# @nickpappasmd on Instagram

- **Type:** Video
- **Original URL:** https://www.instagram.com/p/DbyRmayuh3Q
- **Gondola URL:** https://gondola.cc/posts/68813120-nickpappasmd-instagram
- **Thumbnail:** https://img.gondola.cc/tr:w-,h-,fo-auto/postThumbnails/906744c638.jpg
- **Posted:** 2026-08-08T16:19:10.000+00:00
- **Account Owner:** Nick Pappas, MD (@nickpappasmd) — https://gondola.cc/nickpappasmd

## Caption

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🦶🔩 Stepped on a nail that went through your shoe? Don’t ignore it!

While many puncture wounds heal without problems, a nail that passes through a rubber-soled shoe can introduce bacteria such as Pseudomonas, which can occasionally lead to serious soft tissue infections or even bone infections (osteomyelitis). 👟🦠

🧼 First step: Wash the wound thoroughly with soap and water and cover it with a clean dressing.

🏥 Next, get evaluated at an urgent care or emergency department, especially if the nail penetrated deeply, the wound is dirty, you’re diabetic, immunocompromised, or you’re having increasing pain, redness, swelling, drainage, or fever. Depending on the injury, you may need:
✅ X-rays to look for a retained foreign body or fracture
✅ Antibiotics if your healthcare provider feels they’re indicated (sometimes including those that cover Pseudomonas in shoe-related puncture wounds)
✅ A tetanus booster if it’s been more than 5 years since your last tetanus vaccine for this type of injury

⚠️ The first symptom of tetanus is usually jaw stiffness (“lockjaw”), which typically develops 3–21 days after the injury, most commonly around 7–10 days. As it progresses, severe muscle spasms can affect the neck, back, and the rest of the body.

💉 If you’ve never been vaccinated or your vaccine history is unknown, you may also need tetanus immunoglobulin in addition to starting the vaccine series.

🚑 Once tetanus develops, there is no cure. Treatment involves intensive care, tetanus immunoglobulin, antibiotics, medications to control muscle spasms, and sometimes a ventilator to help you breathe.

☠️ Even with modern medical care, tetanus still carries an estimated 10–20% mortality rate.

The good news? 🙌 Tetanus is almost entirely preventable with proper vaccination. If you step on a nail, don’t just tough it out—getting evaluated early can prevent major complications.

#tetanus #orthopedics #urgentcare #medicaleducation #injuryprevention

## Stats

- **Views:** 45,273
- **Likes:** 393
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- **Comments:** 21

## Tags

medicaleducation, urgentcare, orthopedics, tetanus, injuryprevention

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