Everyone at some point in their life pinches or smashes their
fingertip under or between something. It's just a part of life (ouch)!!
If it were not for the fingernail, the injuries would probably heal
within a few days like a common bruise and have no lasting effect or
pain. However, because the fingertips are highly vascular, minor trauma,
such as a crushing injury or a blow to the fingertip will cause them to
easily bleed underneath the fingernail. Your skin, and the anatomy of
the fingernail, naturally seals that area below the nail and does not
allow the blood to drain. The blood therefore pools in the nail bed,
causing an increase in pressure and intense throbbing pain. This is how
the fingernail becomes darkened, and you can often literally feel
throbbing pain to your injury, with each heartbeat.
Treatment and
Expectations: Immediate treatment includes ice and elevation of the limb
to minimize the swelling of the injury. Sounds easy you say? Well read
on! The next part is not for the faint at heart.
If the pool of
blood under the nail is painful and you can feel a throbbing sensation
(your pulse), then relief can only be achieved by actually releasing the
pressure. This can be done by creating a hole in the top of the
fingernail itself, and allowing the blood to drain. Now this may sound
like the last thing you want to do to an already painful finger, but if
you get in the car and drive to an Urgent Care center, this is exactly
what they would do. The following section describes two basic ways to
painlessly achieve this, one by drilling a hole, and one by burning a
hole. Neither way is any more painful than the other, and both are very
easy to do.
One way to do it: The hole can be made with a
jeweler's drill (a really small drill bit that you can twist by hand),
or an 18 gauge syringe type needle. Clean the top of the nail off with
alcohol and begin drilling the hole directly over the largest and
darkest part of the blood pool. Use a quick twisting motion of the
needle or drill with very little pressure. You won't feel any additional
pain because the nail has no nerves in it. When you get through the
nail, blood will spurt out of the hole, often with surprising force, and
relief will be instantaneous. You can also try to gently squeeze out
any remaining blood from the hole.
The fastest and best way to do
it: The other method involves melting a hole right through the nail.
Although it sounds horrifying, in my experience, it is easier, faster,
less traumatic and more sterile since it cauterizes and kills bacteria
with the heat. To begin, first straighten a small paperclip. Then
holding it with a pair of glove or pliers, heat the paperclip in a flame
until it gets red hot, and then poke a hole in the nail. You really
should not have to push the paperclip, as it will melt through by
itself. Apply just a little pressure, right over the darkest spot, and
continue until you feel a little pop, or blood is released. You want to
do this procedure quickly enough so that you won't have to reheat the
paperclip again to finish the job. When you get through the nail, blood
will spurt out of the hole, often with surprising force, and relief will
be instantaneous. You can also try to gently squeeze out any remaining
blood from the hole.
Whichever method you choose, you don't want
to go deeper than about 1/16 in. (2mm) below the nail. (Don't stress
about this, just estimate it with your good judgment and get it over
with!) After your done, soak in some Hydrogen Peroxide solution, repeat
the soaks three times a day. This is to prevent a clot from forming and
causing pressure to build up again. You might have to squeeze once or
twice again, but usually, the first time does it.
When to seek professional medical attention:
-Signs
and symptoms of infection. -You lose any movement or range of motion in
the body part as a result of the trauma. -The injury appears to be
worse than a simple bloody fingernail. -When in doubt.
