Nail in Foot (ER)
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Comment| Wednesday, July 30th, 2008 | Emily Halevy | CWK Producer |
“Even though it’s a little more dangerous to have a nail go through your [sneakers], it’s certainly less dangerous in the long run to wear shoes to avoid getting your feet cut…shoes usually prevent more injuries than cause injuries.”
– Kathleen Nelson, M.D., professor of pediatrics
“So what brought you to the hospital today, Marvin?” asks Dr. Kathleen Nelson as she walks into the hospital room.
He was playing on his grandmother’s back porch when he stepped on a rusty nail explains Marvin’s mom.
“When we looked at his foot there was a clear area around the puncture wound that looked like there was some infection in there,” says Dr. Nelson. “And so what I see here is a little redness right around where it entered and I see a streak up your foot,” she explains to Marvin.
“Were you wearing shoes when you were stepping on the nail?” Dr. Nelson asks. Marvin nods his head yes.
But they weren’t just shoes, Marvin was wearing sneakers and that can be a problem. “We do particularly worry about nails that go through sneakers. Because the foam sole of the sneaker seems to be a good breeding ground for another kind of germ…pseudomonas,” explains the doctor, “which can lead to infection in the bone.”
For now the treatment is simple and predictable- a tetanus shot and antibiotics in case of a staph or strep infection.
“But we want you to be very careful and watch him closely over the next week to ten days, because if he should develop increasing pain or if his fever doesn’t go away, or if the foot starts hurting more or swelling more, we need to see him again…and we’d have to treat that with something stronger than the medicine we’re gonna give him today…” warns Dr. Nelson, “hope you feel better.”
Tips for Parents
For most children, a trip to the doctor for a shot is a nerve-wracking experience. It is, however, a necessary step to prevent particular diseases and illnesses. This is especially true for Td booster shots, which protect individuals from two serious diseases – tetanus and diphtheria. Your child may be given a tetanus shot if he/she has stepped on a nail or been cut handling a rusty object, especially if it has been over five years since the last shot. Experts recommend getting a booster shot every 10 years throughout an individual’s lifetime. So what is tetanus? Experts at Caring for Kids have developed the following list of facts regarding the disease:
- Tetanus is commonly known as lockjaw.
- It is caused by germs (bacteria) that live in dirt and dust.
- If the tetanus germ gets into an open cut on the body, poison from the germ can spread to the nerves and then into the muscles. Muscles may lock in one place or go into spasm (get very tight), which is very painful.
- In most cases, the first muscles affected are in the jaw. Infected individuals may not be able to swallow or open their mouths.
- If the poison gets to the muscles that help the breathing process, suffocation is a very real possibility.
- The main treatment for tetanus is drugs (antibiotics) to kill the germs. Drugs to control the muscle spasms are also available.
- People who survive tetanus may have long-lasting problems with speech, memory and thinking.
- People who survive can still get tetanus again. For this reason, they should get the vaccine to protect them in the future.
If you believe your child is at risk for developing tetanus, contact your physician immediately. According to experts at the Children’s Hospital of Pittsburgh, your doctor will prescribe treatment for your child based on:
- Your child's age, overall health and medical history.
- The extent of the disease.
- Your child's tolerance for specific medications, procedures or therapies.
- The expectations for the course of the disease.
- Your opinion or preference.
Treatment for tetanus may include:
- Medications (to control spasms).
- A thorough cleansing of the wound.
- A course of tetanus antitoxin injections.
- A tracheotomy (a breathing tube inserted surgically in the windpipe) in severe cases where respiratory problems are present.
References
- Caring for Kids
- Children’s Hospital of Pittsburgh
- KidsHealth
