OT What Kinda of doc do I need
 

So I was working on my 911 last night (only Porsche component of post) and I was trying to get the remains of a bolt out. As I was hammering away at it with a spike to try and save the threads the spike slipped and went into my palm maybe a 1/3 of an inch. pulled it out very little blood etc but it hurt. Woke of this AM and my index finger is aches and my arm below the elbow hurts. Also I can't make a fist or hold a coffee cup with that hand its too weak. I guess the question is did I hit a nerve or a tendon? I would rather avoid the ER but maybe that is the only way to figure this out

Hell, You don't need a doctor. Get back out there.

shop rag and duct tape.

Blood poisoning? Infection? Any red streaks?

If it were me I wouldn't self diagnose.

I prefer electrical tape and paper shop towels... :)

super glue thennnnn duct tape.

Do you have anti-tetanus shot? Or need one?

I did that with a screwdriver over 30 years back. Took a week or so to feel better, but make sure your Tetanus shot is current, within about 7 years. If it doesn't start to feel better in a couple of days, there are Hand Specialists, since they are a very complicated part of the body, so hopefully you did not do any serious damage.

tetanus shot is in order, then back to the salt mine

ER is probably a little much, but if you have a "first care" or some other kind of urgent needs facility I would go there. They will not do any kind of invasive procedure like remove buried debris, but they might give you a localized anesthetic and evacuate the wound if it appears infected. You should consider a tetanus shot, and I am sure they will give you one. Or you could just go down to your local health dept and get one for $30 and superglue it shut--that is a likely technique the doctor will use anyway.

The palm is a fairly sensitive area, although we don't think of it as such. One time I was pounding on something in the garage using my bare palm, and while the immediate force did not seem excessive, the next several day my whole arm hurt and my palm was visibly blue.

LOL. Exactly what I use.

Hit the other hand hard, very hard and you will forget about the other
If you haven't had a tetanus shout in the last ten years get one
Ernie 81sc

In my country you would visit your GP to get an initial assessment , treatment of the wound and if necessary a referral if he/she thinks there are signs of significant trauma. Don't muck around because you do not want a deep space infection. And I'm not talking to the trekkies here. Google DSI.

Reminds me of an event when I did the Greek Island hopping experience a while back. I cut my index finger slightly when I was having a bread and cheese break on the little Naxos harbor wall. I thought nothing about it until the next morning I woke up with a big pain on my finger and the whole hand plus a red blood line under the skin leading from my hand to my elbow. I went to a local clinic where the doctor diagnosed it as a severe infection from traces of the local Naxos cheese. He prescribed antibiotic pills. I still developed a fever that lasted two days but then everything turned better slowly and healed completely. I guess the gist of the story is just go to a local general practitioner doctor and have it checked out. He may do it for less than $100.-

Bandaid? Bah! You mean "b!tch stickers"?

Ok, now in all seriousness you do NOT want to mess around with nerve damage. I'm saying that from the perspective of you do not want to say to yourself "dang I wish I could drive the 911 like I used to be able to". ER is not necessary but if you aren't getting better you should get it seen by a neurologist.

Go to a local "doc in a box" and have them check you out. Get a shot, rub some dirt on it and move on.

I have NO idea if it is a nerve or tendon...if you ask me about other technical "stuff" I might be able to assist or point to another resource....Please Go see your primary physician to have your injured palm checked and diagnosed asap...hope that helps

If I may;
If the wound is only 1/3 inch in depth, it's unlikely involve nerves or tendons. It's a puncture wound, wash it with soap and water to keep it clean. Elevate the hand to limit swelling. Don't use alcohol or peroxide as they both damage tissue and increase the risk of infection. It's supposed to hurt, you don't need oxycodone. If in the next 24 hours the wound becomes more inflamed, swollen or pus appears, you may have an infection. Don't wait to have it checked. Deep hand infections are serious.
my .02 worth
cj md emerg med

I skewered an index finger with an awl last year. Nice deep puncture. Doing something dumb of course... Saw it coming, "just one more poke will get it done"!

Hurt like hell, washed with soap/water. Poured isopropyl on it, band aid and tape, and tried to get back to work...

Next 2-3 days finger was really swollen. Felt like I hit it with a hammer. Couldn't bend it or use it much.

Day 4 it started to feel better and was resolved by the end of the week.

(I am current on Tetanus too)

Hope your hand heals quickly.

Cooper

Another experience I had quite while ago: Doing demolition of an interior stud wall I ended up on a heap of all sections with some nails still sticking out. I stepped on on the went deep into my sole through sneakers. I went to an emergency room at a local hospital. A doctor inspected it and cleaned it. The woulnd was not big but about 1/2 inch deep. The doctor asked me whether I wanted to get antibiotics. I said no if it is not necessary. The doctor said that's OK but you must watch the wound carefully. Come back if there is substantial reddening and swelling. And, he said, it is very important that you soak your foot in very hot soap water. So hot that you can barely stand it. And do that about 5 times a day for 20 minutes each. He advised that That is very important for treating deep puncture wounds. I followed the advice, did a lot of hot soaking, and the wound never got worse.