From the Guidelines
If you step on a nail, immediately clean the wound with soap and water for at least 5 minutes to remove dirt and bacteria, as recommended by the 2015 American Heart Association and American Red Cross guidelines update for first aid 1. This initial step is crucial in preventing infection and promoting healing. After cleaning, apply gentle pressure with a clean cloth to stop any bleeding.
Key Steps in Treatment
- Once cleaned, apply an antibiotic ointment like Neosporin or Polysporin and cover with a sterile bandage, as wounds heal better with less infection if they are covered with an antibiotic ointment or cream and a clean occlusive dressing 1.
- Change the bandage daily or whenever it becomes wet or dirty.
- Monitor the wound for signs of infection such as increasing pain, redness, swelling, warmth, pus, or red streaks extending from the wound.
When to Seek Medical Attention
You should seek medical attention if:
- The nail was rusty
- The wound is deep
- Bleeding doesn't stop after 15 minutes of pressure
- If you haven't had a tetanus shot in the last 5 years, as a tetanus booster (Tdap or Td) is crucial if your immunization isn't current, to prevent serious complications from tetanus bacteria commonly found in soil 1.
Pain Management
For pain management, take over-the-counter medications like acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6 hours as needed.
Promoting Healing
Keep the wound elevated when possible to reduce swelling and promote healing. According to the 2010 American Heart Association and American Red Cross international consensus on first aid science with treatment recommendations, superficial traumatic abrasions should be covered with a clean occlusive dressing and/or a topical antibiotic that keeps the wound moist and prevents drying 1.
From the Research
Treatment Guideline for Stepping on Nail
- The primary concern when stepping on a nail is the risk of tetanus infection, which can be prevented through proper vaccination and wound care.
- According to the World Health Organization's (WHO) position paper on tetanus vaccines 2, tetanus toxoid (TT) vaccines are recommended to prevent tetanus.
- The WHO provides guidance on the optimal timing of recommended tetanus vaccine booster doses, which is essential for individuals who have stepped on a nail and are at risk of tetanus infection.
- The treatment guideline for stepping on a nail typically involves:
- Immediate cleaning and dressing of the wound
- Tetanus vaccination or booster shot, if necessary, as recommended by the WHO 2
- Monitoring for signs of tetanus infection, such as muscle stiffness, spasms, or rigidity
- It is essential to consult a healthcare professional for proper evaluation and treatment, as they can assess the risk of tetanus infection and provide guidance on the necessary course of action.