Way Downstream…

    From San Antonio, a Fourth of July fireworks accident offers a cautionary tale for coming festivities.
     You never know when you’ll end up in proximity to a wild child or beer-soaked fellow who blew a chunk of his paycheck on colorful boomers in Pennsylvania, South Carolina or one of those states that sell real fireworks.
    So it might be good to hear about the 44-year-old Texan who showed up at the San Antonio Military Medical Center last July 4 with a missile-like tube deep in his leg, a firework unexploded after being ignited.
     Fearful of a blast at any moment (not to mention a mess), nearby rooms emptied, the fellow was quarantined and the bomb squad showed up. No loud noise sounded when they dug out the miniature mortar.
     The Journal of Emergency Medicine put things in clinical terms. “He presented to the regional trauma center with an open, comminuted distal femur fracture and radiographic evidence of a potential explosive device in his thigh.”
     The Journal asked this question: Why should an emergency physician be aware of this?
     The author’s answer makes some sense, and not just for doctors:
    “Explosive devices,” he wrote, perhaps not too dramatically, “pose a grave threat when encountered.”