Is Your Child Sick? TM


Puncture Wound

Is this your child's symptom?

  • 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.

When to Call for Puncture Wound

Call 911 Now

  • Deep puncture on the head, neck, chest or stomach
  • You think your child has a life-threatening emergency

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

  • Minor puncture wound

Call 911 Now

  • Deep puncture on the head, neck, chest or stomach
  • You think your child has a life-threatening emergency

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

  • Minor puncture wound

Care Advice for Puncture Wound

  1. What You Should Know About Puncture Wounds:
    • Most puncture wounds do not need to be seen.
    • Here is some care advice that should help.
  2. 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.
  3. 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.
  4. 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.
  5. What to Expect:
    • Puncture wounds seal over in 1 to 2 hours.
    • Pain should go away within 2 days.
  6. 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

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

Disclaimer: This information is not intended 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.


Copyright 1994-2017 Schmitt Pediatric Guidelines LLC. All rights reserved.

Puncture Wound - BB Gun

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.

First Aid - Wound - How to Clean
  • 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.
First Aid - Removing a Splinter

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.
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