Yesterday,while doing some demolition, a nail punctured the skin on my forearm maybe 1/2 inch. Just a little blood and I continued to work after washing the wound and pouring on a little peroxide.
Does everyone always go and get a tetanus shot?
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How long ago did you have a tetanus shot--they last about five years, I think. Tetanus is pretty horrible, so I don't take chances, but tetanus is from a micro-organism in soil (though it is pretty much everywhere). Don't really get it from rusty nails. I'm not a doctor though, and if you are working much construction, it would be a good excuse to get one and be protected. Last time I wanted one just in case, the shots were being rationed (they had a shortage of the stuff) and I couldn't get one. They did let me have one later when I told them I was doing work in the Gulf Coast area after Katrina though, and then gave me the works--flu shot, tetanus, hepatitis and one or two others, just in case.
I think now that they're good for 10 years. With the work we do, I think it's a good idea to keep it current. Call your local Health Department, they can usually take care of it for you for a very minimal charge.
Horses carry tetanus. An open wound and exposure to horses can really hit you. I had a cousin that died as an infant from tetanus, which is "lockjaw". I was about 6 years old, but I remember . . . It wasn't pleasant.
Greg
pouring on a little peroxide.
Peroxide is not recommended for wound treatment - it damages viable flesh.
I disagree. I see the dermatologist A LOT. EVERY time they remove something suspicious,I am instructed to clean the wound with peroxide twice daily then cover with bacitracin and bandage. If peroxide destroyed viable flesh, my wounds would never heal.When I had surgery, Post op was peroxide and and antibacterial ointment and nothing else. If it's good enough to clean surgical wounds, I highly doubt it harms flesh.
Not a Doc here but I tend to agree with Woodturner here. Alot of my first aid training came from a rig nurse friend of mine and she says the same thing about destroying viable flesh. We use sterile wipes available at safety supply stores.
To the best of my knowledge a tetanus shot is good for 10 years. Going to call my Doc's office right now to make sure he has a shot on hand when I have my next visit as I am pretty sure mine has run out.
On a hill by the harbour
peroxide is a one time deal to "boil' out the dirt in small wounds...
Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming<!----><!----><!---->
WOW!!! What a Ride!
Forget the primal scream, just ROAR!!!
"Some days it's just not worth chewing through the restraints"
I follow the logic re:boil but I think a bit of research might be in order considering the downside which is peroxide actually burns the skin. There is a military medic that comes in to the pub and I will ask him for his take. There also may be a bit of what is SOP today may be taboo tomorrow. Tourniquets being a prime example. According to my rig nurse friend the biggest problem with them is that people are not trained to use them properly. If they are applied too tight it will kill the tissue because of lack of oxygenation whereas if they are applied properly the wound should ooze a bit then blood will flow to the extremity.
On a hill by the harbour
Tourniquets have fallen out of favor as a means of stemming arterial bleeding for a while in emergency medicine, because of toxins that build up in the appendage during the absence of blood flow....when blood flow is re-introduced to the affected area, it pushes the toxins into the rest of the body, effectively poisoning organs, leading to lots of complications unrelated to the original injury, like kidney failure. Direct pressure is now the accepted way to go.
just sayin......:)
Bing
All the neat stuff is going out of favor. Sucking out the poison from snake bites is now a no no. Must be hell to be a kid today.
We did have an old woman die of tetanus near here last summer. But people aren't dropping like flies and it is a nursable disease now. Not that I don't think it's a good idea to get the shots, but I don't lose sleep over it when it's been a few years.
Kinda depends on the wound. When I was 12 my Pop got his shoulder with a chainsaw. He lost 3-4 quarts _with_ a tourniquet in an arc around his torso. Then again, I had my foot clamping on top as well. We were in a rural area, and it was the better part of half an hour before the VFD got to us, and another half an hour to the hospital.
Edited 8/7/2009 7:39 pm ET by betterbuiltnyc
Being an old nurse we used to use so toxic stuff now the rule of wound care if you can't put it in your eye don't put it on a wound.
As I was taught if you put peroxide on a wound they will not stitch the wound, due to trapping dead flesh. Just like not closing a bite wound.In the OR were would flush wounds with saline 0.9% and lots of it. One old Doc packed wounds and operative areas with honey.Easy to make your own saline boil water, add salt, put in a clean container and label and date it..
Oral skin and outer skin are differnet so it apples and oranges comparing skin care.As for the tetanus get her done. Go to Public health and then it is documented and when the old brain gets foggy, it a phone call away.
3 1/2 inch nail right thru runner and foot and runner top, dancing on a slope trying to turn off chainsaw. While screaming for DW to come with hammer.
