Community Emergency Department Management of a Nail Gun Puncture Wound: A Case Report

Nail gun injuries, generally accidental, result in puncture wounds usually involving the hands and fingers, and such injuries are common in both urban and rural settings. Recognition of the extent of soft tissue injury, establishing hemostasis, assessing for bony, tendinous, or neurovascular injury, and consideration of infection prophylaxis and pain control are key components of emergency department (ED) workup. This report describes the management of a 51-year-old male who presented to a community setting ED with a chief complaint of left hand pain after sustaining a nail gun injury just prior to arrival. We will address immediate management, ED treatment, and ultimate disposition, as well as management strategies for patients who present with similar complaints to a community-setting ED.