Nailed It!

​What do you do for a nail from a nail gun in the hand? This procedure is simple, but you have to worry about the aftermath. Complicated issues may arise post-procedure in the days to weeks after extraction, including retained foreign bodies, infection, fractures, disability, pain, nerve damage, tendon rupture, and cosmetic concerns.​Removing the nail is only half the battle. Proper removal, treatment, and follow-up should be considered with all foreign bodies in the skin, especially the hand. Being prepared for the possible aftershocks will help your patient have a successful recovery.A 23-year-old man with a nail from a nail gun in his left hand. Photos by Martha Roberts.Approximately 25,000 work‐related and consumer nail gun injuries are treated in the ED each year, according to The American Journal of Industrial Medicine. (2015;58[8]:880.) Patients with nail gun injuries will arrive at the ED with their hands raised in the air because any movement usually causes significant pain and immobilizing the area above the heart provides temporary relief. The nail should be removed as soon as possible if there is significant bleeding so that pressure can be applied, especially if a large vessel or artery is involved. You may consider immediately injecting the area around the nail with 1% lidocaine with epinephrine to help control the bleeding and pain.The hand and fingers have thousands of nerve innervations, which are extremely sensitive. We suggest oral or IM analgesia...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs