Each year, paramedics have to spend the day after Thanksgiving treating trampled shoppers, bruised brawlers and people hit in parking lots.
Emergency rooms and ambulance services, across the US have to bolster their staffs and supplies to cope with the incoming traumas.
Here are some of the most common ways that more than a hundred people in the last 10 years have been injured on this auspicious day.
Customers rushed the gates as an Ohio store opened for Black Friday in 2011
1. Parking spot spars: Concussions, broken bones and beatings
Shoppers rushing to and from the stores on their Black Friday hit list are more likely to drive aggressively and focus more on their bargain goals than the pedestrians around them.
Last year in the US at least four people were seriously injured in store parking lots, including a man who tried to help a woman who was being beaten in a Walmart parking lot was shot and killed, and another man was shot and killed over a parking spot.
Pedestrian accidents usually result in much more minor injuries, but many still need immediate attention to ensure that they do not get worse over time.
The most common injuries are head traumas, internal bleeding, fractures, and spine and hip injuries.
Paramedics focus first on assessing victims for head and spinal injuries, stabilizing them to prevent long term brain damage or paralysis.
2. Stampedes: Crushed organs, internal bleeding and broken bones
It only takes six or seven people to exert nearly 1,000 pounds of pressure, enough to easily crush internal organs.
Last year, at least one woman was trampled in South Africa, sustaining a shoulder injury on Black Friday.
A fight between two shoppers in Alabama today led to an all out brawl, and left one woman on the ground
Hordes of shoppers rushing the just-opened doors of big box stores like Walmart and Best Buy never fail to make Black Friday headlines.
Real stampedes, injuring people who fall and trampled by others, are fairly rare, but the risk at packed shops is very real.
Stampedes may be triggered by a crowd’s excitement or desperation. Retailers rely in part on creating a sense of scarcity to lure shoppers out to claim the best deals.
So when there’s news – of a new discount for a limited time or that supplies are running low – the fear of missing out can get the best of people, leading them to charge ahead of, and sometimes over, their fellow shoppers.
If you find yourself caught in a surging crowd, the best thing to do is stay on your feet. If you do fall, curling up helps to protect you from too much pressure in one place. Turning on your side so that your shoulders absorb shock is better than leaving your spine or stomach vulnerable.
Bruising and pain can indicate to paramedics trampling may have caused someone internal bleeding.
But not all ambulances carry ultrasound equipment to assess the extent of the damage. Patients may have to be rushed to hospitals to prevent potentially fatal blood loss.
3. In-store injuries: Crushed by boxes and slammed by carts
As customers clamber to grab merchandise off of shelves, heavy boxes can become unstable, threatening to fall on heads or crush feet.
Like car injuries, if something heavy has fallen on a patient’s head, paramedics have to work quickly to assess if the impact has caused a concussion, or damaged neck vertebrae.
Black Friday shoppers scramble to grab TVs on Black Friday in Brazil this year, passing the heavy boxes over heads
Smashed fingers and feet are more easily treatable, and paramedics are equipped to stitch up cuts or set possible broken bones.
Stores like Target use plastic shopping carts, which are lighter and don’t have the sharp edges of old-fashioned metal baskets. But overloaded carts can tip over easily, knocking over shoppers and crushing appendages.
4. Violence: stabbings, shootings and fist fights
Already today, once person has been shot while shopping at a Missouri Mall, and a brawl has broken out in Alabama.
Black Friday shoppers are in the competitive spirit when they are bargain hunting, primed and ready to defend their prized finds.
But the excitement can quickly escalate into aggression when we feel like someone else is threatening our access to one of ‘a limited supply’ of products, and even more so if they got what we’ve been in line for since four in the morning.
Last year, a woman was beaten, a man used his belt as a whip, there were three shooting incidents and a police officer was stabbed by a shoplifter.
Mine: Fights tend to break out during Black Friday shopping because stores create an atmosphere of competition for the best deals
Many malls in the US prepare for violence by hiring their own ambulances for the day, and scheduling additional security staff.
Most violent incidents do not involve weapons, but even a well-thrown punch or hard kick can cause life-threatening head trauma or internal injuries.
As is the case in any violent incident, paramedics primary concern is to make sure a victim does not bleed to death before reaching the hospital for treatment.
If a brawl turns bloody. paramedics mostly rely on tourniquets and gauze to pack wounds and minimize the blood flow to the area before getting a patient to a hospital.