Puncture wounds: First aid

A puncture wound, such as from stepping on a nail, doesn't usually cause much bleeding. But these wounds are often deep and can be dangerous because of the risk of infection.

Treatment

To take care of a puncture wound:

1. Wash your hands. This helps prevent infection.
2. Stop the bleeding. Apply gentle pressure with a clean bandage or cloth.
3. Clean the wound. Rinse the wound with clear water for 5 to 10 minutes. If dirt or debris remains in the wound, use a washcloth to gently scrub it off. See your health care team if you can't remove all of the dirt or debris.
4. Apply an ointment. Apply a thin layer of an antibiotic cream or ointment (Neosporin, Polysporin). For the first two days, rewash the area and reapply the antibiotic when you change the dressing. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the product and seek medical care. For those people who could have an allergic reaction to antibiotic cream or ointment, petroleum jelly (Vaseline) may be used.
5. Cover the wound. Bandages help keep the wound clean.
6. Change the dressing. Do this daily or whenever the bandage becomes wet or dirty.
7. Watch for signs of infection. See a doctor if the wound isn't healing or you notice any increasing pain, pus, swelling or fever. Spreading redness is a sign of infection. You may not be able to see redness on brown or Black skin, or the infection's streaks may look purplish-gray or darker than your usual skin color.

When to seek emergency help

Get medical help at once if your wound:

• Keeps bleeding after a few minutes of direct pressure.
• Is due to an animal or human bite.
• Is deep and dirty.
• Is caused by a metal object.
• Is deep and to the head, neck, scrotum, chest or abdomen.
• Is over a joint and could be deep.
• Is due to an assault or attempted suicide.

When to call your doctor

Seek medical care if your wound shows signs of infection, such as:

• Fever.
• Redness, swelling, warmth or increasing pain around the wound.
• Bad smell coming from the wound.
• Pus coming out of the wound.
• Red streaks around the wound or going up your arm or leg.

If you haven't had a tetanus shot in the past five years and the wound is deep or dirty, your health care professional may recommend a booster. You should have a booster shot within 48 hours of your injury.

If the wound was caused by a cat or a dog, try to confirm that its rabies vaccination is up to date. If it was caused by a wild animal, seek advice from your doctor about which animals are most likely to carry rabies.