Puncture Wounds & Nail Gun Injuries
A puncture wound is a small hole made by a pointed object like a nail, screw, staple, wire or tool tip. It may not look serious, but it can go deep and carry dirt and germs into the body. Nail guns send nails fast enough to go through bone, which is why they cause so many construction injuries.
- Construction
- Carpentry
- Home
Call 911 right away if
- The object went into the head, neck, chest, abdomen or groin
- It’s in the eye or near the spine
- There’s heavy bleeding that doesn’t stop with pressure
- The person has trouble breathing, is confused, or loses consciousness
- The object is large or deeply embedded
Embedded objects: do not pull them out
- Don’t remove a nail, screw or other object that is stuck in the body, especially in the head, chest, abdomen or neck. It may be plugging a blood vessel, and pulling it out can cause severe bleeding or more damage.
- Don’t push it further in or wiggle it.
- Don’t cut a nail’s head off with a tool unless a trained responder directs you to.
Instead:
- Keep the person still and calm.
- Stabilize the object with bulky dressings or cloth around it so it doesn’t move.
- Apply pressure around, not on, the object to control bleeding. See Bleeding Control.
- If a nail gun is still attached to the person, disconnect the air hose or battery before doing anything else.
- Wait for emergency responders.
Minor puncture wounds (small, no object left in)
- Wash your hands, then control any bleeding with gentle pressure.
- Rinse the wound with clean running water for several minutes. Clean the skin around it with soap and water.
- Look for pieces of the object or debris. If something remains, don’t dig for it; get medical care.
- Cover with a clean bandage and change it daily.
- Watch for infection: increasing pain, redness, swelling, warmth, pus, fever or red streaks. See a doctor if they appear.
See a doctor for
- Any wound from a nail gun or high-pressure tool, even if it looks small
- A deep puncture through a boot or shoe, which can carry germs into the foot
- A wound with dirt, rust or an unknown object
- A wound over a joint, bone or the hand
- Animal bites, which need extra care. See Dog Bites & Animal Attacks
- Any wound if your tetanus shot isn’t up to date
Tetanus bacteria live in soil and rust, and can cause a dangerous infection. Health agencies generally recommend a booster if your last shot was more than 5 years ago for a dirty wound (10 years for a clean one). Ask a doctor.
Nail gun injuries
Nail guns cause tens of thousands of emergency room visits each year in the U.S. Most injuries are to the hands and fingers, followed by the legs and feet, and some are fatal. Common causes are nails that go through the wood and out the other side, ricochets, and accidental firing.
- Use a sequential trigger (single-shot) tool instead of a contact (bump) trigger. Studies show sequential triggers cut injuries substantially. See Nail Guns.
- Keep your hands and body away from the nail path, and never point it at anyone.
- Disconnect the air or battery when clearing jams, carrying the tool up a ladder or walking on a roof.
- Wear safety glasses and follow the manufacturer’s instructions.
- Don’t hold the work with your hand near where nails will go.
Report it
Report any puncture wound at work to your supervisor, and file a first aid or injury report. See Incident Investigation.
Standards & references
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