less painful heparin injections?

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Looking for ways to make the daily heparin injections easier on my patients. Some are pretty bruised and one cried the other day. I do everything the way I should but it hurts them so much; I don't think its my technique as much as the medication itself, and the fact that they are getting it TID.

Does anyone have suggestions? What about the less painful sites? Where I recently started working, the side of the thigh seems to be the popular spot. Is there anywhere else less painful?

Thanks in advance!

Specializes in Med-Surg/Tele, ER.

Thanks for the air bubble suggestion! I've been using it with great success.

Also, I haven't seen it mentioned I don't think ... but I always change the needle after drawing-up the Heparin.

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Specializes in behavioral health.

I can recall as a nursing student, we were taught to hold the skin taught. WE gave them in the abd. and rotated sites. Also, counted to 10 before removing needle. I know that I had heparin injections as a patient, and they were quite painful. They were in the abdomen, my skin was pinched up, and it hurt!

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Specializes in Med-Surg, ED.

Now I'm confused, aren't we supposed to pinch with SQ? To keep the meds from getting out of the sq space??

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Specializes in behavioral health.

Yep! But, that it is what we were taught in school. I did them that way while in nursing school. I always questioned it, though. While actully working as a nurse,I never actually gave heparin, except for pre-filled lovenox injections. I did do them in abd. with squeezing the skin.

But, I have another question while we are talking injections. For IMs, we were always taught stretch the skin tight. But, for IM injection in deltoid, I have always had them given to me by nurse squeezing skin. e.g. flu vaccines. Maybe because the needle is bigger, and the deltoid is a small muscle?

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Specializes in Cardiac, ED.
I draw up the injections with a tuberculin syringe (can substitute with an insulin syringe) and put an air bubble in it (similar to lovenox) tapping it to the top of the syringe. Pinch the site prior to injecting, inject into the normal abdominal areas, not too slowly but steady, pull out right right after the air bubble goes in. With this technique I never get any blood and have yet to see any bruising (except if the patient rubs or bangs the area). Of course, be sure to rotate sites.

Hope this helps.

THANK YOU!!

I have tried this and it works great!! My pts are greatfull!;)

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Specializes in behavioral health.

NursingAgainstdaOdds,

Oh yeah, I do remember changing the needles as well.

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In my facility we use the abdomen for heparin injections. I don't usually get many c/o pain with heparin. Some people do c/o burning with the Lovenox injections.

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What is the reason to have them wiggle their toes? Any rationals?

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Specializes in ER, progressive care.

Use a brand new needle. Usually the doc orders 5,000 units (1cc vial) of heparin SQ Q12H. We have prepackaged 3cc syringes with a 23-gauge 1" needle. I'll use that to draw it up and then switch out for brand new 5/8" needle. No one has really ever said a word but it also depends on the patient.

And PLEASE rotate sites!!!! I took care of a patient who was getting Lovenox injections in the same side/area for 3 days and there was a TON of bruising and it felt like a VERY hard mass in the area :eek: I don't know what that nurse or those nurses who had this patient before me were thinking :nono:

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What is the reason to have them wiggle their toes? Any rationals?

Distraction. I have them take a deep breath in while I count to 3. When I say 3 they blow out hard, like blowing out candles and I go for it. I've had many people say they didn't even realize I was done. Distraction is a great thing! lol

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Specializes in Progressive, Intermediate Care, and Stepdown.
what is the purpose of the air bubble? Is it for pain control? Do you inject the air bubble too?

Air bubble "locks" medication in place and prevents leakage and other post said, "bruising."

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