For most Americans, the 4th of July is marked by patriotic celebrations with family and friends — but for some, the festive holiday can end with an unplanned trip to the emergency room.

More than 45,000 people visit the ER on July 4 and 5 each year, according to the Pew Research Center — which means Independence Day has the year’s highest number of daily medical emergencies.

“This time of year, we see big increases in traumatic injuries and heat-related illness,” Dr. Ryan Marino, M.D., an ER doctor and associate professor at Case Western Reserve University in Cleveland, Ohio.

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“While fireworks accidents and injuries get most of the attention, there are far more falls, broken bones, head injuries and car accidents, just to name a few.”

As people are more likely to be outside and active during the holiday, that makes them more prone to accidents and injuries, Marino added.

Dr. Robert Biernbaum, an emergency medicine physician in Fairport, New York, who is also the chief medical officer at WellNow Urgent Care, echoed that July 4th is one of the busiest holidays for ERs across the country. 

“We routinely see a sharp spike in preventable injuries and medical emergencies,” he told Fox News Digital. 

Most common 4th of July injuries

Several ER doctors shared the specific injuries that dominate emergency rooms during this holiday weekend.

Fireworks-related injuries

Fireworks are “by far” the most frequent source of injury, according to Biernbaum. 

“We see everything from minor hand and facial burns to severe trauma from fireworks exploding in close proximity,” he said. “Improvised or illegal fireworks tend to cause the worst damage.”

“We routinely see a sharp spike in preventable injuries and medical emergencies.”

Dr. Betsy Koickel, chief medical officer of Memorial Hermann-GoHealth Urgent Care in Houston, Texas, echoed that fireworks can cause a wide variety of injuries, many of them severe. 

“Eye injuries are particularly troubling, as they can include corneal burns, scratches or even permanent vision loss due to flying debris or sudden explosions,” she told Fox News Digital. 

“Never participate in potentially dangerous activities, like driving or boating, while you are impaired,” a doctor advised. (iStock)

“The loud blasts can also harm hearing, especially in young children, sometimes resulting in ringing in the ears (tinnitus) or even long-term hearing damage.”

In more serious incidents, people have suffered deep lacerations, lost fingers or sustained facial injuries when fireworks exploded too close or malfunctioned, Koickel added. 

Alcohol-related incidents

With more people indulging in alcoholic beverages for the 4th, Dr. Ellana Stinson, a board-certified emergency medicine physician at Boston Medical Center, said she has seen everything from falls and cuts to vehicle accidents and alcohol poisoning. 

“Impaired judgment is a leading cause behind many ER visits,” she added.

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Biernbaum reiterated that intoxication leads to a range of emergencies, even contributing to assaults and drownings. “We often see head injuries or fractures in patients who’ve had too much to drink,” he noted.

Grill burns and cooking accidents

July is the peak month for grill fires, according to the National Fire Protection Association.

“Mishandling propane tanks or grills results in flash burns and cuts, particularly to the hands and arms,” Biernbaum said.

Heat exhaustion and dehydration

“Many patients come in with heat exhaustion or heatstroke after prolonged outdoor activities without proper hydration,” Biernbaum said.

This condition can be life-threatening, particularly for elderly people and children, the doctor cautioned.

“It’s crucial to closely supervise children if they’re around sparklers, and they should never handle sparklers or any type of fireworks on their own,” one doctor said. (iStock)

Marino added, “The heat that we saw most recently not only caused problems like heat illness and heat stroke, but can put people at risk for things like dehydration and kidney damage if they aren’t careful about staying cool and staying hydrated.”

Car and boat accidents

“Unfortunately, holiday weekends can also bring an uptick in violence-related injuries or major trauma from boating or car accidents,” Stinson cautioned.

She shared one example when she treated a young man who fell from a speeding boat after a few too many drinks. “He struck the water hard and was rushed in with a ruptured spleen and multiple fractures — we nearly lost him,” she told Fox News Digital. 

