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The skin is punctured by a narrow, pointed object
Commonly caused by a nail, sewing needle, pencil, toothpick
Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are not toxic.
Animal caused it, see ANIMAL OR HUMAN BITE
Looks infected, see WOUND INFECTION
Skin is cut or scraped (not punctured), see CUTS, SCRAPES, or BRUISES (SKIN INJURY)
Foreign body (e.g., sliver) remains in the skin, see SKIN FOREIGN BODY
Puncture on the head, neck, chest or abdomen that may go deep
You think your child has a serious injury
Bleeding that won't stop after 10 minutes of direct pressure
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 still in the wound
Won't stand (bear weight or walk) on punctured foot
Needle stick from used or discarded injection needle
Sharp object or setting was very dirty (e.g., a barnyard)
No previous tetanus shots
Dirt (debris) or pencil lead pigment is not gone after 15 minutes of scrubbing
Wound looks infected (redness, red streaks, swollen, tenderness)
You think your child needs to be seen urgently
You think your child needs to be seen, but not urgently
Last tetanus shot over 5 years ago
You have other questions or concerns
Minor puncture wound and you don't think your child needs to be seen
Wash the wound with soap and warm water for 15 minutes.
For any dirt or debris, scrub the wound surface back and forth with a wash cloth to remove it.
If the wound re-bleeds a little, that may help remove germs.
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 such as Polysporin (no prescription needed). Then, cover with a Band-Aid to reduce the risk of infection. Re-wash the area and re-apply an antibiotic ointment every 12 hours for 2 days.
Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for any pain.
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
Pain becomes severe
It begins to look infected (redness, red streaks, tenderness, pus, fever)
Your child becomes worse
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