Doctors are seeing a surge in ER cases that have to do with holiday decorating. That’s right,  falling off of ladders while putting up Christmas lights or even falling off roofs. And then there’s the few who are hospitalized from injuries caused by “DUI” — decorating under the influence.

“They try to decorate when they’re drunk,” Dr. Carlos Roldan, a Texas ER doctor who has seen plenty of holiday injury cases, told NBC News. “And the next thing you know, we seem them [in the ER].”

Dr. Roldan also told NBC News the story of a man who fell off a ladder in September while putting up Christmas lights. “He lost his balance as his wife was on the ladder trying to hand him his walker,” Roldan, who works at Memorial Hermann-Hospital in Houston, said. “Who told him he should be on the roof?”

The Consumer Product Safety Commission (CPSC) found that the number of U.S. ER cases that have to do with holiday decorating has risen significantly in the past several years — from 12,000 cases in 2009 to 15,000 last year. “We’ve seen a bump each year since [2009],” Kim Dulic, a CPSC spokeswoman, told NBC News. This averages out to about 250 people per day who are injured between the months of November and January. The typical injuries include lacerations, falls, and back strains, but Roldan mentions that there are more serious injuries: “From broken necks to broken hips, the consequences can be catastrophic,” he told NBC.

But that’s not all — of course, how could we forget Christmas tree fires? Between 2009 and 2011, 200 inflamed trees accounted for some 10 deaths and $16 million lost in property, the CPSC reports.

Ladder Safety 101

Ladders seem to be a big problem. So many people have fallen off ladders while decorating the house or the tree that the CPSC posted several guidelines on how to use one safely. For example, you should always put your ladder on stable ground. Double check the maximum load rating to make sure it can withstand both your weight and the load you are carrying. Have someone stand at the bottom of the ladder to hold it from tipping, and make sure you stay grounded in the center of each ladder rung to prevent it from leaning too far in one direction.

The CPSC also provides some tips for safe trees, candles, lights, and fireplaces. Set up your Christmas trees away from any heat source, including heaters or radiators. Make sure you water the tree daily to keep it from drying out too soon. CPSC Acting Chairman Robert Adler says, “Keep Christmas trees watered well, don’t leave candles unattended, and use caution whenever you are on a ladder … Adding safety to your checklist can keep a holiday tradition from becoming a holiday tragedy.”