“Many patients come in with heat exhaustion or heatstroke after prolonged outdoor activities.”

Biernbaum noted that lack of life jackets, speeding and alcohol all contribute to injuries, ranging from fractures to near-drownings.

Drownings and near-drownings

July has the highest number of drowning deaths compared to all other months, according to the Centers for Disease Control and Prevention (CDC).

Children are particularly at risk, as drowning is the top cause of death for kids aged 1 to 4.

“I’ve cared for individuals pulled from the water unconscious after near drownings, often because no one was watching closely or due to alcohol-blurred judgment,” Stinson said. 

Tips for a safe 4th of July celebration

Ensure fireworks safety

Experts agree that fireworks are best left to the professionals.

“But if you do participate in home fireworks, make sure there are designated adults who are in charge, alert and sober,” Koikel advised. “Keep a bucket of water or fire extinguisher handy nearby.”

“A little planning and caution go a long way.”

Fireworks should only be set off in safe, open spaces that are far away from people, pets, buildings and grass or trees, according to the doctor.

“It’s crucial to closely supervise children if they’re around sparklers, and they should never handle sparklers or any type of fireworks on their own,” Koikel said.

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Anyone handling fireworks should wear protective eyewear to guard against flying sparks or debris, Koikel said. “It’s also wise to avoid loose clothing that could catch fire and to tie back long hair to reduce risk.”

Fireworks should only be set off in safe, open spaces that are far away from people, pets, buildings and grass or trees, according to one doctor. (iStock)

Those lighting fireworks should follow all local laws and safety guidelines, she added.

Additional fireworks safety guidelines can be found on the National Safety Council’s website at https://www.nsc.org/.

Observe boat safety

Many boating-related injuries occur on the feet, according to Dr. Jared L. Ross, emergency medicine physician and a professor at the University of Missouri.

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“Having a sturdy pair of water shoes both protects against injuries and makes slips and falls less likely,” he told Fox News Digital. 

“Life vests (PFDs) are a must for everyone on the water — even the best swimmer can’t stay afloat if they have been knocked unconscious by a head injury.”

Prevent overheating

“It is crucial to stay well-hydrated, avoid the sun between noon and 2 p.m., apply sunscreen and wear a large-brimmed hat,” Ross recommended.

All experts suggested taking breaks in the shade or air-conditioning, especially if consuming alcohol.

Moderate alcohol consumption

If you are going to partake, Ross said it’s important to moderate your consumption. 

“The risks from alcohol greatly increase after three drinks per day,” he said. “Never participate in potentially dangerous activities, like driving or boating, while you are impaired.”

“Never participate in potentially dangerous activities, like driving or boating, while you are impaired,” a doctor advised. (iStock)

For those who consume alcohol, Marino emphasized the importance of staying away from dangers like fireworks and planning in advance for sober rides. 

“Also, make sure to stay hydrated, since alcohol also causes dehydration,” he added.

Supervise children at all times

All experts emphasized this safety tip — particularly around grills, water and fireworks.

“The 4th of July should be a celebration, not a trip to the ER,” Biernbaum said. “A little planning and caution go a long way.”

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“If something does go wrong, don’t hesitate to seek care immediately — time is critical with burns, head injuries and heat-related illness.”

It’s also wise to stay brushed up on basic first aid and to keep a well-stocked emergency kit on hand, Stinson added.

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Beyond diabetes control and weight management, GLP-1s could have yet another benefit: helping with migraines.

In a small study, a GLP-1 drug shrank the number of days people spent with a migraine by almost half in a given month.

Presented at the European Academy of Neurology Congress in Helinski, Finland, on June 21, the results suggest promising future uses of the popular obesity and diabetes drugs.

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Nearly 40 million Americans deal with migraines, according to the World Health Organization (WHO) — and for many, they’re more than just a headache.

