Answer – Health Literacy Pop Quiz

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Question

What’s more dangerous? Stepping on a rusty nail barefoot, or stepping on a clean nail through sneakers?


Answer (Also see Disclaimer)

Puncture through footwear.
This doesn’t seem to get enough public attention, but I think it’s really important to know.

If you step on a nail with bare feet, it’s usually not too much of a problem because the bacteria on the skin (Staphylococcus and Streptococcus, “staph and strep”) are relatively easy to kill.

However, if a nail punctures through a sneaker or sandal, the bacteria that grows there can be a big problem. It’s called Pseudomonas and only a few antibiotics work well against it. Plus, it can even cause a bone infection (osteomyelitis) that can be a big problem and need prolonged treatment.

For those reasons, when the skin is punctured through footwear, seek medical attention. It doesn’t have to be immediately but I would say by the next day.

I generally recommend starting a prescription for an antibiotic called ciprofloxacin, if there are no reasons not to (such as allergy).

Both instances usually mean you need a Tetanus booster if it’s been more than 5 years since your last one… not from the rust but from the dirt on the nail and puncture through the skin. This is also not a need to go to the hospital the same day. Often you can get a tetanus shot at a public health office, pharmacy, or clinic.


This is an excerpt from PART 4: ARMCHAIR EMERG DOC in a section called “Tips and Tricks for Common Conditions”

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