Somehow there is a country song in my mental picture of you dancing with a nail in your foot and chainsaw in your hand.
medical saline isn't sodium chloride is it? I'd think the chlorine would be hard on tissue. I have some special salts for making saline for nasal rinsing.
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I only know what I learned in high school about chemistry, but there would be no free chlorine in salt solution--sodium chloride dissolved in water is still sodium chloride. Otherwise the sodium would be a problem too. Maybe there are sodium ions and chloride (chlorine?) ions, but as far as I know, when the water evaporates, you have left as much salt as you had when you started, so if any of the components off gassed, that wouldn't be the case. Another salt I know of is potassium choride, and you'd have the same problem with that. I guess Epsom salts woul not have chlorine.
Yes, normal saline is sodium cloride.
John
sometimes they are cheaper at the county health department
Thanks for clarifying what I said before about tourniquets. My foggy memory had it as lack of oxegen but I asked a military field medic about it yesterday and the toxin build up is absolutley correct. Sometimes they are the only choice though..........
I also asked him about the peroxide thing and yes it is somewhat taboo nowadays. His advice was saline to flush the wound and of course we all have eyewash kits with a supply of sterile saline right?
On a hill by the harbour
If it's good enough to clean surgical wounds, I highly doubt it harms flesh.
I'm not that kind of doctor, but according to the MD's and the research, peroxide is no longer recommended for any kind of wound care. Not sure why your dermatologist would recommend peroxide. Maybe you can sue him for malpractice ;-)
http://www.medscape.com/viewarticle/456300
I can tell you I have a scar caused by using hydrogen peroxide to clean what would have otherwise been a minor wound. This occurred more that 30 years ago, and the bleaching and tissue damage caused by the peroxide is still significant.
These dental implants I got a few months ago were giving me problems shortly after. The implantologist (MD, DDS) instructed me to use a diluted (half and half) peroxide solution and a curved plastic end hypo syringe to wash out the debris in the pockets about the implant.
I haven't died yet. And the procedure seemed to work out quite well...
From Wikipedia (there's far more than this) :
Therapeutic use
Hydrogen peroxide is generally recognized as safe (GRAS) as an antimicrobial agent, an oxidizing agent and for other purposes by the FDA.[29]
Hydrogen peroxide has been used as an antiseptic and anti-bacterial agent for many years due to its oxidizing effect. While its use has decreased in recent years with the popularity of readily-available over the counter products, it is still used by many hospitals, doctors and dentists.
Like many oxidative antiseptics, hydrogen peroxide causes mild damage to tissue in open wounds, but it also is effective at rapidly stopping capillary bleeding (slow blood oozing from small vessels in abrasions), and is sometimes used sparingly for this purpose, as well as cleaning.
Hydrogen peroxide can be used as a toothpaste when mixed with correct quantities of baking soda and salt.[30]
Hydrogen peroxide and benzoyl peroxide are sometimes used to treat acne.[31]
Hydrogen peroxide is used as an emetic in veterinary practice.[32]
And I recall from my microbiology days that peroxide is used as a method to determine which staph's are peroxidase positive or negative. The bubbling one sees when the juice is applied to the colony is the breakdown of the peroxide into H2 and H2O. I'm thinking those aren't too awfully dangerous.
Well considering she's a Dr and you're somebody I've never met from the internet, I think I'll keep following her advice. Hard to say that in a non-offensive way, but I really mean none. You have piqued my curiosity though, so I will definitely ask her about it when I do see her. And I see her 2x a year so it won't be long. I once worked with an old timer that always told me to "stick it in cider". Never figured out what he meant till years later.
Well considering she's a Dr and you're somebody I've never met from the internet, I think I'll keep following her advice.
It's always wise to at least confirm information on the net - anyone can post anything. And, as I said, I am not an MD.
Did you at least stay at a Holiday Inn Express last night?
Now that was funny...holiday inn express. DBF and I laugh about that commercial.
Did you at least stay at a Holiday Inn Express last night?
Sorry, I think I missed it - I assume that is a reference to commercial or something?
yes it is.
I once drove a drywall screw through my finger (it came out through the fingernail).
Did not have insurance so I soaked it in peroxide for about two hours on an emergency room doctor's phone advice.
Healed like a charm, no infection or problems. I always have it in the house, heck I used to dilute it and gargle with it. Mike
Small wheel turn by the fire and rod, big wheel turn by the grace of god.
As you need a login to view that info, do you mind copy/pasting it here?
Tu stultus esRebuilding my home in Cypress, CAAlso a CRX fanatic!
Look, just send me to my drawer. This whole talking-to-you thing is like double punishment.
As you need a login to view that info, do you mind copy/pasting it here?
I didn't need a login to view it, they must not allow links directly to their articles.
If you click the link I posted, then click on WebMD articles and search, you can get to the paper I cited (without needing a login).
