What should you do if you step on a nail?

After being punctured in the foot by an iron nail, follow these steps for wound management:

1. Irrigate the wound thoroughly with normal saline to remove rust, dust, and other contaminants—especially important for deep wounds—to ensure complete cleansing and prevent residual debris. Leftover contaminants may lead to recurrent local infection.

2. Irrigate the wound with hydrogen peroxide, which kills anaerobic bacteria—including Clostridium tetani, the causative agent of tetanus—thereby reducing the risk of tetanus infection.

3. Rinse the wound again with normal saline to remove residual hydrogen peroxide.

4. Disinfect the surrounding skin with iodophor (povidone-iodine).

5. Administer tetanus antitoxin (TAT) or tetanus immunoglobulin (TIG), as clinically indicated.

6. Initiate a three-day course of oral antibiotics. Given the high bacterial load on the foot—predominantly Gram-positive cocci—cephalosporins or penicillins are recommended.