Urgent or Emergency Care?
If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.
Help Me Decide
- The skin is punctured by a pointed narrow object
Causes of Puncture Wounds
- Metal: Nail, sewing needle, pin, tack
- Pencil: Pencil lead is actually graphite (harmless). It is not poisonous lead. Even colored leads are not toxic.
- Wood: Toothpick
Complications of Puncture Wounds
- Retained Foreign Body (Object). This happens if part of the sharp object breaks off in the skin. The pain will not go away until it is removed.
- Wound Infection. This happens in 4% of foot punctures. The main symptom is spreading redness 2 or 3 days after the injury.
- Bone Infection. If the sharp object also hits a bone, the bone can become infected. Punctures of the ball of the foot are at greatest risk. The main symptoms are increased swelling and pain 2 weeks after the injury.
Call 911 Now
- Deep puncture on the head, neck, chest or stomach
- You think your child has a life-threatening emergency
Go to ER Now
- Bleeding won't stop after 10 minutes of direct pressure
- Puncture on the head, neck, chest, or stomach that could be deep
- Tip of the object broke off in the body
Call Doctor Now or Go to ER
- Puncture into a joint
- Feels like something is still in the wound
- Won't stand (bear weight or walk) on punctured foot
- Needle stick from used shot needle
- Sharp object or setting was very dirty (such as a playground or dirty water)
- No past tetanus shots
- Dirt in the wound is not gone after 15 minutes of scrubbing
- Severe pain and not improved 2 hours after taking pain medicine
- Wound looks infected (spreading redness, red streaks)
- Fever occurs
- You think your child has a serious injury
- You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
- Last tetanus shot was over 5 years ago
- You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
- You have other questions or concerns
Self Care at Home
Care Advice for Puncture Wound
- What You Should Know About Puncture Wounds:
- Most puncture wounds do not need to be seen.
- Here is some care advice that should help.
- Cleaning the Wound:
- First wash off the foot, hand or other punctured skin with soap and water.
- Then soak the puncture wound in warm soapy water for 15 minutes.
- For any dirt or debris, gently scrub the wound surface back and forth. Use a wash cloth to remove any dirt.
- If the wound re-bleeds a little, that may help remove germs.
- Antibiotic Ointment:
- Use an antibiotic ointment (such as Polysporin). No prescription is needed.
- Then, cover with a bandage (such as Band-Aid). This helps to reduce the risk of infection.
- Re-wash the wound and put on antibiotic ointment every 12 hours.
- Do this for 2 days.
- Pain Medicine:
- To help with the pain, give an acetaminophen product (such as Tylenol).
- Another choice is an ibuprofen product (such as Advil).
- Use as needed.
- What to Expect:
- Puncture wounds seal over in 1 to 2 hours.
- Pain should go away within 2 days.
- Call Your Doctor If:
- Dirt in the wound still there after 15 minutes of scrubbing
- Pain becomes severe
- Looks infected (redness, red streaks, pus, fever)
- You think your child needs to be seen
- Your child becomes worse
Care Advice for Puncture Wound
This photo shows a puncture wound from a BB gun in left upper arm. Note the small hole in the arm where the BB struck and entered the skin.
- Wash the wound with soap and water for 5 minutes.
- Gently scrub out any dirt with a washcloth.
- Cover the wound with a sterile gauze or a clean cloth.
- Apply direct pressure for 10 minutes to stop any bleeding.
You can remove splinters, larger slivers, and thorns with a needle and tweezers. Check the tweezers beforehand to be certain the ends (pickups) meet exactly. (If they do not, bend them.) Sterilize the tools with rubbing alcohol or a flame.
Clean the skin surrounding the sliver briefly with rubbing alcohol before trying to remove it. Be careful not to push the splinter in deeper. If you don't have rubbing alcohol, use soap and water, but don't soak the area if FB is wood (Reason: can cause swelling of the splinter).
Remove the splinter:
- Step 1: Use the needle to completely expose the large end of the sliver. Use good lighting. A magnifying glass may help.
- Step 2: Then grasp the end firmly with the tweezers and pull it out at the same angle that it went in. Getting a good grip the first time is especially important with slivers that go in perpendicular to the skin or those trapped under the fingernail.
The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.
Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
- You can have a conversation with your child's doctor.
- Your child's doctor can perform a physical examination and any necessary tests.
- Your child could have an underlying medical problem that requires a physician to detect.
- If your child is taking medications, they could influence how he experiences various symptoms.
If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!
And when in doubt, call your child's doctor NOW or go to the closest emergency department.
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