Across the land, emergency room doctors and nurses are bracing for summer's wildest holiday: the Fourth of July.
"We see a blip" in every accident category but winter sports, says David Alexander, spokesman for the National Safety Council.
Most accident rates are higher throughout the summer. Yet Independence Day creates a spike of mayhem all its own.
If the holiday is warm, it sparks some of the heaviest drinking all year, safety experts say. Add up the party atmosphere, extra driving, water sports and threat of fireworks, and you have a deadly combination.
Drinking underlies at least half of serious traffic accidents and most boating accidents, say emergency room doctors like Bradford Walters, a senior staff physician at Henry Ford Hospital in Detroit.
"If it's a beautiful summer weekend, we can anticipate a real rock and roll here in the ER, because people will really put on a snootful," says Dr. Walters.
Media coverage of holiday traffic accidents has become routine, numbing the public, he says: "People hear about the deaths but don't hear about the terrible maimings, about all the people who won't be productive citizens the rest of their lives."
When it comes to boating accidents, the Fourth of July has no peer. Again, the common factor is booze, says Dr. Walters:
"For some reason, people who normally wouldn't think of drinking and driving will get hammered and then go out on the water. This results in everything from boat collisions to skiing accidents to drownings. And these days we're talking some very powerful boats. People have V-6 engines that go 60 mph, and they're driving them intoxicated."
In back yards, holiday danger lurks beneath cool, blue waters. About 5,000 people nationwide will have serious accidents around a pool this year, many occurring this weekend.
Says Dr. Walters, "An awful lot of people will have pool parties, with alcohol flowing, and that's the right mix for swimming and diving accidents.
"At a lake, you run into the water. But at a pool, you're standing on the edge or on a diving board with that temptation to dive.
"Most backyard pools are 8 feet deep or less. If you're 5-foot-10, it doesn't take much to get to the bottom quickly. Getting hit on the forehead snaps the head back and can really do damage. These people come floating to the top paralyzed."
The nation's plastic surgeons have issued a warning about fireworks injuries, which last year caused more than 11,000 serious injuries -- two-thirds of them in the weeks before and after the Fourth of July. Kids ages 10-14 are 10 times more likely than people 25 and older to be injured.
Plastic surgeons have made big strides in using lasers to erase from victims' faces the black spots -- sometimes numbering in the thousands -- caused by black powder explosions. But they can't replace fingers or eyes, often destroyed in fireworks accidents.
Even sparklers can cause tragedy. "The wire gets very hot, and after it burns down you can't see the darkened end of the wire. Then, when they're waved around in the dark by younger children standing close together, whack -- you get an eye injury," says Dr. Walters.
Household and weapons injuries are common throughout summer, but especially so now, when booze and leisure time mix with holiday revelry.
Sports accidents, although rarely deadly, are another July Fourth tradition. Most injuries are muscle strains and sprains to people unaccustomed to swinging a bat or running the bases.
"These people don't exercise most of the year. Then they go to the family picnic and play for three hours in a sport without appropriate warm-up, maybe after they've been drinking. The next day, they hurt," says Dr. David Janda, a sports medicine expert in Ann Arbor, Mich., and national expert on baseball injuries.
People who aren't used to swinging a bat may do so just as a toddler walks by, says Dr. Janda. Or they may slide into a base on an unfamiliar field, where glass or metal can shred flesh or an immovable base may rip knee ligaments.
Dr. Janda, a recent appointee to the federal government's Advisory Panel for Injury Prevention and Control, wrote the lead editorial in July's Clinical Journal of Sports Medicine on the need for accident prevention.
Citing support from the National Academy of Sciences, he makes a case that accident prevention offers the greatest potential health-care savings per dollar invested.
"Accidents are the least recognized problem in health care today," says Dr. Janda. "The biggest bang for our buck in terms of research would be funding ways to prevent accidents of all kinds, from car accidents to sports injuries, gunshot injuries and household accidents."
Yet, despite his hopes for research, Dr. Janda says there is nothing on the horizon for increasing the holiday supply of one crucial safeguard against accidents of all kinds.