As Texans head out for the Fourth of July, Dr. David Lim is reminding people to stay hydrated, be aware of their surroundings and keep an eye on children and elderly people.

Lim is the emergency department director for Baptist Health System in San Antonio and New Braunfels. He said he does not expect a busier emergency department on July 4 or the surrounding weekends, although more visits may be related to heat illness, burns from fireworks or other issues associated with the holiday.

What you need to know

In 2023, around 9,700 people nationwide were treated in emergency rooms for fireworks-related injuries, according to a recent report from the U.S. Consumer Product Safety Commission.

“Something I always tell people that love fireworks is to just really leave it to the professionals,” Lim said.

Many Texas cities do not allow the sale or use of fireworks within city limits, although some counties allow people to light fireworks in unincorporated areas. Contact your local officials for more details.

Items such as sparklers, trick noisemakers and smoke devices are legal in Texas, according to the Texas Department of Insurance. Around Independence Day, fireworks may only be sold by licensed retailers from June 24 to midnight July 4.

Experts recommend the following safety measures when using legal fireworks:
  • Always supervise children around fireworks.
  • Never point fireworks at people, animals, buildings or flammable objects.
  • Never use fireworks under the influence of alcohol or drugs.
  • Light fireworks on asphalt or cement, away from grass and buildings.
  • Keep a bucket of water or a hose nearby in case of an emergency.
  • Place used fireworks on asphalt or cement and soak them in water before disposing.
  • Light fireworks one at a time, and do not try to relight or pick up malfunctioning fireworks.
  • Keep pets indoors when using fireworks.
If you are hurt or burnt by fireworks, Lim recommends visiting the emergency room for injuries that penetrate the skin; blast-related injuries; or injuries on sensitive areas like the hands, eyes or face.

Also of note

On a 90-degree day, the temperature inside a vehicle can reach 130 degrees Fahrenheit in less than 30 minutes, the Texas Department of Public Safety said in a news release.

Babies and young children, elderly people, people with other health conditions, and people without access to air conditioning or water are often most impacted by extreme heat. Lim said staying cool and hydrated are key to preventing heat-related illnesses.

“Unfortunately, some people just might not have access to cooling facilities or what some of us might take for granted, but just trying to stay out of the sun and direct heat is very important,” Lim said.

Know the signs

Lim said people may not realize they are experiencing heat exhaustion, which is characterized by feelings of weakness or nausea, headaches, lightheadedness, clammy skin and heavy sweating. If you see signs of heat exhaustion, experts say you should move the person to a cooler environment—ideally in air conditioning—loosen or remove excess clothing and offer them cold water.

“If it progresses further, then we worry about developing potentially heat stroke, which could be fatal,” Lim said. “And with heat stroke, what's going on is, essentially, your brain is overheating, and it's presenting like an actual stroke. Patients could be very confused or altered; they could be not able to talk, not able to walk, and those patients need an [urgent] evaluation by a health professional.”

Other symptoms of heat stroke include red, hot and dry skin; a throbbing headache; fainting; loss of consciousness; and an extremely high body temperature of 103 degrees or higher.

One more thing

To prevent accidents at lakes, rivers and pools this summer, officials encourage Texans to always watch children, wear life jackets in open water and avoid alcohol when boating.

According to Austin-Travis County Emergency Medical Services, someone may be drowning if:
  • Their head is low in the water or titled back with their mouth open
  • Their eyes are glazed over or unfocused
  • They are hyperventilating or gasping for air
  • They do not respond when asked if they are OK
  • They are not using their legs
  • They are trying to swim but are not making any progress
“Make sure that you're watching kids when they're around water, and have a water guardian—make sure that person is sober and has a good count of how many children they're supposed to be watching,” ATCEMS Public Information Officer Christa Stedman said during a May 22 news conference. “Teach your kids how to swim, and have older children swim with a buddy.”