Difference between revisions of "Treat a Puncture Wound"

{{fa}}Did you know that puncture wounds account for five percent of the admission reasons for children going to emergency centers?<ref name="rf1">Dr Lewis First, Vermont Children's Hospital, http://www.youtube.com/watch?v=26Gdqjna2OA&feature=player_embedded</ref> Puncture wounds occur when a narrow, pointed object such as a nail, tack, sliver or other similar sharp object pierces the skin. These wounds tend to be narrow and can be quite deep if the object was driven into the skin with substantial force. Minor puncture wounds can be treated fairly easily at home, saving you a trip to the emergency room; major puncture wounds, on the other hand, should be treated as soon as possible by a medical professional.  Read the following article to learn how to assess and treat minor and more serious puncture wounds.[[Category:First Aid and Emergencies]]

#Treat the wound immediately. Provided a puncture wound is attended to quickly, it will usually not become serious. If left unattended, however, infection introduced through the puncture site can become life-threatening for the patient.<ref name="rf2">https://myhealth.alberta.ca/health/Pages/conditions.aspx?hwid=pntwd&#hw99931</ref> <ref name="rf3">http://www.mckinley.illinois.edu/Handouts/wound_infection_symptoms.html</ref>

#Wash your hands with soap or an antibacterial solution. This will prevent infection.<ref name="rf4">http://www.nlm.nih.gov/medlineplus/ency/article/000043.htm</ref>

#*Clean any instruments you might use during treatment with rubbing alcohol. These may include tweezers.<ref name="rf5">http://www.seattlechildrens.org/medical-conditions/symptom-index/puncture-wound/</ref><ref name="rf6">http://www.mayoclinic.org/first-aid/first-aid-puncture-wounds/basics/art-20056665</ref>

#Clean the wound with soap and warm water. Cleanse the wound under warm water for between five and 15 minutes, and then wash the wound with soap and a clean cloth. <ref name="rf4" />  <ref name="rf5" />

#Stop the bleeding. Minor puncture wounds usually do not bleed profusely.<ref name="rf6" /> Use a clean cloth to apply gentle, direct pressure on the wound until the bleeding stops.

#*A small amount of bleeding may actually help to clean the wound. You can allow small wounds to bleed for about five minutes.<ref name="rf5" /> <ref name="rf2" />

#*If the bleeding continues after several minutes of pressure, or the bleeding is severe, ongoing, or alarms you, seek medical attention immediately.<ref name="rf6" /><ref name="rf7">http://www.pennmedicine.org/encyclopedia/em_PrintArticle.aspx?gcid=000043</ref>  

#*The wound shows signs of infection, including redness and swelling around the affected area, increasing pain or a throbbing sensation, pus or other discharge, or the patient experiences chills or a fever (see Part 4).<ref name="rf7" /><ref name="rf4" />

#Keep pressure on the wound. If the bleeding is severe and you do not have access to a clean cloth or bandage, use your hand.<ref name="rf8">http://www.stjohn.org.nz/first-aid/first-aid-library/bleeding/</ref>

#Raise the affected body part. Keep the affected area raised above the patient’s heart, if possible. This will help to bring the bleeding under control.<ref name="rf8" />

#Do not remove objects embedded in the skin. Instead, apply a thick padding of bandages or clean cloth around the foreign object. Make sure there is as little pressure as possible on the embedded object. <ref name="rf8" />

#Keep the patient in a resting position. To help slow the bleeding, the patient should be kept at total rest for at least 10 minutes. <ref name="rf8" />

#*Keep pressure on the wound and replace bandages if they become soaked with blood.<ref name="rf8" />

#Remove the object (or objects) if it is not large. Small splinters and other sharp objects can be removed with disinfected tweezers. If you find a large object, or one that is embedded deeply into the flesh, seek medical attention.<ref name="rf7" />

#Clean dirt and other small particles from the surface of the wound. Rub the wound with a clean cloth and/or remove the particles with disinfected tweezers.<ref name="rf5" /> <ref name="rf6" />

#*All manner of foreign objects can become embedded in a puncture wound, including wood, cloth, rubber, dirt and other materials; these may be difficult or impossible to see when treating the wound at home. However, do not poke or dig around in the wound; if you believe there are still foreign objects in the wound, seek medical attention. <ref name="rf9">http://www.uofmmedicalcenter.org/healthlibrary/Article/116455EN</ref> <ref name="rf4" />

#Treat and bandage the wound. If the puncture is free of debris and sharp objects, apply an antibacterial ointment or cream and cover with a bandage. <ref name="rf7" />

#*Topical antibiotic ointments like Neosporin and Polysporin are effective, and don’t require a prescription. Apply every 12 hours for 2 days. <ref name="rf5" /> <ref name="rf6" />

#*Use a porous adhesive dressing or bandage that won’t stick to the wound. Change daily, to ensure that the wound stays healthy and dry. <ref name="rf10">St John, The New Zealand First Aid Handbook, p. 27, (2009), ISBN 978-014-301187-3</ref><ref name="rf4" />

#*Avoid activities that may place a strain on the affected area and could re-open the wound. <ref name="rf11">https://myhealth.alberta.ca/health/aftercareinformation/pages/conditions.aspx?hwid=uf7580</ref>

#Monitor the puncture for infection. Minor puncture wounds should heal in less than two weeks. <ref name="rf12">http://www.uofmmedicalcenter.org/healthlibrary/Article/116454EN</ref> If you notice any of the following symptoms, seek medical assistance immediately:

#*Swelling in the neck, armpits or groin glands. <ref name="rf3" /> <ref name="rf13">http://www.nhs.uk/Conditions/Cuts-and-grazes/Pages/Introduction.aspx</ref>

#*The patient has never received a tetanus shot.<ref name="rf14">http://www.nlm.nih.gov/medlineplus/ency/article/000615.htm</ref> <ref name="rf15">http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Acute_Disease_Service/Disease_Information/Tetanus.html</ref>

*Be sure to watch for signs of infection around the wound site until it heals. Symptoms such as redness, swelling, throbbing, red streaks or pus  may indicate an infection.<ref name="rf16">http://www.mckinley.uiuc.edu/Handouts/wound_infection_symptoms.html</ref>