First aid: Puncture wounds

A puncture wound doesn't usually cause excessive bleeding. Often the wound seems to close almost instantly. But these features don't mean treatment isn't necessary.

A puncture wound — such as from stepping on a nail — can be dangerous because of the risk of infection. The object that caused the wound may carry spores of tetanus or other bacteria, especially if the object has been exposed to the soil. Puncture wounds resulting from human or animal bites, including those of domestic dogs and cats, may be especially prone to infection. Puncture wounds on the foot also are more vulnerable to infection.

If the bite was deep enough to draw blood and the bleeding persists, seek medical attention. Otherwise, follow these steps:

1. Stop the bleeding. Minor cuts and scrapes usually stop bleeding on their own. If they don't, apply gentle pressure with a clean cloth or bandage. If bleeding persists — if the blood spurts or continues to flow after several minutes of pressure — seek emergency assistance.
2. Clean the wound. Rinse the wound well with clear water. Use tweezers cleaned with alcohol to remove small, superficial particles. If debris still remains in the wound, see your doctor. Thorough wound cleaning reduces the risk of tetanus. To clean the area around the wound, use soap and a clean cloth.
3. Apply an antibiotic. After you clean the wound, apply a thin layer of an antibiotic cream or ointment such as Neosporin or Polysporin to help keep the surface moist. These products don't make the wound heal faster, but they can discourage infection and allow your body to close the wound more efficiently. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment.
4. Cover the wound. Exposure to air speeds healing, but bandages can help keep the wound clean and keep harmful bacteria out.
5. Change the dressing. Do so at least daily or whenever it becomes wet or dirty. If you're allergic to the adhesive used in most bandages, switch to adhesive-free dressings or sterile gauze and hypoallergenic paper tape, which don't cause allergic reactions. These supplies are generally available at pharmacies.
6. Watch for signs of infection. See your doctor if the wound doesn't heal or if you notice any redness, drainage, warmth or swelling.

If the puncture is deep, is in your foot, is contaminated or is the result of an animal or human bite, see your doctor. He or she will evaluate the wound, clean it and, if necessary, close it. If you haven't had a tetanus shot within five years, your doctor may recommend a booster within 48 hours of the injury.

If an animal — especially a stray dog or a wild animal — inflicted the wound, you may have been exposed to rabies. Your doctor may give you antibiotics and suggest initiation of a rabies vaccination series. Report such incidents to county public health officials. If the bite is from someone's pet, it's important to contact the pet owner to confirm the animal's rabies immunization status. If unknown, the animal should be confined for 10 days of observation by a veterinarian.