Heparin injection = epic fail! Help!

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Hello! Today I gave two separate heparin injections, both in the pt.'s abdomen. I pinched the skin and punctured the skin, released the pinched skin and pushed the plunger. Both times as I was pushing the plunger, the heparin flowed right back out and all over the pt.'s abdomen. My preceptor wasn't sure why, other than maybe the needle had become loose. I'm really stressing over this now...is it something in my technique? I've given many heparin injections before, but it's been a while. I've never experienced this before. Please help!!! Thank you!

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Are they the pre-filled syringes? If you twist the cap rather than pulling it straight off (it seems darn near impossible - you have to really yank it) the needle can loosen.

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We were taught to pinch the skin, inject the needle, push the plunger (slowly) and release the skin and pull out the needle at the same time. Releasing the skin right after injection will move the placement of the needle.

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Specializes in Labor and Delivery.
We were taught to pinch the skin, inject the needle, push the plunger (slowly) and release the skin and pull out the needle at the same time. Releasing the skin right after injection will move the placement of the needle.

We were taught that way too and it wouldn't make sense to pinch then let it go and inject because then what would the point be of pinching anyhow.

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Specializes in Adult Internal Medicine.

Make sure you are keeping the needle in, sounds like it is coming out either when you release the skin or you are being to tentative and not getting the needle in the patient.

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Not sure if this applies to heparin, but I thought I'd throw it out there because maybe it would apply. I'm still a beginning student. I have diabetic children who take insulin sq regularly and one of my boys has problems with leaking insulin. If he isn't rotating his sites well the insulin will leak from the site because it doesn't absorb well from areas that have been overused.

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We were taught to pinch the skin, push the plunger, then release the pinched skin. If you release the pinched skin after you pierced it, the needle is bound to slip back to the surface.

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Specializes in Nursing Assistant.

Potter and Perry state to pinch skin, insert needle, release skin and inject. They do state that as an option, for Hep or an injection pen you can continue to pinch until all of the meds are injected.

I am assuming your Hep was pre-filled...

If so, did it have a bubble at the top?

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No it wasnt prefilled...we draw up our own.... If the bubble wasn't there might that be the problem?

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Specializes in Nursing Assistant.
No it wasnt prefilled...we draw up our own.... If the bubble wasn't there might that be the problem?

We had pre-filled which had a bubble at the top that we were to keep in the syringe...it had something to do with 'sealing it'...

I just did a quick google and found this-

https://patienteducation.osumc.edu/Documents/LovenoxSubq.pdf

Hope it helps :)

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The bubble kind of pushes the rest of the med in when doing a sub q injection :-)

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Thanks for the replies everyone! Mystery was solved tonight... It was that the needle came loose from the hub so it was leaking. The nurse I was working with tonight told me it happens fairly often!

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