occurred in 31.1%; burns in 27%.Surgical intervention was needed in 79.1%. ICU admission occurred in 18.4% (median stay 3 days); median hospital stay was 4 days. No fatalities were reported.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e. \u003c/em\u003eFWIs are increasing, causing significant extremity and ocular trauma; stronger prevention and enforcement are needed.\u003c/p\u003e","manuscriptTitle":"Epidemiology and Clinical Characteristics of Fireworks-Related Injuries in Los Angeles County Trauma Centers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-02 17:38:03","doi":"10.21203/rs.3.rs-6895198/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-19T07:40:20+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-07T15:06:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"333354149111426429157931204858895685735","date":"2025-08-30T19:12:15+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-21T21:29:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"284867286369657389023706937575859373979","date":"2025-08-07T07:30:30+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-29T20:06:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-29T20:04:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-25T01:46:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Trauma and Emergency Surgery","date":"2025-06-14T17:16:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-trauma-and-emergency-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejot","sideBox":"Learn more about [European Journal of Trauma and Emergency Surgery](http://link.springer.com/journal/68)","snPcode":"68","submissionUrl":"https://submission.nature.com/new-submission/68/3","title":"European Journal of Trauma and Emergency Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"ca2d5e38-d912-40c5-ab54-ed6676c0a829","owner":[],"postedDate":"July 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-23T16:11:32+00:00","versionOfRecord":{"articleIdentity":"rs-6895198","link":"https://doi.org/10.1007/s00068-026-03090-y","journal":{"identity":"european-journal-of-trauma-and-emergency-surgery","isVorOnly":false,"title":"European Journal of Trauma and Emergency Surgery"},"publishedOn":"2026-02-16 15:59:09","publishedOnDateReadable":"February 16th, 2026"},"versionCreatedAt":"2025-07-02 17:38:03","video":"","vorDoi":"10.1007/s00068-026-03090-y","vorDoiUrl":"https://doi.org/10.1007/s00068-026-03090-y","workflowStages":[]},"version":"v1","identity":"rs-6895198","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6895198","identity":"rs-6895198","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}