Nope - I think you have a cookie that the site recognizes. I did the search, found the link to the article, but when I click it I get the log-in page.
Tu stultus esRebuilding my home in Cypress, CAAlso a CRX fanatic!
Look, just send me to my drawer. This whole talking-to-you thing is like double punishment.
Hydrogen peroxide:I used it for years.............. even kept a bottle in the shop to wash over cuts and scrapes as an antiseptic. couple of years ago I was in the ER getting a bad cut stitched up. Asked the ER doc about hydrogen peroxide. He said it was a bad idea for the same reason others have mentioned.Best treatment: stop bleeding first (pressure), run water over cu(t if possible) to irrigate and wash any debris in wound, then use soap and water to clean wound. OK to apply antibiotic salve once would is dry.********************************************************
"It is what we learn after we think we know it all, that counts."
John Wooden 1910-
"... even kept a bottle in the shop to wash over cuts and scrapes as an antiseptic."Similarly, I keep a bottle of Jack Daniels in the shop "to use as antiseptic".It also works very well as a pain relieverDC
With all due respect to your dermatologist... There is a wealth of literature available for both surgery as well as wound healing that many commonly applied ointments, salves and "feel good" items are in fact damaging to healing tissues. Unfortunately the response it is good enough for my dermatologist is a logical fallacy, sort of like "billions and billions sold, everybody is doing it etc. The arguement that the bubbles mean it is killing "jimmie germs" is bogus. It is merely a reaction of the peroxide H2O2 with the metal ions in your tissues. This is why it also fizzes when you put it on a drop of blood on your clothes and can be used to remove fresh blood stains.
I would suggest your dermatologist just wants the wound kept clean or perhaps that was how he or she was trained. Those of use who teach teh new crop of physcians on a day to day basis understand the answer to the question "why do we do it that way ? " is not because that is the way we have always done it."
Current literature suggests keeping wounds clean dry. If you need to clean something mild soap and water works just fine. Curiously enough the current fear of the dreaded bacteria from the dark side or the moon, Uranus or some other planet is just that a story. This has driven a great cottage industry in Neosporin (now available in a handy purse carried spray for the uber neurotic), other salves, ointments etc. Does anyone remember Bactine? Methiolate? Isodine?
If the wound is created in a dirty environment wash it out. Puncture wounds are tough to clense to their depths. Let it bleed some try to get all the dirt and other crusty stuff out. When in doubt let a doc check it out!
I still use Bactine--one of the best things for certain uses--it is mildly anesthetic and it tastes good besides! Remember "ST-37"? That was good for teething (been a while since I've needed it for that though). I still use Povidone Iodine--it doesn't stain. One of my faves for local aneshesia when removing slivers, lancing boils and so on is Chroraseptic, which also has carbolic acid to kill germs. My doctor frowns on my doing "home surgery" and laughed when I told him that my X-acto knife usually worked well. He told the nurse to hand him his "number 11 (?) blade" and said he thought is was a little better than an X-acto knife. I saw his point right away (just before I fainted (just kidding)).
I would no longer use merthiolate, unless you don't think you're getting enough mercury in your diet! I get enough in my flu shots!
Edited 8/9/2009 3:18 pm ET by Danno
AHH the blasts from the past. Goes to show we are so well designed the even misplaced technology can not hurt us too much.
"Does everyone always go and get a tetanus shot?"
Depends if my mother in law finds out. She is a nurse and I tried the "it's good for 7 (at the time) years and I'm on year 5". Didn't go over too well, lol.
She and my doc said, "they are good for 10 years but generally for incidental scratches and unknown risk".
If you got poked after a year I would get one again or at least call my doc, clinic or doc in the box to be sure. After 5 years I wouldn't hesitate.
I musta had 5 tetanus shots even before I was 20 YO when Mom and Pop had the say. Probably had 5 since then.
They all hurt like h3ll for a few days.
last one I got was about 15 years ago, been cut plenty since then, including a 20d all the way into the femur (pulled it out with a crowbar) and a 12d ring shank all the way thru my palm (always wondered what it felt like to Jesus, wasn't too bad actually). Had to pull the ring shank with claw hammer.
Stepped on more that a few nails in the last 15 also.
Guess by this time I'm done with tetanus shots.... own theory is that after 10 of them it's good for 100 years <G>
12d ring shank all the way thru my palm (always wondered what it felt like to Jesus
I think they used a little larger spike for that, and he kind of hung off of it ;-)
If you were able and willing to hang from a 12d through your palm, I'm really, really impressed.
BTW, scholars believe that the spikes used to crucify Jesus were actually nailed through the wrist, not the palm - the palm doesn't have enough strength to support the body in that way.
