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First Aid: Punctures

A break in the skin is an open door, inviting dirt and germs to enter your body and cause infection.

1.  Clean Thoroughly

  • Gently squeeze small puncture wounds for a minute or two to encourage bleeding. This helps flush out any germs that may have been pushed inside the body.

  • Soak the wound in warm, soapy water to help the injury heal from the inside out.

  • Cover the wound with a gauze dressing to absorb any drainage and let air in for faster healing.

2.Stabilize Embedded Objects

  • If an object lodges in the body, apply direct pressure around the wound to control bleeding. (Wear gloves or use other protection as a barrier between you and any blood.)

  • Wrap gauze or cloth around the object to hold it steady. Tape the wrapping in place.

  • DON’T increase the risk of internal bleeding by trying to remove an embedded object.

Call 911 immediately if the victim has any of the following:

  • Uncontrollable bleeding

  • Shock symptoms:

    • The skin or the pink tissue inside the lower lip may turn pale.

    • The skin may feel cold and damp.

    • The pulse may be so light or race so fast that you can’t count the beats.

    • The victim may be confused or unable to concentrate or may stare blankly. Over time, the victim may even become unconscious.

  • A large object, such as a knife, embedded in the body

While you wait for help:

1 Reassure the person.

2 Treat for shock or provide rescue breathing or CPR, if needed.

Seek medical help if any of the following is true:

  • The wound covers a large area or is deep.

  • The ear or eye is punctured.

  • An object such as a nail remains lodged in the body.

  • The injury is on the face or any area where scarring is a concern.

  • The person needs protection against tetanus. This is a disease caused by bacteria that may enter any break in the skin and bring on a life-threatening illness called lockjaw. The body’s defenses may need a boost if it’s been more than five years since the last tetanus vaccination.
Publication Source: Lammers RL, Clinical Procedures in Emergency Medicine, 4th ed., Chapter 35 - Principles of wound management, 2004, pp 626-633
Online Medical Reviewer: Keyes, Linda MD
Date Last Reviewed: 6/1/2005
Date Last Modified: 6/1/2005