It won’t be long before it’s the Fourth of July and we hear the whistling and thunderous booms of fireworks streaking through the sky.

And while “consumer” fireworks such as bottle rockets, skyrockets and roman candles are illegal in Illinois, according to the state’s Pyrotechnic Use Act, others are considered non-consumer fireworks including sparklers, smoke bombs and party poppers.

But that doesn’t make them completely safe.

In 2023, the United States Consumer Product Safety Commission (CPSC) received approximately 9,700 reports of injuries and eight deaths because of fireworks. And it’s not just injuries that happen on July 4. According to CPSC, 66% of injuries happened before and after the holiday.

Stathis Poulakidas, MD, the burn center medical director at OSF HealthCare Saint Anthony Medical Center in Rockford, says the number of injuries reported is probably low, given the number of people who don’t immediately seek treatment.

“The simplest of fireworks, which anybody would think is a sparkler, can burn up to 1,800 degrees,” says Dr. Poulakidas. “The first thing everybody wants to do is hand the baby the sparkler and say, ‘go ahead. Run around and have a good time.’ But then it falls to their shoes, they burn horrifically. So not even the simplest of fireworks is safe.”

Another problem is the combination of adults drinking alcohol while handling fireworks. Dr. Poulakidas says this lethal mix puts you and those around you at your gathering in danger. “I see more adults than I see children with firework injuries,” he says. “The only children we see are the ones that are too close to the actual fireworks, as the adults are manipulating them while intoxicated. Then the fireworks injure the child.”

According to the CPSC, 41% of the injuries were to the head, eyes, face and ears. Another 35% are hands and fingers; 42% of injuries were burns.

That’s where Dr. Poulakidas comes in. In the burn center, he sees some of the worst injuries because of fireworks mishaps. He calls it the blast effect, which can severely injure intestines, eyes and rupture eardrums, given the proximity of the fireworks and the loud explosion. “We'll see minor burns to the hands, to the face. We'll see digits or fingers get blown off,” he says. “We've seen whole hands blown off and people lose arms.” (2:25-2:36)

And if clothing catches on fire, Dr. Poulakidas says there’s a greater likelihood of second degree burns to your chest, arms and legs, which could lead to treatment options that include skin grafting.  

Bottom line: Dr. Poulakidas encourages people of all ages to have fun this year. But sit back, watch the spectacle and let the experts handle the fireworks. “We want everybody to use good judgment and safe measures to prevent injury,” he says. “Because I think prevention is the key, instead of dealing with an injury after something has occurred.” 

Fireworks Safety Tips (courtesy of CPSC)

·         Never allow children to play with or ignite fireworks, including sparklers.

·         Make sure fireworks are legal in your area before buying or using them.

·         Keep a bucket of water or garden hose handy in case of fire.

·         Never try to re-light or pick up fireworks that haven’t fully ignited.

·         Never use fireworks while impaired by drugs or alcohol. 

 

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B-roll 

When Gordon Ramsay raises his voice, it’s usually about an undercooked dish.

But in 2024, the celebrity chef was calling for help after a scary bicycle accident.

“It really shook me,” says the avid cyclist in a June 15, 2024, Instagram post. “Honestly, I’m lucky to be here.”

Ramsay says he didn’t suffer any major injuries, but he’s bruised and on the mend. And he’s again joining health care professionals in stressing the importance of wearing a helmet and biking within your means.

“I don’t care how short the journey is,” Ramsay says.

Biking accidents in the emergency department

Kurt Bloomstrand, MD, an emergency medicine physician who sees patients at OSF HealthCare, has treated people who have fallen off a moving object. It could be a bicycle, scooter or motorcycle. Sometimes it’s a child who’s learning their way. Or it could be an adult who didn’t hit the brakes in time.

“A lot of times what happens is they fall off the bike, put their arm out to protect themselves and injure their arm,” Dr. Bloomstrand says.

“But most importantly, we also see head injuries. We know that people who get in a bike accident have better outcomes if they’re wearing a helmet. People that are not have a higher risk of head injuries and traumatic brain injuries,” he adds.