Migraines are the second-leading cause of disability worldwide, the above agency states, with symptoms including severe headaches, nausea and sensitivity to light often disrupting daily activities. 

Previous studies have shown that GLP-1s can reduce pressure inside the skull, which is a possible cause of migraines, according to multiple health organizations.

Neurologist and study lead Simone Braca of the University of Naples Federico II in Italy, along with his colleagues, explored whether liraglutide, an earlier version of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), could help migraine sufferers. 

“Most patients felt better within the first two weeks and reported quality of life improved significantly.”

Thirty-one adults, 26 of them women, got daily injections of liraglutide for 12 weeks. The participants, who all met the criteria for obesity, also continued to take their current migraine medications.

At the start of the experiment, participants reported headaches about 20 days out of a month. After 12 weeks of liraglutide, the average number dropped to about 11 days.

“Most patients felt better within the first two weeks and reported quality of life improved significantly,” said Braca in a press release for the study, which was published in the journal Headache last month.

Participants’ weight stayed about the same during the trial, suggesting that headache reductions weren’t tied to weight loss. (iStock)

The relief from migraines lasted for the full three-month observation period, the researcher noted, although weight loss was “modest and statistically non-significant.”

Participants’ weight stayed about the same during the trial, suggesting that the headache reductions weren’t tied to weight loss.

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“Liraglutide is a ‘middle-aged’ GLP-1, with Ozempic and Mounjaro being newer,” Dr. Sue Decotiis, a triple board-certified weight loss specialist in New York City, told Fox News Digital.

Decotiis, who was not involved in the study, said that liraglutide is not as effective as its newer cousins for weight loss or diabetes, and is not frequently used for these purposes.

At the start of the experiment, participants reported headaches about 20 days out of a month. After 12 weeks of liraglutide, that number had dropped to 11. (iStock)

“Many pharmacies are not even stocking it due to declining demand, yet it gets into the brain well enough to reduce migraines,” she noted.

Potential limitations

The trial didn’t include a comparison group, and participants and researchers all knew that everyone received liraglutide, the researchers noted. 

Mild gastrointestinal side effects (mainly nausea and constipation) occurred in 38% of participants, but did not lead to treatment discontinuation.

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Further research may include other groups, such as control groups and people without obesity, to compare the drug’s effects.

“The study was very small,” Decotiis confirmed to Fox News Digital.

“The benefit lasted for the full three-month observation period, even though weight loss was modest and statistically non-significant,” said the study researcher. (iStock)

Given its size and brief duration, the findings could be limited until further research is conducted, according to the expert.

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The researchers also tested only one drug, liraglutide, “which is not used as frequently in the general population as semaglutide or tirzepatide are,” Decotiis added.

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Next, the team is planning a randomized, double-blind trial that will also measure pressure inside the skull. 

“We also want to determine whether other GLP-1 drugs can deliver the same relief, possibly with even fewer gastrointestinal side effects,” Braca said in the same press release.

Flying with hundreds of other people at one time can be a gateway to illness.

Various airplane surfaces — such as overhead bins, tray tables, instruction cards and seat covers — are some of the biggest sources of germs, according to flight attendants. 

Even the water in the bathroom can pose a risk — leading some people to question whether it’s even sanitary to wash one’s hands on a flight.

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“It’s a good idea for passengers to use hand sanitizer after stowing away their luggage, touching anything in the seat pocket in front of them, and going to the bathroom,” flight attendant and travel blogger Josephine Remo, who is based in Portugal, previously told Travel & Leisure.

Bathrooms can be especially dirty, as the toilets are regularly cleaned, but the locks and door handles may not be, according to Remo.

The water in the bathroom can contain a plethora of contaminants, research suggests, which could be found in bathroom sink water and drinking water, as well as the coffee, tea and ice served onboard.

A 2019 study by the Hunter College NYC Food Policy Center confirmed that select airlines have potentially provided passengers with unhealthy drinking water.

