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Skin is punctured by a narrow sharp object (e.g., a nail, pencil, toothpick)
Needlesticks: Any needlestick from a used or discarded needle should be reported immediately to the doctor. In some cases, medicines should be started to prevent transmission of the HIV (AIDS) virus.
Foot Punctures through Athletic Shoes: Puncture wounds into the bottom of the foot have a risk of infection of approximately 4%. This increases to 25% in patients with puncture wounds through athletic (tennis) shoes into the bottom of the foot near the toes. Pain persisting greater than 4-5 days after the injury is suggestive of infection.
Pencil Lead Punctures: Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are nontoxic. However, they will cause a tattoo and should be scrubbed out.
Animal caused it, see ANIMAL BITE
It looks infected, see WOUND INFECTION
Skin is cut or scraped (not punctured), see SKIN INJURY
FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.
FIRST AID Advice for Shock: Lie down with feet elevated.
Puncture on the head, neck, chest, back, or abdomen that may go deep
You think you have a serious injury
Puncture on the head, neck, chest, abdomen that isn't deep
Puncture overlying a joint
Tip of the object is broken off and missing
Feels like something is still in the wound
Can't stand (bear weight or walk) on punctured foot
Needle stick from used injection needle, and you were possibly exposed to another person's blood
Sharp object was very dirty (e.g., a barnyard)
Setting was dirty and puncture occurred on bare foot
Dirt (debris) that can be seen in the wound is not gone after 15 minutes of scrubbing
Wound looks infected (redness, red streaks, swollen, tenderness)
No previous tetanus shots
You think you need to be seen
Diabetic and puncture wound of foot
Last tetanus booster was over 5 years ago
You have other questions or concerns
Puncture through shoe (e.g., tennis shoe) and into bottom of foot
Pain has not improved after 3 days
Minor puncture wound and you don't think you need to be seen
Cleansing: Wash the wound with soap and warm water for 15 minutes. For any dirt or debris, scrub the wound back and forth with a washcloth to remove it.
Trimming: Cut off any flaps of loose skin that seal the wound and interfere with drainage or removing debris. Use a fine scissors, after cleaning them with rubbing alcohol.
Antibiotic Ointment: Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Re-soak the area and re-apply an antibiotic ointment every 12 hours for 2 days.
For pain relief, take acetaminophen, ibuprofen, or naproxen.
Acetaminophen (e.g., Tylenol):
Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.
Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.
The most you should take each day is 3,000 mg.
Ibuprofen (e.g., Motrin, Advil):
Take 400 mg by mouth every 6 hours.
Another choice is to take 600 mg by mouth every 8 hours.
Use the lowest amount that makes your pain feel better.
Naproxen (e.g., Aleve):
Take 250-500 mg by mouth every 12 hours.
Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An acetaminophen overdose can hurt the liver.
Caution: Do not take acetaminophen if you have liver disease.
Caution: Do not take ibuprofen or naproxen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of medicine. Do not take ibuprofen or naproxen for more than 7 days without consulting your doctor.
Before taking any medicine, read all the instructions on the package
Expected Course: Puncture wounds seal over in 1 to 2 hours. Pain should resolve within 2 days.
Call Your Doctor If:
Dirt in the wound persists after 15 minutes of scrubbing
It begins to look infected (redness, red streaks, tenderness, pus, fever)
Pain becomes severe
You become worse
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