Those head injuries are not something to take lightly, Dr. Bloomstrand says. Traumatic brain injuries can result in lifelong complications or death.

“When we see people in the emergency department who have suffered from a bicycle accident, we’re going to do a rapid trauma assessment,” Dr. Bloomstrand explains. “We’re going to pay special attention to the head. We’re going to make sure there are no signs of skull fracture or neurological abnormality. Depending on the severity of the injury, we may do a CAT scan [also called a CT scan] to make sure there’s no internal injury like bleeding on the brain. Those internal injuries are life-threatening emergencies that need to be addressed quickly.”

Advice

Check these off your list the next time you get on a bicycle or something similar:

• People of all ages should wear a helmet while biking. Young kids who are learning to ride should also wear knee elbow pads.
   
• Long shirts and pants and closed toe shoes (not sandals) are better than bare skin if you fall and skid on pavement (commonly called “road rash”).
   
• Be alert when riding. Don’t ride while tired or under the influence of alcohol or drugs. If you’re listening to music, consider having one ear free so you can hear your surroundings.
   
• Don’t ride above your means. Choose a speed and terrain that fits your skills.
   
• Keep your bike in good condition and configured to match your height. Your feet should touch the ground when seated. This should be true for all ages. A child should not “grow into” a bike. 
  
  At night, a headlight, reflectors, flag and a horn help you to be seen and heard. Bright-colored clothing also helps your visibility at night.
   
• Look closely before crossing an intersection, and obey all traffic laws. This typically includes riding on the right side of the road. Use universal hand signals: left arm straight for a left turn, left arm bent up for a right turn and left arm bent down for a stop. Make eye contact with the driver of a vehicle before passing in front of them.
   
• One person should ride a bike at a time, and keep both hands on the handlebars. Put items like books in a backpack or basket. Don’t try to carry items and ride.
   
• If you or someone you’re with suffers a bike injury, call 9-1-1 immediately.

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It’s the dead of winter, and you need to run to the mailbox or let your dog out. It’s just a minute, you think. A sweater and sandals will be fine.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall who sees cold weather injuries often. She says exposure to frigid temperatures can have serious consequences.

Types of cold weather injuries

• Frostnip: Draper says this is a mild form of frostbite where exposure to cold temperatures turns the skin pink or red. Your skin may feel burning or numb.

“The numbness typically goes away with rewarming,” Draper says.

• Frostbite: This is a more severe case of cold exposure. Your skin may be numb and appear yellow, white, gray or black. It may feel waxy and have blisters.
   
• Hypothermia: This is when the body’s temperature drops below 95 degrees.

“There are different stages,” Draper explains. “The first is our natural response of shivering. It gets more severe. The person may get confused and have lethargy, memory loss and slurred speech. It can lead to a coma and death.”

Inside, too?

Yes, there’s a risk for these injuries inside, too, Draper says. Notably, there have been cases of infants getting hypothermia.

“The room may be too cold, and they’re not dressed appropriately,” Draper says. “If they’re in a bassinet or crib with just a onesie and it’s cold, that can lead to hypothermia.”

Signs of infant hypothermia are bright red skin and decreased energy. Sleep experts use a thermal overall grade scale (TOG) to suggest how much clothing a baby should wear to sleep depending on the temperature of the room.

Treatment

Draper says she usually sees cases of frostbite and hypothermia sent to the emergency department. Providers will rewarm you with warm water or blankets and may provide warm liquids to drink, warmed oxygen through a mask and nasal tube or heated fluids through an intravenous line (IV) or other methods. Medication can also help with pain and blood flow.

“The hospital has more imaging resources to see the impact of the tissue damage,” compared to urgent care, Draper says.

For frostnip, you can take steps to warm up at home.

“It’s not as fast as possible. It’s not as hot as possible. It’s just that gradual warming,” Draper says. “Get off your cool or wet clothes immediately. You don’t want to stick your hands or feet into hot, steaming water. Just warm water.”

That’s because hot water can burn your skin. And if your skin is numb, you may not feel the burn before the damage is done. If water is not available, you can place your hands in your armpits. And handle the sensitive skin gently. Don’t rub or massage it. If your feet are affected, get off your feet.

