Every year, about 10,000 people are rushed to the emergency department for fireworks injuries. Fire Captain Jay Northup never thought he would be counted among them. He took all the right precautions as he organized his backyard Fourth of July fireworks celebration. But a split second of poor judgement nearly cost him his vision and his life.
A 23-year veteran of the Euclid Fire Department in Euclid, Ohio, he had the training and experience to safely execute a pyrotechnic display to impress family and friends. And it wasn’t the first time Northup, 47, had organized the neighborhood fireworks display.
He had strategically placed the launch pad behind his garage, where he set up a 12-shot box of mortars that, when lit, would shoot a couple hundred feet into the air. The kids, including his 15-year-old twins, and adults were at the front of the house, safely away from the launch pad.
Alone in the backyard, he started lighting up $600 worth of fireworks. The first three mortars went off as intended, but then, silence. After about 10 minutes, he decided to investigate the dud. His face was about 12 inches above the cylinder, when the dud suddenly exploded. The blast threw him to the ground, leaving him completely disoriented and unable to see.
“It felt like something was pouring out of my right eye, and I just had no idea what was going on,” Northup said. “I thought I was dying.”
His wife, an ER nurse, managed to stay calm as she rushed her bleeding husband the 12 miles from their home to Metro Health in Cleveland, where doctors immediately began treating his life-threatening injuries.
The impact from the explosion caused a subdural hematoma, one of the deadliest of all head injuries. Once doctors controlled the bleeding and pressure in his brain, they turned to the cuts on his forehead that required 35 stitches to close. His face was also burned and bruised.
"I thought I was dying." - Jay Northup, firefighter
After Northup was stable, it was up to ophthalmologist Thomas Steinemann, MD, to save his sight. His right eye took a direct hit from the mortar, burning off his eyelashes and the skin around his eye. The impact deformed the front part of his eye, damaging the cornea and sending shockwaves to the back of his eye, bruising the retina. Blood had begun to pool inside his eye, a dangerous condition that increases pressure inside the eye and can lead to blindness.
Dr. Steinemann treated him with special eyedrops to control the inflammation in his eye, and antibiotic eyedrops and ointment to prevent infection. In about a week, Northup’s vision began to improve, but Dr. Steinemann could already detect trouble ahead. A traumatic cataract was beginning to form. Like a typical cataract caused by aging, a traumatic cataract happens when the lens of the eye begins to get cloudy and must be surgically removed to restore normal vision. It’s a common condition following a traumatic injury to the eye.
About 10 months after the fireworks injury, Dr. Steinemann performed cataract surgery on his right eye, restoring Northup’s sight once again. While Northup made a full recovery and returned to work as a firefighter, he was left with a lasting defect. His pupil is paralyzed; it can no longer expand and contract to accommodate lighting conditions.
The pupil is like a camera, it opens to a larger setting when indoors to let the light in and to a smaller setting outdoors to keep the light out. Dr. Steinemann explained that Northup’s “camera” is permanently stuck on the indoor setting, making it painful to be outside without sunglasses.
ER Visits Explode on the 4th
Thomas Steinemann, MD, examines firefighter Jay Northup's eyes to monitor his vision and his recovery as he continues to heal from the fireworks explosion that almost blinded him.
Ophthalmologists have reason to fear the Fourth of July. According to the latest U.S. Consumer Product Safety Commission data (PDF, 648KB), fireworks caused approximately 10,000 visits to the emergency department in 2016, about 9,000 of which were for eye injuries. Injuries range from cuts and bruises to damaged corneas, retinas and ruptured eyeballs.
"Even those little, innocent-looking sparklers people give children burn at 2,000 degrees." - Dr. Steinemann
Mortars like those Northup purchased aren’t the main culprit. Most injuries are caused by legal fireworks parents buy for their children, such as sparklers, firecrackers, bottle rockets, and Roman candles.
“As ophthalmologists, we see so many preventable eye injuries, in adults and children” said Dr. Steinemann. “Even those little, innocent-looking sparklers people give children burn at 2,000 degrees.”
The American Academy of Ophthalmology advises that the safest way to view fireworks is to watch a professional show. For those who choose to set off fireworks, the Academy recommends wearing protective eyewear and keeping a hose and buckets of water on hand for duds and misfires. Soak the dud from a distance with a hose or a bucket of water. Pick it up with a shovel and fully submerge it in a bucket of water to ensure it’s safe for disposal.
After Recovery, Advocacy
Firefighter Jay Northup just a few hours after the exposion and being admitted to the Level 1 Trauma Center at Metro Health in Cleveland.
It took time for Northup to recover from his physical and emotional injuries. “One split second of a very bad decision almost cost me my life,” Northup said.
"I think fireworks can be safe, but they’re also unpredictable, and I have a totally different outlook now." - Jay Northup
Did he take some razzing at the firehouse? Yes, but it’s how firefighters cope with a stressful job. He no longer cares about bringing attention to his mistake. He is on a mission to make sure no one else becomes a statistic.
“I think fireworks can be safe, but they’re also unpredictable, and I have a totally different outlook now,” Northup said. “My advice for celebrating the Fourth of July? Leave the fireworks to the professionals or, better yet, just go have a nice family picnic.”