Scratched by a nail. Red circle appears. Emergency room?

January 15, 2011 2:13 PM

"Go to the emergency room?" filter. My friend got scratched on the neck by a nail, or maybe by the edge of a board. The two cuts are very superficial. We immediately washed it and soaked it with rubbing alcohol. Now, an hour or two later, a red circle surrounds the area. Is this emergency-room material?

The two scratches are very superficial, almost as if a cat had scratched him with its claws. They are about an inch or two long, a quarter inch apart. The red circle surrounds the area and has a diameter of about 4 inches. It's not raised. It's not that the entire area is red; it's his regular white skin surrounded by a circle. It's very circular.

Time of getting scratched: 12:20 pm.
Time of washing off: 12:40 pm.
Time of first noticing this circle: 2:00 pm.

Our inclination is to go to urgent care, but if this is the kind of thing that regularly happens with ... rubbing alcohol? annoying scratches? ... then it would be nice to save the $150.

He had his tetanus shot renewed last month.

posted by salvia to health & fitness (16 answers total)

Mark where the circle is with pen. If it grows beyond that over the next few hours, then ER or urgent care for sure; it's a sign that infection has set in and is growing. Is there any localized swelling? Is the area warmer than it should be?
posted by rtha at 2:17 PM on January 15, 2011 [13 favorites]

I would apply topical antibiotic (Neosporin or something similar) and just keep an eye on it.
posted by pantarei70 at 2:19 PM on January 15, 2011

Rtha's got a good idea. My brother ended up with a 2 inch deep hole in his leg from flesh eating bacteria and it happened with astonishing speed - over a weekend. Not that I think your friend has flesh eating bacteria but tetanus isn't the only bad thing you can get.
posted by jaimystery at 2:36 PM on January 15, 2011

You probably just irritated the surrounding skin by the scrubbing and the alcohol. Just keep an eye on it.
posted by The otter lady at 2:40 PM on January 15, 2011

I'm gonna go with topical antibiotic + occasional observation. The red circle getting larger is not a OMG GO TO EMERGENCY ROOM NOW event, but if it persists until tomorrow with neosporin/whatever application then I'd consider going to a walk-in clinic or some similar low-priority medical facility. Don't go to the ER unless the thing is hot and/or swollen and/or leaking pus, or your friend develops additional symptoms (a fever for example).
posted by tehloki at 2:41 PM on January 15, 2011 [2 favorites]

for superficial cuts use 3% hydrogen peroxide. It kills everything - including the good stuff, so you should probably go with saline for larger wounds where scar tissue will be an issue, but for scratches and small cuts peroxide is the safest route.
posted by any major dude at 2:45 PM on January 15, 2011

Yeah, if he has MRSA you don't mess around with that because it gets bad fast. Do what rtha says- monitor extremely closely and if its getting worse, time to go in.
posted by slow graffiti at 2:59 PM on January 15, 2011

Thanks everyone. We marked the circle. It's not particularly warmer, maybe 5-10% or my imagination. We are at the store buying antibacterial ointment.

Wow jaimystery, I hope he's okay; that story will inspire us to watch this pretty closely.
posted by salvia at 3:01 PM on January 15, 2011

Heat is what to look for. Heat is infection. You will know it when you feel it, it'll be burny feeling hot, not just warm.
posted by fire&wings at 3:22 PM on January 15, 2011

The circle hasn't grown and is fading. The more I think about it, the more I remember this once happening to me with the same (old?) rubbing alcohol.

Thanks to the advice to wait and see. And thanks to all who answered. Crisis and unnecessary emergency care averted.
posted by salvia at 4:18 PM on January 15, 2011 [1 favorite]

Whew!

Anecdatally, we were with a friend a while back who had a cat scratch on his hand. It was bothering him. Fortunately, another friend with us is a nurse; she looked at it, kept an eye on it, and when the swelling and area of heat seemed to be spreading, she drove him to urgent care and he got antibiotics. Hands are apparently particularly susceptible to this kind of infection. Glad your friend is okay!
posted by rtha at 7:19 PM on January 15, 2011

Has your friend had had a tetanus shot before?
posted by onegoodthing at 12:01 AM on January 16, 2011

Yes and he had a booster a month ago.
posted by salvia at 9:52 AM on January 16, 2011

Don't use peroxide or rubbing alcohol. Just use plain old soap & water. Really, if you have peroxide in your first aid kid for cuts, remove it.

From webmd: "Clean With Hydrogen Peroxide or Alcohol? FALSE

Using hydrogen peroxide or rubbing alcohol to clean an injury can actually harm the tissue and delay healing. The best way to clean a minor wound is with cool running water and mild soap. Rinse the wound for at least five minutes to remove dirt, debris, and bacteria. Wounds that are large, deep, or bleeding nonstop should be treated by a professional."
posted by drstein at 1:06 PM on January 18, 2011 [1 favorite]

In case anyone is still wondering, this went away by the end of the day, with no additional badness, and nothing bad has happened since. He also called the insurance company on-call nurse, whose advice was similar to the advice here. "Wait and see" was the correct response in this case. Thanks!
posted by salvia at 10:55 AM on February 16, 2011

Called it! Sensible medical intervention away
posted by tehloki at 3:00 PM on February 16, 2011