Do you have a puncture wound? Review
health risks that may make any symptom more serious.
This is a wound caused by a sharp, pointed object going through the skin. Puncture wounds are deeper and narrower than cuts.
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Why do we ask this question?
If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms. If your symptoms aren’t related to those organs, you can choose the gender you identify with. If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you. Do you have an eye injury?
Do you have an injury caused by a fish hook?
Do you have a deep wound in your head, neck, chest, or belly?
A deep puncture wound in any of these areas could damage the internal organs.
Yes
Deep puncture wound to head, neck, chest, or belly
No
Deep puncture wound to head, neck, chest, or belly
Are you having
trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain lasted for more than 8 hours?
Yes
Pain for more than 8 hours
No
Pain for more than 8 hours
Is the pain getting worse?
Have you been injected with something under high pressure, like oil or paint from a sprayer?
Yes
Injection under high pressure
No
Injection under high pressure
Is there a deep puncture in or over a joint?
A puncture that goes into a joint can be serious.
Yes
Deep puncture in joint area
No
Deep puncture in joint area
Do you have a wound on your arm, leg, hand, or foot that is more than just a scratch?
For an arm or leg wound, is the skin below the wound (farther down the limb) blue, pale, or cold to the touch and different from the other arm or leg?
This may mean that a major blood vessel was damaged and that blood is not reaching the rest of the arm or leg.
Yes
Skin is blue, pale, or cold below an arm or leg injury
No
Skin is blue, pale, or cold below an arm or leg injury
Can you move the area below the injury normally, even though it may hurt?
Yes
Able to move limb normally below injury
No
Unable to move limb normally below injury
For an arm or leg wound, is there any numbness, tingling, or loss of feeling around the wound or below the wound (farther down the arm or leg)?
This may mean that a nerve was damaged.
Yes
Numbness, tingling, or loss of feeling around or below an arm or leg injury
No
Numbness, tingling, or loss of feeling around or below an arm or leg injury
Do you think you may have a fever?
Are there red streaks leading away from the area or pus draining from it?
Do you have diabetes, a
weakened immune system , peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Have you been stuck with a used or dirty needle?
Yes
Stuck with used or dirty needle
No
Stuck with used or dirty needle
Is there an object stuck in the wound, and you can't get it out?
You may not be able to remove it because of where or how deep the wound is or because it causes severe pain.
Is the object large or small?
Large means things like a nail or piece of wood that is at least 5.1 cm (2 in.) long and anything bigger than that. Small means things like a pencil tip or a small splinter or sliver.
Large
Large embedded object
Small
Small embedded object
Did you have swelling or bruising within 30 minutes of the injury?
Yes
Swelling or bruising within 30 minutes of injury
No
Swelling or bruising within 30 minutes of injury
Has the swelling or bruising raised a lump that's more than about 4 cm (1.5 in.) across or deep? This would be bigger than a golf ball or Ping-Pong ball.
Yes
Lump bigger than golf ball or Ping-Pong ball
No
Lump bigger than golf ball or Ping-Pong ball
Do you have a puncture wound in your foot?
Yes
Puncture wound in foot
Did the object go through a shoe or boot?
An object that has enough force behind it to go through a shoe can cause serious injury to the foot. Puncture wounds in the sole of the foot also have a high risk of infection.
Yes
Object went through a shoe or boot
No
Object went through a shoe or boot
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
Your age . Babies and older adults tend to get sicker quicker.Your overall health . If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.Medicines you take . Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.Recent health events , such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.Your health habits and lifestyle , such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.Try Home Treatment You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Try home treatment to relieve the symptoms. Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner. Symptoms of infection may include:
Increased pain, swelling, warmth, or redness in or around the area. Red streaks leading from the area. Pus draining from the area. A fever. Pain in adults and older children
Severe pain (8 to 10) : The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.Moderate pain (5 to 7) : The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.Mild pain (1 to 4) : You notice the pain, but it is not bad enough to disrupt your sleep or activities.Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
Severe pain (8 to 10) : The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.Moderate pain (5 to 7) : The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.Mild pain (1 to 4) : The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
Diseases such as diabetes, cancer, heart disease, and HIV/AIDS. Long-term alcohol and drug problems. Steroid medicines, which may be used to treat a variety of conditions. Chemotherapy and radiation therapy for cancer. Other medicines used to treat autoimmune disease. Medicines taken after organ transplant. Not having a spleen. With severe bleeding , any of these may be true:
Blood is pumping from the wound. The bleeding does not stop or slow down with pressure. Blood is quickly soaking through bandage after bandage. With moderate bleeding , any of these may be true:
The bleeding slows or stops with pressure but starts again if you remove the pressure. The blood may soak through a few bandages, but it is not fast or out of control. With mild bleeding , any of these may be true:
The bleeding stops on its own or with pressure. The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes. Usually found in dirt and soil, tetanus bacteria typically enter the body through a wound. Wounds may include a bite, a cut, a puncture, a burn, a scrape, insect bites, or any injury that may cause broken skin. Tetanus can also happen with other infections, like dental infections. It can happen during a surgery or pregnancy and delivery.
A wound can be so small, you may not notice you have one. Or a skin blister could break and become an open wound. If there is any delay in finding or cleaning a wound, there is an increased risk for skin infection and a chance for tetanus to get in the wound. A tetanus infection can start 3 to 21 days after the bacteria enter the wound. Be especially careful about wounds on your fingers and toes.
Many people may not know when they got their last tetanus shot. So it's a good idea to call your doctor to see if you need one.
Make sure to stay up to date on your tetanus shots. A tetanus shot is recommended:
For a dirty wound that has things like dirt, saliva, or feces in it, if you haven't had a tetanus shot in the past 5 years.For a clean wound , if you haven't had a tetanus shot in the past 10 years.Symptoms of difficulty breathing can range from mild to severe. For example:
You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing). It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you're at rest (severe difficulty breathing). Seek Care Today Based on your answers, you may need care soon . The problem probably will not get better without medical care.
Call your doctor today to discuss the symptoms and arrange for care. If you cannot reach your doctor or you don't have one, seek care today. If it is evening, watch the symptoms and seek care in the morning. If the symptoms get worse, seek care sooner. Seek Care Now Based on your answers, you may need care right away . The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and arrange for care. If you cannot reach your doctor or you don't have one, seek care in the next hour. You do not need to call an ambulance unless: You cannot travel safely either by driving yourself or by having someone else drive you. You are in an area where heavy traffic or other problems may slow you down. Call 911 Based on your answers, you need emergency care.
Call 911 or other emergency services now .
Sometimes people don't want to call 911 . They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Call 911 Based on your answers, you need emergency care.
Call 911 or other emergency services now .
Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.
Sometimes people don't want to call 911 911
Eye Injuries
Fish Hook Injuries
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