[jmgrn65]

I just read the Lovenox site for injection. It doesn't say one way or the other, it just says doen't dispell the error so not to waste any medication. But I swear I remeber reading the literature that said to dispel the air after the medication to minimize bruising.

[Pipsqueak]

I was taught and I also read on the insert (not recently though) that the air bubble follows the med. Not to be stupid, but usually the pt is laying down, therefore when you give the injection, wouldn't the air bubble automatically move toward the plunger? If you can't tell, I don't give a whole lot of lovenox.

[DutchgirlRN]

Originally Posted by onyx77

I don't understand how injecting the air first would help prevent the loss of the med.

The way I understood it was that the air being injected first creates a small pocket in the SQ tissue which causes the lovenox to be absorbed more quickly, hence not losing it and is distrubuted more evenly. I may be wrong. That's how I remember reading it when I first started giving it. Perhaps it's changed over the years. You know it's hard to teach an old dog new tricks.

[sirI]

Subcutaneous Injection Technique: Patients should be lying down and Lovenox administered by deep SC injection. To avoid the loss of drug when using the 30 and 40 mg prefilled syringes, do not expel the air bubble from the syringe before the injection.

http://products.sanofi-aventis.us/lo...oxed%20Warning

The air bubble preceeds the actual drug injection for one does not want to risk losing any of the drug from the syringe. The air bubble acts as a "safety feature" to prevent accidentially losing any of the drug.

[november551]

From my understanding the air went in last to "lock" the medication into the SQ tissue and help prevent bruising. This rationale makes the most sense to me, personally. It's just like Z-Tracking an IM injection except you're using air. The "delivering the whole dose" rationale makes sense too, but at the same time why aren't we taught to do this with insulin as well, since insulin units are so tiny in volume?

Pushing the air out or putting air in first doesn't really make a lot of sense to me but whatever (I've been wrong in the past!).

[RN007]

From the manufacturer's website:

Subcutaneous Injection Technique: Patients should be lying down and Lovenox administered by deep SC injection. To avoid the loss of drug when using the 30 and 40 mg prefilled syringes, do not expel the air bubble from the syringe before the injection. Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall. The whole length of the needle should be introduced into a skin fold held between the thumb and forefinger; the skin fold should be held throughout the injection. To minimize bruising, do not rub the injection site after completion of the injection.

http://products.sanofi-aventis.us/lo...Administration

Hope this helps!

[DutchgirlRN]

Originally Posted by sirI

http://products.sanofi-aventis.us/lo...oxed%20Warning

The air bubble preceeds the actual drug injection for one does not want to risk losing any of the drug from the syringe. The air bubble acts as a "safety feature" to prevent accidentially losing any of the drug.

THANK YOU sirI, I see I have not lost my mind after all. We old dogs are still sharp as ever girl!

[rnmi2004]

I was taught the air bubble follows the injection of the medication. Since my patients are lying down, I'm not sure how I'd get the air in them first...

[TigerGalLE]

I've yet to see anything that proves the correct way to do it... Does anyone have any reliable sources that tell us the correct way??? The sources only say to not expel the air bubble before injection...

Tiger

[Reno1978]

I sent the manufacturer an inquiry - I'll report back if they respond.

I understand the rationale between both methods...both explanations make sense.