There’s nothing like carving a pumpkin to get into the Halloween mood. But if you don’t do it safely, you might spend time in an emergency room instead of out trick-or-treating with the rest of the witches, ghosts, and goblins.

Each October hospitals treat four to five times more hand injuries than usual as a result of pumpkin-carving injuries. “The most common accidents associated with pumpkin carving are stab wounds to the fingers and palm,” says Stuart J. Elkowitz, M.D., a hand surgeon at Somers Orthopaedic Surgery & Sports Medicine Group in Carmel, N.Y., who repairs the resulting gashes every Halloween. It’s often the index finger that’s punctured, he says, causing damage to tendons, nerves, or arteries.

Why is carving so dangerous? Pumpkins can be both slippery and tough. Cuts can occur when a knife sticks in the rind, then abruptly dislodges as you tug it out, slicing your supporting hand. Or you can cut yourself if the handle gets slippery with pumpkin pulp, causing your hand to slide down the blade as you push the knife into the pumpkin.

Here are five ways to avoid a pumpkin-carving nightmare:

1. Use the Right Tools

Consumer Reports tested pumpkin-carving kits a few years ago and noted that an advantage of the specialty tools—readily found online and in convenience stores—was that they can saw through rinds, poke holes, and scoop out innards without being razor-sharp. The instruments are also generally small, which makes them easier to control than most knives and easier to use when making intricate cuts.

2. Carve Before Taking the Top Off the Pumpkin

“That way you won’t be tempted to put your hand inside and cut toward your hand,” advises Stuart J. Elkowitz, M.D., a hand surgeon. He also recommends stabilizing the pumpkin by holding the top and pointing the blade down.

3. Take Precautions

That means carving in a clean, dry, and well-lit area, keeping your hands and tools clean and dry, and taking your time.

4. Don’t Let Kids Carve

Most Halloween accidents happen to kids ages 10 to 14, according to a study published in the journal Pediatrics in 2010. So don’t let children 14 and younger do the actual carving. Instead, have them draw the pattern with a marker and clean out the pulp and seeds with their hands or a spoon—but make sure an adult does the actual cutting. It’s important to supervise older teens, too. Elkowitz notes that adolescents often become patients because parents think they’re responsible enough to be left on their own. So have them use pumpkin-carving kits or, if you think they're responsible enough to use knives, make sure they use short-handled ones, and that the knives are kept clean and dry. 

5. Know First Aid

In case someone does get cut while carving a pumpkin, apply direct pressure to the injury using a clean, dry cloth. If bleeding doesn't stop in 15 minutes, get to an emergency room or urgent-care clinic.