Prevention

Draper says older adults, people who work or do activities outside (like hunters or hikers), unhoused people and people with medical conditions (like peripheral artery disease, diabetes and Raynaud’s disease) are at a higher risk of cold weather injuries. Getting stranded in a vehicle without proper protection is also common in the winter. Drinking alcohol or using drugs may lead to you losing consciousness outside. And smoking impacts blood circulation, putting you at a higher risk, Draper says.

Some ways to beat the cold:

• Dress in layers. You can always take a layer off, but you can’t put one on if you leave it at home. Make a hat, scarf, gloves and winter boots part of your wardrobe. Make sure the clothes aren’t too tight to allow for blood circulation. And look for water-resistant garments when buying clothes.
   
• Have winter weather supplies, like blankets, flares, a first aid kit and food, in your vehicle.
   
• Be well fed and hydrated. Body fat, though unhealthy in excess, helps us stay warm. For drinks, avoid alcohol and caffeinated beverages.
   
• During outdoor activities, take breaks and go with a buddy. Keep a close eye on kids who may not realize how cold they are. Come inside to change from wet to dry clothes. Let others know your plans and when you’ll be back. If you’re not back in time, that’s a sign you may have fallen victim to the cold, and help should be sent.

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Sudafed has been a household name for decades, with the drug’s active ingredient pseudoephedrine being around since the 1920s.

Recently, the U.S. Food and Drug Administration (FDA) claimed Sudafed PE, one of Sudafed’s more popular items, is not effective and should be banned from over-the-counter use. The announcement came roughly a year after a panel of advisors to the FDA unanimously said phenylephrine doesn’t work to clear up congestion when taken orally.

The PE in Sudafed PE comes from another active ingredient, phenylephrine, marketed as a product taken by mouth that should provide temporary relief of nasal congestion. Many other over-the-counter (OTC) combination drugs contain phenylephrine, including some items under the brand names NyQuil, Benadryl and Mucinex.

The FDA advisor panel’s decision led CVS pharmacy to pull common cold and cough medicines from store shelves in October 2023, which list phenylephrine as the main ingredient.

“It is the FDA’s role to ensure that drugs are safe and effective,” said Patrizia Cavazzoni, MD, director of the FDA’s Center for Drug Evaluation and Research (CDER). “Based on our review of available data, and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant.”

The FDA points out that while phenylephrine is found in many nasal sprays as well, its recommendation is only related to orally administered phenylephrine.

Entering public comment period

Jason Scheid, the director of Pharmacy Services for Community & Specialty Pharmacy for OSF HealthCare, says the FDA is now seeking public comments on its proposal until May 7, 2025. A final order will be issued after the 180-day comment period.

“At that point (after the 180 days) the FDA will provide the manufacturers with their due warning whether they have to pull the products or reformulate it to find an alternative that meets the labeling requirements,” Scheid says.

Scheid anticipates if drugmakers wanted to reformulate these products, and wanted them to remain as oral decongestants, the companies would have to put pseudoephedrine into the products. This would push more products behind the pharmacy counter, like the original Sudafed.

“If you’re looking for an oral decongestant, the original Sudafed is a good alternative,” Scheid adds. “You have to show your ID and there are purchase limitations. It has shown itself to be an effective alternative. There are nasal decongestants you can try, like Afrin. There’s also nasal steroids and antihistamines, this gets more into the allergy nasal sprays that can help prevent congestion symptoms. You can pick any of those up over the counter at a local pharmacy.”

Phenylephrine or Placebo?

The FDA clarifies that while it’s proposing these products be banned from store shelves, there aren’t any safety concerns attached to them. They’re simply just not effective. Many medications will claim to offer multiple benefits. For example, Mucinex Sinus-Max® claims to clear sinus congestion and relieve headaches, while thinning and loosening mucus. But the drug also has Acetaminophen and Guaifenesin in it. Scheid says this proposal simply targets the phenylephrine component when considering nasal decongestion, so other benefits might still be possible.

