911 warning

Puncture Wound

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Does this describe your child's symptoms?

Click image for more info

X-Ray - BB in Left Upper Arm

Puncture Wound - BB Gun

First Aid - Removing a Splinter

Puncture Wound - With a Foreign Body

Definition

  • The skin is punctured by a narrow, pointed object

Causes

  • Commonly caused by a nail, sewing needle, pencil, toothpick

  • Pencil lead is actually graphite (harmless), not poisonous lead. Even colored leads are not toxic.

If not, see these topics

  • 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

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When to Call Your Doctor

call 911

Call 911 Now (your child may need an ambulance) If

  • Puncture on the head, neck, chest or abdomen that may go deep

call now

Call Your Doctor Now (night or day) If

  • 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

  • Severe pain

  • Wound looks infected (redness, red streaks, swollen, tenderness)

  • Fever occurs

  • You think your child needs to be seen urgently

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen, but not urgently

  • Last tetanus shot over 5 years ago

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

home care

Parent Care at Home If

  • Minor puncture wound and you don't think your child needs to be seen

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HOME CARE ADVICE FOR PUNCTURE WOUND

  1. Cleansing:

    • 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.

  2. 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.

  3. 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.

  4. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen for any pain.

  5. Expected Course: Puncture wounds seal over in 1 to 2 hours. Pain should resolve within 2 days.

  6. 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

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

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