Lots of historians or whatever pretty much agree that crucifixions involved nailing more through what we would call the wrist just above the palm. Usually damaged the nerves there, so I would imagine it hurt a lot--not to mention you probably weren't hanging half the weight of your body from the nail! Just saying....
Edit: I see two others already told you the same thing. Never mind!
Edited 8/7/2009 3:33 pm ET by Danno
Tetnus boosters are good for 10 years now.... if you can't remember your last one your probably due.
I got one 18 months ago when I stepped on a nail doing some demo work. I made an appointment with the Doc to get a shot.
I told them I just wanted a tetnus shot.... no problem with wound care.
Went in the next morning to get my shot.... 5min later I'm at the front desk paying my bill.
$95....... I was po'd at the sticker shock.....said they had to charge a Dr, visit even though I just barely said hello to him in the lobby.
Bit my tongue
Wrote a check
Sulked off.
All that said to reiterate what someone said earlier about going to the health unit and not getting charged thru the nose.
My last tetanus shot was about 10 years ago when I stepped on a rusty nail.
How'sever, bout a week later, my calf started swelling and became sore. The doc sent me in for a ultrasound and they found lots of tiny clots throughout the calf.
Had to rest and take it easy for a while...
If I got a Tetnis shot everytime I hurt myself, I wouldnt be able to work. :>)
Let us know how it turns out.
Family.....They're always there when they need you.
The last time I got a tetanus shot for an on the job injury there was a debate/discussion between the safety rep and the nurse about whether a tetanus shot was neccesary/did any good anymore.
The consensus of opinion was that a tetanus shot is not any use any more, the last case of it was over a generation ago, but that it wouldn't hurt.
I went ahead and got the shot cause it was free, I was already there anyway, and it probably wouldn't hurt anything to get it, but from what I heard tetanus shots are unneccesary now.
As I said in my post, we had a woman nearby die of it last year. It's still around. Whether it's a major problem is another question.
Last I looked, the average number of cases of tetanus is about 40 per year in the US, with about 10% fatality. Most cases are due to underimmunization. If anyone in the medical field told you that tetanus vaccine is no longer needed, they should lose their license. The reason we have such a low incidence is because of the vaccine. The bacteria (Clostridium tetani) is still present in the same numbers as it was a century ago. This is not an illness that can be obliterated by vaccine such that we can safely go back to the unvaccinated state (such as with smallpox).
The vaccine protects for about ten years, but if there is a contaminated wound, the recommmendation is to reimmunize if it has been 5 years since the previous vaccine.
John
Edited 8/9/2009 12:19 am ET by kiddoc
"Last I looked, the average number of cases of tetanus is about 40 per year in the US, with about 10% fatality. Most cases are due to underimmunization."
It would be interesting to know what the immunization rate of the US population against tetanus is. Even at a wildly optimistic rate of 80%, you are only looking at 1 in 17 million chance of dying if you are not immunized. And given that the fatalities among those infected are invariably those with compromised immune systems, it really isn't that big a deal.
Unless you're the one that gets it.
John
No from the descriptions I've heard I can't say I'd be all that keep on having tetanus, but from a public health standpoint it seems like a fairly low risk compared to even bee stings and Frisbees.
But that is because we have done a really great job of vaccinating. If you look at the incidence prior to 1940s (when we got the vaccine) compared to now you will realize the importance.
John
You should probably read up a little more and check your sources for veracity
Welcome to the Taunton University of Knowledge FHB Campus at Breaktime. where ... Excellence is its own reward!
good Lord, No! I'd be getting a shot every week!
A tetanus shot is good for ten years, so if it's been quite a while, get updated whether you have a hole in your arm or not.
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Taunton University of Knowledge FHB Campus at Breaktime.
where ...
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Tetanus prophylactic recommendations haven't changed for decades: Once every 10 years--UNLESS you have a "tetanus prone" wound, in which case you need the shot if it's been more than 5 years since you've had one. What constitutes "tetanus prone" is a little trickier but generally it needs to be a cut/puncture from something that had been in the soil. So, for instance, if you puncture yourself with a rusty nail in an attic, you don't need to worry about it from a TETANUS standpoint.
And, IMO, Wikipedia is a wonderful resource but it wouldn't be my first stop for medical information.
So, for instance, if you puncture yourself with a rusty nail in an attic, you don't need to worry about it from a TETANUS standpoint.
Um, doctors have stated for decades that if you are injured by a rusty metal object you should get a tetanus shot. Doesn't really matter if it has been in the ground or not.
<Um, doctors have stated for decades that if you are injured by a rusty metal object you should get a tetanus shot. >Undoubtedly there are still some out there that do say that but that doesn't make them right. OWT! Knowledge changes. Remember, it wasn't that long ago we thought that after a heart attack the patient needed to stay flat on his back, in bed, for weeks. ;-)
Never.