Of the 11 major and 12 regional airlines studied, 15 airlines received an Onboard Water Health Score of 2 or lower out of 5.

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The federal government’s Aircraft Drinking Water Rule (ADWR) requires airlines to provide passengers and crew with safe drinking water, according to the researchers.

Airlines are also required to test the water for bacteria and E. coli, and to disinfect and flush the aircraft’s water tank four times per year.

Various airplane surfaces — such as overhead bins, tray tables, instruction cards and seat covers — are some of the biggest sources of germs, according to flight attendants.  (iStock)

“Alternatively, an airline may choose to disinfect and flush once a year, but then it must test monthly,” the researchers noted.

“The 2019 Airline Water Study also finds that the Environmental Protection Agency – one of the federal agencies responsible for ensuring safe aircraft drinking water – rarely levies civil penalties to airlines in violation of the ADWR.”

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In an interview with Fox News Digital, travel expert and author of ViewFromTheWing.com Gary Leff confirmed that “very little cleaning” happens between most domestic flights.

“Planes aren’t on the ground very long — an airline only makes money when their planes are in the air,” said the expert, who is based in Austin, Texas. “And cleaning crews often have to come onboard and tidy while passengers are deplaning.”

“Different airlines take different approaches, and cleaning will vary across different cabins and classes of service.”

“When an inbound aircraft is late, the airline wants to make up time, and cleaning is often sacrificed,” he pointed out. “When airlines face financial struggles, deep cleans are one of the first things cut.”

Bathrooms can be particularly dirty due to passenger hygiene, according to Leff, and can get “pretty gross” over the course of a flight.

“When an inbound aircraft is late, the airline wants to make up time, and cleaning is often sacrificed,” a travel expert noted. (iStock)

Different airlines take different approaches, and cleaning will vary across cabins and classes of service, he noted.

“I’m not going to suggest it’s unsafe, per se — just disgusting,” Leff said. 

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“Don’t go into the [lavatory] with bare feet. Bring your own sanitizer. And consider wiping down surfaces you’ll be touching if you’re so inclined, just knowing that this hasn’t been done for you.”

Fox News’ senior medical analyst Dr. Marc Siegel also confirmed to Fox News Digital how “filthy” airplane bathrooms tend to be, including the water, as various studies have shown.

Bathrooms can be particularly dirty due to passenger hygiene, according to one expert, and can get “pretty gross” over the course of a flight. (iStock)

“The tray tables are common surfaces that can be covered with bacteria and viruses,” he cautioned. 

“And though the HEPA filters overhead are effective, they don’t really work until the plane is in the air and the filtration system is fully engaged. And [they] don’t prevent the person next to you from coughing on you.”

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Before and during a flight, the doctor suggested keeping well-hydrated, which can help fight off infection by keeping nasal membranes moist.

He also encourages the use of sanitizers, wipes or gels to disinfect surfaces and hands.

“I prefer washing hands thoroughly with soap, but on planes, I prefer sanitizers and wipes,” Siegel said.

Dr. Siegel prefers the use of hand sanitizers on planes instead of handwashing. (iStock)

In a statement sent to Fox News Digital, the EPA explained that the primary purpose of the ADWR is to “ensure that safe and reliable drinking water is provided to aircraft passengers and crew through requiring development and implementation of aircraft water system operations and maintenance plans that include strategies for monitoring, disinfection, and reporting.”

The EPA revealed that drinking water safety is “jointly regulated” by the EPA, FDA and FAA.

“The regulatory structure for all public water systems, including aircraft, relies upon self-monitoring and reporting of results to the primacy agency,” the agency said. “The EPA is responsible for oversight of the aircraft public water systems and provides guidance to help air carriers comply with ADWR.”

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An FAA spokesperson told Fox News Digital in a statement that the FAA is an “aviation safety agency” and water quality is “not within our regulatory authority.”

Fox News Digital reached out to OSHA for comment.