This is kinda embarrassing… It’s such a small thing and really I get small nicks etc on the job probably at least weekly. This is something is a little unusual though. Anyway I shot a small staple into my hand – the fleshy part between the thumb and forefinger. A 3/8” T-50. To tell you the truth I didn’t even realize I had done it until a few minutes later when I saw the staple and just pulled out and discarded it. There was little bit of blood so I just sucked it off (kind of gross I know but as far as I know SOP for a job site) and kept working. Not really another thought about it. Then this morning, less than 18 hrs after the fact I notice the area up above the two little puncture marks is turning red. An area about 1.5: in diameter. Seems kinda fast for that to happen… Again, I’m used to little bumps and burses but this just seems a little weird. My first thought was to ask the wife but knowing her – bless her heart – she’d probably have an ambulance sent to site to pick me up and I’d end up with a $2000 medical bill.
I’ve herd some scary stories about blood poisoning and the like. I called my dr’s office and they said I had a tetnus shot (actually a T-DAP whatever that is – some kind of combination shot) in March 03…
Thoughts?
Replies
It's probably a minor infection that can be treated with some antibiotic ointment (polysporin) and a bandaid. Left untreated though and it could grow.
I said PROBABLY. Hopefully it isn't anything worse.
Good luck.
You do not want a serious hand infection
1. Time for a tetanus booster. The last time I checked, they are recommended every 10 years unless you have an injury such as the one you describe, in which case a booster is recommended if your last one was more than 5 years ago. T-DAP probably stands for Tetanus-Diphtheria And Pertussis (whooping cough)
2. Puncture wounds seal off quickly, and are impossible to clean or get oxygen into. They are prime candidates for infection.
3. If a hand infection is allowed to get out of control, it quickly gets into tendon sheaths, joints, and bones - whereupon the only effective treatment is surgically filetting open the hand, washing everything out, and leaving it open with a drain for a few days to a few weeks with regular irrigation and antibiotics. Oh, and yes, the medical bill will knock you out.
All of which could usually have been prevented by going to the ER for antibiotics at the first sign of greater-than-usual inflammation.
BTW, I know everyone does it (me, too), but human saliva is about the worst thing you could put into a wound. "Human bite wound, hand" (AKA a punch in the mouth) = automatic antibiotics in the ER even if there are no signs of infection, and through an IV if there are.
Rebeccah
I don't know what the heck is
I don't know what the heck is wrong with the reply feature, that it won't let me put spaces between my paragraphs. I don't remember it behaving this way before.
Rebeccah
I've had a couple
of finger/thumb infections that almost got away.
One was a slit on the outside of a knuckle from the edge of some metal cornerbead. I probably washed it a little and put a bandaid on it. A few days later it had closed up but then it got very red and sore. I went to the doctor. He was a no-nonsense type, he grabbed it with both hands and used his thumbs to yank it open. I hollered, he said sorry, he proceeded to rinse it out and bandage it, I took a round of antibiotics, that was that.
More recently I got a tiny splinter in the tip of my thumb while doing demo in a 100 y/o building. Thought nothing of it. Late that night it was kind of sore, first thing in the morning it was swelling like a grape. Went to the doctor, he said you are about four hours from going to the hospital in a helicopter, you should have called me in the middle of the night. Antibiotics reduced the swelling and it recovered.
I have found that soaking fingers/hands in warm water loaded with epsom salt makes a lot of difference. I do this immediately if I get a significant cut or puncture, ideally the wound is still bleeding.
Sorry, a little bit disgusting, but you need to take this stuff very seriously.
Thanks for the replys.
After making the post I scheduled with the Dr's office to get a tetnus shot. It's tomorow 0900 AM.
The redening has darkened and spread a little. The odd thing is that the discoleration is not directly at the site of the wound, but rather up the hand a bit.
I am a 30 year veteran of Emergency Medicine.
Tetanus is not the likely culprit and the tetanus booster is not the answer. I would normally go 10 years between shots unless this is a high risk wound ie. soil contaminated puncture wound.
Sounds like you do have a cellulitis. Your description of the first web space is somewhat reassuring. The worst hand infections involve the joints and tendon sheaths and that is not what you are describing. Nevertheless, hand infections can be serious, but shame on the doctor mentioned above for saying helicopter transport may have been necessary. That's overheated drama. Flexor [the palm side] infections are worse than extensor [back of the hand] infections.
The redness and red streaks are NOT "blood poisoning". They are an indication of infection and inflammation ascending the lymph chanels. Serious but NOT in the blood stream.
My past expereince on this site tells me many participants are self insured, have high detuctibles or have no insurance. I had a guy the other day who had a bad mitre saw injury exposing his thumb extensor tendon. The registration clerk told him if he paid cash the day of treatment, the hospital would give him a 60% discount and 50% if he paid in one week. I think that is excellent and you should ask for the same type of deal if you find yourself in the ED.
Topical antibiotics are pretty much window dressing and 20% people may develop allergies to the neomycin in Neosporin.
The day after my first post I went to the doctor. He perscribed antibiotics and a tetunus shot as a precaution. He said that based on my line of work <10 year intervals for the tetnus-combo shots wasn't a bad thing.
"shame on the doctor mentioned above for saying helicopter"
I live on an island, there is no hospital here, you get flown if you need to go there unless you can take your sweet time. By the time the Doc was looking at my thumb it looked like hell and felt worse. He's a 30-year guy himself and not much for drama, so I tend to follow his advice.
injury
thats exactly where I shot myself with a framing nail a couple months ago. Stupid. I was bounce firing the tool, and on one shot I tripped and the nose of the tool hit something and it was pointing at my left hand. So there is my left hand with an inch of nail sticking out of it. It wasn't a shiny new nail either. I forgot to buy nails for this job, so I had to scavenge anything I could find. The tool was loded with rusty, ring-shank, god knows how old, with dried on pl 400. I pulled it out, walked over to the dumpster and kicked it a couple times, then asked a co worker to take me to emergency care. He looks at it and goes" thats nothing". I get exray(didn't hit bone), a prescription for peniccilin, and a bandage and get sent back to work.
When I went to get the prescription filled that evening, there was someone trying to commit suicide. Just when I handed my presciption to the phamacist, his phone rang, on the other end was somone asking him about how many pills to take to take care of his worries. He was on like three diffearant phones, one with the police, one with the guy, one with 911, AND trying to fill my presciption at the same time!
Think about it!
that flesh eating bacteria is on the spread, and people's immune systems are not what they used to be, from individual aging, pollution, and over-reliance on anti-biotics, while the bacteria have been bred stronger.
Just two days ago, I was shopping for light bulbs and cleaning products in the local Lowes. Someplace between going into the store and loading the booty into the car, I got a scratch close to 2" long. Not deep enough to produce a drop of blood, but by the time we had driven a few miles, I had purple on both sides of it 1/4" out and it was burning. I scrubbed it down with the alcohol based anti bac hand wash stuff in the console ( swine flu preventive stuff...) while driving, 5then treated it again better when we got home. Next AM, it was angry red 1/2" either side and a red spot further up. I really scrubbed hard this time and applied that orange stuff they use in the hospital. It looks normal now, but I pay attention to this stuff, having had cellulitis twice now, and one of the variables in Mom's death was MRSA
The ones that don't bleed don't get flushed out clean from the inside and are more susceptible.
Sounds like an allergic reaction to me.
or other inflamation -
like iritated from pesticides or something like that