HELP...my unvaxed son stepped on a nail

[darlintxmomma]

my almost 4 year old unvaxed son just stepped on a rusty nail in the dirt out in our backyard. my hubby just replaced our back fence cause it was rotten and this nail must have hidden when he was cleaning up. its a nice puncture wound but i cant tell how deep it is but he did bleed for a short bit. no gushing or anything but enough that i had to wipe up a glob of blood from the floor when he put his foot down. do i need to take him in. as much as i hate the thought and know that bleeding is a good thing when it comes to this situation, he didnt bleed very long. is that still gonna be enough to keep him from getting tetnus?
is there anything else i can do to prevent infection? i sprayed him down with bactine (his magic spray cause of the lidocaine).
please help. i need advice and reassurance.

[Gitti]

As long as it bled there was enough oxygen where I would not worry about it. I would wash it out with H2O2 a few times and that's about it.

I came back to say it doesn't have to bleed 'long'- just a drop or two to show that oxygen is in the area. Blood is loaded with oxygen.

Personally I would not take him into the ER nor to a doctor. Tetanus has never been a concern for kids. Only for old people and most of them only if they are diabetic. The reason is because kids have a quick blood supply. Someone old probably wouldn't have bled at all.

[darlintxmomma]

thanks.....i just wasnt sure if it should have been gushing blood to be safe. ill clean it good with peroxide when he wakes up. he exhausted himself crying and passed out.

[knucklehead]

Just be careful using hydrogen peroxide on a puncture wound. Abcesses can form because the hole becomes blocked from the byproducts of the reaction of the H2O2 and blood.

[umsami]

In this case, I would definitely call your pediatrician. Also read up on tetanus, so you know what to be on the lookout for.
http://en.wikipedia.org/wiki/Tetanus

[MayBaby2007]

Originally Posted by umsami

In this case, I would definitely call your pediatrician. Also read up on tetanus, so you know what to be on the lookout for.
http://en.wikipedia.org/wiki/Tetanus

Won't most ped's flat out recommend a tetanus shot though? Mine would for sure.

I cut my finger on a broken window last year and went in for stitches. The ER docs were shoving a tentanus shot at me--for a cut from a window.

I trust them (docs) like I would trust a Cobra.

[burke-a-bee]

I would also add some raw honey to it.

[Viola]

Originally Posted by MayBaby2007

Won't most ped's flat out recommend a tetanus shot though? Mine would for sure.

Yes, but I think she is saying to be on the lookout for the symptoms of tetanus, and weigh the risks vs. the benefit of a tetanus vaccination.

[umsami]

Originally Posted by MayBaby2007

Won't most ped's flat out recommend a tetanus shot though? Mine would for sure.

I cut my finger on a broken window last year and went in for stitches. The ER docs were shoving a tentanus shot at me--for a cut from a window.

I trust them (docs) like I would trust a Cobra.

That might not be the first step... it would depend on the ped. They may do the spatula test or some other such thing. They may do metronidazole or whatever. But in this case, if tetanus really seemed likely, then yes... I would get the vax. It's no longer a theoretical my child may someday be exposed to some random illness... or even to a unlikely to be fatal illness. Tetanus really has the potential to kill a child. Not just a random 1 in a million shot.

[Tracy]

Here are the hard numbers for 2007. This is what I found for the last week of the year..... this is the total amount of cases reported to the CDC for 2007.....

Total reported cases to the cdc:

Disease Cases

Diptheria 0
Measles 28
Mumps 707
Rubella 12
Congenital rubella 0
Tetanus 19
Hib (under 5)
Sero b-17
Non sero b-141
Unknown b-187


out of 300 million people.

http://www.mothering.com/discussions...ad.php?t=57794

[Gitti]

so, how's your LO? I suspect he is fine and already on the mend.

Honey on the wound is a great idea. I forgot about that. Next time I'll suggest honey instead of H2O2.

[Baby_Vol]

What does honey do, out of curiosity?

I have an un-vaxed 12 month old ....tetnus is the only thing I do worry about at times.

H2O2 is just peroxide, right?

[umsami]

Originally Posted by Baby_Vol

What does honey do, out of curiosity?

I have an un-vaxed 12 month old ....tetnus is the only thing I do worry about at times.

H2O2 is just peroxide, right?

Honey is used in wound care for its antibacterial properties. Some types of honey are effective against MRSA and other tough to treat infections.

H202=hydrogen peroxide

Symptoms for tetanus show on average 8 days after exposure...so keep that in mind. Mortality rate is 25%.

[Gitti]

Originally Posted by umsami

Symptoms for tetanus show on average 8 days after exposure...

In a very, very small percentage of injured. Mostly in the elderly with diabetes. It is not a risk for kids. Never had been. It is nothing to worry about, really.

[luminesce]

Originally Posted by Tracy

Here are the hard numbers for 2007. This is what I found for the last week of the year..... this is the total amount of cases reported to the CDC for 2007.....

Total reported cases to the cdc:

Disease Cases

Diptheria 0
Measles 28
Mumps 707
Rubella 12
Congenital rubella 0
Tetanus 19
Hib (under 5)
Sero b-17
Non sero b-141
Unknown b-187


out of 300 million people.

http://www.mothering.com/discussions...ad.php?t=57794

This is interesting, but not really relevant since you don't know how many people were unvaccinated. In unvaccinated children, I believe there were about 15 cases across an eight year span according to one study I read. Again, though, I'm not sure how many children were unvaccinated. If you look at uptake rates, you can probably get a general idea. Statistically, it appears that there is more of a risk if you are not vaccinated. However, I also believe that it is still rare in either group of individuals.

All that said, a puncture wound does greatly increase your risk. Personally, I'd be worried but I have no idea if I'd request the TIG or not (it is a blood product which carries risk.) We'll probably consider the vaccine around age 5-7 (maybe 7 so we can get the Td) because I'm not sure I want to be in this position. I stepped on a rusty nail when I was a kid too.

[DocJenn]

I've heard that garlic oil and oregano oils have good antibacterial properties.

And I find it curious that the CDC states 19 people have contracted tetanus in 2007. (Tetanus, I believe, is not a reportable disease....meaning that if you get tetanus, your doc does not have to report it to the health dept). However, in the CDC vaccine information sheet that I must give out to each of my patients, it states 'Tetanus leads to death in about 1 out of 10 cases". I believe (but don't quote me) they are also counting the deaths from tetanus of infants in 3rd world countries. And if you do a little more digging, of the 19 cases in the US, the vast majority of the people didn't know where they contracted it.

Makes ya wonder.....

[Symbi]

DocJenn,
What is your conclusion from the info that the vast majority didn't know where they contracted it? To me this seems a little more alarming--so my child could contract tetanus without even a visible wound?
Thanks.

[DocJenn]

I have no clue how they got tetanus.

(imagine that....a doctor stating they don't know everything! )

[Gitti]

Originally Posted by DocJenn

And if you do a little more digging, of the 19 cases in the US, the vast majority of the people didn't know where they contracted it.

.

Do you know how old they were?
Because if they were quite elderly and diabetic, they may not have noticed an injury or due to poor circulation.

I seriously doubt that any kids die of tetanus without signs of a deep wound, burn, or crush wound due to an acciden. (In every one of those cases the TIG vax would be given.)

[Symbi]

Originally Posted by DocJenn

I have no clue how they got tetanus.

(imagine that....a doctor stating they don't know everything! )

Thanks, Doc Jenn! :-)

Just a follow-up question---does it seem to you that the concern over contracting tetanus would be more worrisome if it can be contracted without ever seeing a wound? I hope that question makes sense. :-)