What should I do if I step on glass?

Management of Glass-Related Foot Injuries

If you step on glass, immediately clean the wound with clean water, apply pressure to stop bleeding, inspect for visible glass fragments, and seek medical attention for deep wounds, persistent bleeding, or if you suspect retained glass fragments.

Initial First Aid Steps

1. Assess the wound severity:

   • Check for active bleeding
   • Determine depth of penetration
   • Look for visible glass fragments

2. Control bleeding:

   • Apply direct pressure with a clean cloth or bandage 1
   • Elevate the foot above heart level if possible

3. Clean the wound:

   • Rinse thoroughly with clean running water 1
   • Use cold or lukewarm water (cold water is as effective as warm water) 1
   • Avoid soaking the foot in a bath 1
   • If running water is unavailable, use any source of clean water 1

4. Inspect for glass fragments:

   • Look carefully for visible glass pieces
   • Do not probe deeply into the wound
   • Leave deeply embedded fragments for medical professionals to remove

When to Seek Medical Attention

Seek immediate medical care if:

• The wound is deep (beyond superficial skin layers)
• Bleeding doesn't stop with pressure
• You suspect glass remains in the wound
• The wound shows signs of infection (increasing pain, redness, warmth, swelling)
• You have diabetes or peripheral neuropathy 1
• You have not had a tetanus shot in the last 5-10 years

Medical Management

Healthcare providers will typically:

1. Evaluate the wound:

   • Assess depth and structures involved
   • Check for neurovascular damage
   • Determine if imaging is needed

2. Imaging for glass detection:

   • X-rays are highly effective (98% sensitivity) for detecting radiopaque glass 1
   • Ultrasound may be used for non-radiopaque foreign bodies (90% sensitivity) 1
   • Deep wounds benefit more from imaging than superficial wounds 2

3. Glass removal and wound management:

   • Thorough cleaning and exploration 3
   • Removal of all glass fragments
   • Debridement of devitalized tissue if needed
   • Application of antibiotic ointment for superficial wounds 1
   • Sterile dressing application 3

Special Considerations

• Diabetes: People with diabetes should never walk barefoot, even indoors, due to risk of unnoticed injuries 1
• Retained glass: Glass fragments can cause complications including infection, delayed healing, persistent pain, and injury from migration 4
• Deep injuries: Glass can cause significant damage to underlying structures including nerves, blood vessels, and tendons 5
• Infection prevention: Cover wounds with antibiotic ointment and clean occlusive dressing 1

Follow-up Care

• Keep the wound clean and dry
• Change dressings regularly
• Monitor for signs of infection
• Avoid walking barefoot, especially while the wound is healing
• Seek immediate medical attention if you notice increasing pain, redness, swelling, or drainage

Glass-related injuries are common but can be serious. While superficial wounds can often be managed at home with proper cleaning and care, deeper wounds or those with suspected retained glass should be evaluated by healthcare professionals to prevent complications and ensure proper healing.