“It might provide you a placebo-type effect. You might just feel better because of the other ingredients in it, but that one (phenylephrine) solely is not meeting the effectiveness criteria to remain over the counter,” Scheid says.

Natural treatment options that can relieve symptoms

“Using that hot shower or cool mist humidifier will add moisture to where you are to help with that congestion,” Scheid says. “Something as simple as saline nasal spray will add some moisture to the nasal cavity and give some relief.”

It’s always important to clean your humidifier after each use to prevent mold and other bacteria from being released in the air.

Don’t overdo it on the nasal sprays

Another reason why it’s important to read labels is the effect nasal sprays can have if they are used longer than their intended use. Most nasal decongestant sprays will recommend using the product for three days or less.

“What happens is a rebound nasal congestion, where you lose the effectiveness of the medication to relieve that pressure, and it causes more pressure if it’s used more than just a couple days,” Scheid says.

If congestion is caused by allergies

About one quarter (25.7%) of American adults have a seasonal allergy, according to the Centers for Disease Control and Prevention (CDC), while nearly one in five (18.9%) children are affected. Scheid says treating nasal congestion for those with allergies is a longer-lasting issue.

“You’re looking at longer-term solutions then. You’re either using a long-term nasal steroid spray or antihistamine spray, or oral antihistamine.”

Scheid says if the FDA’s proposal goes through in May, pharmacy shelves will look a whole lot different than they do now.

Another way to clear congestion is to stay hydrated. Drinking water will help thin out mucus discharge from the nose and loosen up any phlegm in the lungs, making it easier to cough up.

Video Interview Clips

“OSF Specialty Pharmacy is the only physical specialty pharmacy in the tri-county area to provide specialty medications for multiple complex or chronic disease states, allowing the patients the choice of picking up their prescription without having to go to a remote location by FedEx or UPS,” says Jerry Storm, Senior Vice President of Pharmacy Services at OSF HealthCare. “There is not another full-service Specialty Pharmacy in Peoria. Patients will have the ability to come on-site to pick it up. Most Specialty Pharmacies are located out of town.”

The OSF Specialty Pharmacy will supply medications across the 15-hospital OSF HealthCare Ministry. These drugs cover patients who are facing all kinds of different disease. The prescriptions could be for patients with arthritis, gastrointestinal issues, neurological disorders, and much more.

“This new service for our patients in need of specialty medications is an example of our dedication to improve specialty pharmacy care, one patient at a time, through educational, clinical, financial and service excellence,” said Sister Diane Marie McGrew, O.S.F. “We know that specialty drugs can be complicated. That’s why we have established this service to provide our patients with the highest level of custom care and to make sure they have the guidance, clarity and peace of mind to manage their condition well and live a healthier, happier life.

Additionally, specialty medications are typically expensive, but OSF is committed to minimizing costs to patients by working with insurance and maximizing manufacturer support programs.  This groundbreaking resource will enable OSF caregivers to take even better care of patients.

Storm says the impact of the OSF Specialty Pharmacy will mainly impact Illinoisans initially, but it could also benefit those across state lines.

“We can service any pharmacy in Illinois. With the wraparound pharmacies, we can service sites outside of Illinois such as Indiana. We might have Mission Partners who work in Danville, but work in Indiana. We can still service them,” Storm says. “We will make every effort to take care of manufacturer discounts and assistance programs. There’s coupons that a lot of manufacturers will offer to drive those costs down.”

That Integrated Pharmacy Distribution Center, which is adjacent to the Specialty Pharmacy, is the central distribution center for all medications used throughout the OSF HealthCare Ministry and how OSF was able to safely store and distribute COVID-19 vaccines throughout the pandemic.

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B-Roll

The pros and cons of social media are well documented. It allows you to connect with friends and pursue passions, but bullying and misinformation can be rampant.

But can frequent social media use lead to changes in brain development during the formative adolescent years? A recent study suggests so, but much more investigation is needed, says Karna Sherwood, MD, a neurologist at OSF HealthCare in Alton, Illinois.

The study tracked 169 sixth and seventh graders and found those who habitually checked social media were more sensitive to rewards and punishments. To view it a different way, kids who constantly refresh Facebook hoping the likes on their post will go up may be more impulsive to seek out real-life recognition.

