Episode Transcript
Announcer: Is it bad enough to go to the Emergency Room, or isn't it? You're listening to "ER or Not" on The Scope.
Interview: It's time for "ER or Not" on The Scope. That's where we come up with a scenario and then you make the call, whether or not you should go to the ER or not. Dr. Troy Madsen's an emergency room physician at University of Utah Health Care.
Interview: Today's "ER or Not", it's very seasonal, Dr. Madsen. Christmastime, sometimes you have those nice glass ornaments on the tree, sometimes they fall down, sometimes you step on them. "I stepped on a glass ornament." Is that a reason to go to the ER or not? What do you think?
Dr. Madsen: So this is a great reason not to go to the ER but to an urgent care, assuming one's open, depending on what day of the week it is. If it's Christmas, probably no urgent cares are open, but if you drop something glass, whether it's a glass ornament, or a glass cup or mug, or anything like that, and it breaks and you step on it, it's a reason, definitely, to get medical attention. I would not wait to talk to your doctor and set up an appointment.
First of all, you know, we worry about the age of a laceration. So if you somehow cut your foot on this glass ornament and it needs to be repaired, if you wait longer than 12 hours, the infection risk really goes up so you want to get attention that day. But it's also not the sort of thing where you need to rush into an ER for this.
Now, the big thing I worry about with people who step on glass, whether it's an ornament or something else, is glass that's actually in the wound itself. So, typically, what I'll do is get an Xray of the foot or the hand, or whatever it is that got cut on the glass, just to make sure there's no sign of any glass in there. And then, we will numb up the wound and wash it out really well, get a good look in there, make sure there's no glass, going to feel around with some instruments to make sure that's not touching any glass that's in that wound, make sure it's cleaned out, no glass is in there. And then, once we're done, sew it up.
But, again, that's absolutely something they could do in an urgent care. They can get an X-ray. If they find any complications, like any sort of nerve damage or tendon damage, then they are going to send you to an ER. So I would say if you stepped on a glass ornament and your toes aren't bending quite as well as they should, or you've got a numb toe, something that suggests that this glass cut through a nerve or a tendon, go to the ER. Otherwise, an urgent care is great for this.
Interview: And the main concern there is infection?
Dr. Madsen: The main concern is, number one, getting attention in a timely manner because if you wait too long, the infection risk goes up. But then, number two, having a retained piece of glass in there, that can cause issues where that can then sometimes get lodged up against a nerve or against a tendon.
Interview: Oh, okay.
Dr. Madsen: Yeah, and then that can cause some chronic pain, maybe even cause some issues down the road. So you want to make sure there's not glass sitting in there that gets sewn up into that wound or just gets retained in a healing wound.
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