Firecracker and Blast Injuries

Jonathan Eisenberg, MD

As a child, my father told me a story about his neighbor who had a mishap with a firecracker and blew off the second through fourth digits.  He would then hold out his thumb and pinky and wave to me.  This scared me to such an extent that I still have never lit a firecracker, even during my less frontal lobe-oriented teen years.  I now think that this story was a fabrication—but it is not that far off from its realistic basis.

Fireworks are most popular during the month surrounding July 4th in the US.  These colorful combustibles have been around in the US since July 4th, 1777, and we spend more than $700 million dollars per year on them.  There are many varieties and categories from novelty and daytime fireworks (both generally have smaller explosions) to the larger aerial fireworks and a host of nuanced state laws which allow for an all, some, or none approach to sales. read more

Severe Acute Respiratory Syndrome Coronavirus-2 and Multi-system Inflammatory Syndrome in Children: Preliminary Reports

By Nicholas Pokrajac, MD, Co-editor

What is the Multi-system Inflammatory Syndrome in Children (MIS-C)?

Most children infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) have a mild course of illness.1 However, there have been recent reports of a number of children developing a condition with similarities to Kawasaki disease (KD) and toxic shock syndrome (TSS) within epicenters of the SARS-CoV-2 outbreak, including over 200 children in New York, Italy, and the United Kingdom. This condition has been named the Multisystem Inflammatory Syndrome in Children (MIS-C). As of May 14, 2020, the Centers for Disease Control and Prevention (CDC) recommends reporting of suspected cases to their local or state health departments. This article is a brief summary of preliminary reports on MIS-C to serve as a primer for emergency clinicians. read more