“At a certain point, 10 likes or 20 likes are no longer gratifying enough,” Dr. Sherwood says. “And then you have to find another way to get even more likes or more appreciation.”

That “another way” could lead to risky behaviors such as substance abuse. But Dr. Sherwood says more study is needed to conclusively make the link. Just how much does our life in the digital realm affect our life away from the device?

“A follow up study would certainly investigate if [frequent social media use] has an effect on rates of anxiety and depression,” says Dr. Sherwood. “Could this affect addiction? And what interventions could be taken to nullify those behaviors?

“As a society, if we want to raise happy and healthy people in an age where we are getting better technologically, what steps do we need to take?”

Until then, Dr. Sherwood has some good advice no matter your age or number of Twitter followers.

“Until you get the rest of the information, it’s better to have some degree of regulation,” and restraint with social media, Dr. Sherwood says.

Learn more about how the brain works on the OSF HealthCare website.

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Previous coverage

Tackling pediatric mental health

Bullying and the era of technology

Is social media impacting your mental health?

Kids' screen time: How much is too much?

Tackling any task – from a child walking to an adult learning a new job – starts with a first step. The same goes for taking care of your mental and behavioral health, but even the experts admit it may be daunting to ask for help. During the holiday season where some people may experience loneliness and depression, experts are reminding you there are resources to bridge the gap between “what do I do?” and “I have the care I need.”

Katie Koeller is a behavioral health navigator (BHN) at OSF HealthCare in Alton, Illinois. BHN is a free, ministry-wide service at OSF HealthCare, but you don’t have to be an OSF HealthCare patient to use it. The program helps people in areas like depression, anxiety, drug or alcohol use, and problems with work, school, or relationships. The BHN talks to the patient – either at a provider’s office or over the phone – about what care they need, and they point the person to that care as close to home and as soon as possible. The BHN also checks the patient’s insurance coverage to see how it lines up with the care needed.

“We would do an intake,” Koeller explains. “So we'd ask questions, making sure that they're not in a crisis situation at the time and see what their symptoms are. And then that way we can better judge what they would be suited for as far as counseling, psychiatry, substance use treatment, whatever it may be.”

Koeller notes the treatment could be out-patient (the typical office visit) or in-patient (live-in treatment). She says a BHN will also check-in with the patient via phone call or message on OSF HealthCare’s secure online portal. Koeller says it’s usually three check-ins over a month, but each case is different.

“Some people just decide maybe it's not what they need, maybe just talking with somebody like me and just getting educated and feeling like they have that opportunity or just the knowledge about the community resources is enough,” Koeller says. “Because then they were like, ‘Well I can decide later on if that's what I need.’  But for the most part, I feel like a lot of patients are appreciative and do really like the service and find it helpful.”

Koeller, a BHN for three years, says even if the patient is on a good path, the BHN tells them they can always call back if they need more help.

The tendency to stay quiet about mental health is still an issue, Koeller says. But she’s seeing another roadblock to care.

“A lot of people just feel like they don't have time for it. I've heard a lot of people say that ‘I can't take off work for it.’” Koeller says. “I feel like a lot of people don't consider it to be [a crisis]. You don't want it to get to that [crisis] point. So they kind of push it back like it's not as important as my physical health.”

But in reality, Koeller says, mental health does impact physical health. In other words, if your mind hurts, your body may hurt, too.

Koeller also notes that some insurance providers can help with transportation – getting a ride to a counselor appointment, for example. Telehealth – a digital appointment with a provider from home – is also an option that’s growing in use. OSF SilverCloud is another resource designed for workplaces. These are some of the many things a BHN can check on and, at a minimum, educate the patient on what’s available.

Patients who are experiencing a mental or behavioral health issue can contact their primary care provider or – if you live within OSF HeathCare’s footprint – use the behavioral health navigator program. If you’re in a crisis situation that needs a first responder, call 9-1-1. If it leans toward a mental health crisis, call the National Suicide Prevention Lifeline at 9-8-8.

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