Revelers of all kinds will be celebrating this Halloween. But mischief makers, fallen angels and all manner of witch's brews can turn the holiday into a devil's playground -- to the chagrin of local emergency departments.
"I can't tell you how many times I have seen a super hero find out he or she could not actually fly and get hurt trying!" said Dr. Richard O'Brien, attending emergency physician at Moses Taylor Hospital in Scranton, Pa., and spokesperson for the American College of Emergency Physicians.
While Halloween can be just another night for some ERs, many note an uptick of incapacitated ghouls and goblins hobbling through the doors.
Dr. Gerard Brogan, associate professor of Clinical Emergency Medicine at NYU School of Medicine, recalled one child who came to the ER bleeding after tripping and hitting his head. The child's friend thought his Frankenstein costume was terrific, not realizing the blood was real.
But going house-to-house to collect candy can pose real dangers for kids and adults, especially if they are walking at night dressed in dark costumes.
"Of primary concern is pedestrian versus auto accidents, which are an obvious danger when you mix excited children, dusk and moving vehicles," said Dr. Lara Zibners Lohr, pediatric emergency physician and author of "If Your Kid Eats This Book Everything Will Still be Okay." "Kids who are excited by the holiday may not remember to obey the rules about crossing the street and are at risk for both minor and major trauma."
Doctors advise everyone to wear something reflective, to avoid walking around at night and to wear masks and clothes that fit properly and don't obstruct vision or movement to prevent trips and falls.
While the fun of Halloween for many is the candy treats, people who prefer tricks should beware that they can come back to haunt you.
Dr. B. Bryan Jordan, associate chairman at Bridgeport Hospital in Bridgeport, Conn., recalled an outbreak of salmonella poisoning in a group of kids throwing eggs.
"They were too sick to have fun on Halloween," Jordan said.
But not all injuries are trick-or-treat-related.
"I once took care of a teenager who had his arm almost completely chopped off by a friend with a toy ax," said Dr. Alison Tothy, head of pediatric emergency medicine at the University of Chicago Medical Center. "They were reenacting a sci-fi movie and the kids didn't realize how sharp the ax was."
Nor are Halloween injuries limited to children. Dr. David Ross, an emergency physician at Penrose Hospital in Colorado Springs, Colo., said the most frequent ER patients on Halloween are adults intoxicated by alcohol or drugs.
But such patients can be a welcome break from the normal routine, Ross noted, recalling one group of drunk young adults dressed up as brontosauruses.
"It sort of livens up the ER when they [come]," Ross said.
But some seasonal accidents are not so banal.
"Given the somewhat sexual content of Halloween for young adults, we have seen some fairly bizarre items attached to a male patient's penis during various games, usually associated with some type of intoxication," said Dr. Carl Schultz, professor of Emergency Medicine at UC Irvine.
Other common injuries are cuts and lacerations during pumpkin carving, Schultz said.
For those heading out to trick-or-treat on Halloween night, doctors say adult supervision for kids and young adults is the best way to head off accidents.
"The most trouble we see is after dark," Brogan said. "Parental supervision is key. The larger the group of kids going around, the more potential for trouble."