Children's Unit
 
se/b07/15: Pointy shoes
 
Child on bed
Back to St Emlyn's Reception

1. What would you do next?

Pull the nail out using appropriate analgesia and distraction. We would try with free flow entonox and distraction and find this usually succesful. Alternatively Ketamine sedation could be used (but it is rarely necessary).

2. Would you have taken the X-ray?

Arguably not. Can you think of a circumstance when the X-ray would have stopped you taking the nail out? I can't.

3. Would you give antibiotics?

Not prophylactically unless the nail was heavily soiled or if there was bony involvement, or immunosupression. You should of course check the immunisation history with particular attention to tetanus prophylaxis.