Lovenox(enoxaparin) SQ - page 4
Where do you inject it? I was told ALWAYS SQ in the abdomen. If given other areas can cause bleeds and hematoma.... Read More
Dec 14, '05Quote from sharannWhere do you inject it? I was told ALWAYS SQ in the abdomen. If given other areas can cause bleeds and hematoma.
All we were ever taught was to give Lovenox SQ in the abdomen only.
Jun 9, '06Where do we give (if at all) a SQ lovenox shot to an extremely emaciated patient? I could not find a fold of fat at all anywhere abdominally, no love handles. What do I do?
Jun 14, '06Quote from themonalisaGee... if the patient extremely emaciated then you're probably not gonna find decent folds of fat anywhere on that person, so an alternate location wouldn't make sense. I'd let the Primary know about this.Where do we give (if at all) a SQ lovenox shot to an extremely emaciated patient? I could not find a fold of fat at all anywhere abdominally, no love handles. What do I do?
Jun 26, '06HI:
i have read several of the posts---i am a little nervous. I am starting Lovenox injections tomorrow with the hope of sustaining a pregnancy. I have one child & have had several m/c after the 1st birth. After some research & meetings with a DR-I decided to try Lovenox. Both DR & pharmacist said it's ok to administer the shot in thigh or bottom---i have no proven clotting issues. Should I be administering this in the abdomen? does it truly matter? I'm confused.... thanks
Jun 26, '06I have recently researched this very topic, we were taught to always give in abd. Pt refused to have it given in the abd, and you bet I contacted the MD, both the research and he said that it really didn't matter. I had trouble finding research the supported only abd injection.
Dec 26, '06I have a different twist to the Lovenox Sq injection discussion. I just started to inject myself with Lovenox for fertility reasons. I have been a nurse for 19 years and I never knew they hurt so bad. I am not a wimp when it comes to pain either. I came to the internet to find out any creative ways to reduce bruising and pain. I really don't want textbook rules, just creativity to get me through 9 months of pain. Numbing the area with ice, constricting blood vessels?? Just out of a hot shower is not good, more bruising. I do use abdominal sites but I was looking for any sugestions. The injection itself isn't bad but the medicine really stings going in.
Dec 26, '06when it was first introduced, we were inserviced by the drug rep to give it in the "love handles" ("Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall." ).
later, we were told we could give in abdomen as well.
Dec 30, '06I voted abdomen for all the reasons mentioned....what scares me most about threads like this is the attitude of so many...they give care how they want....not according to policy and procedure....it really is a huge problem amongst nurses. I find it quite disturbing.
Jan 1, '07I remember once giving a Lovenox shot and the patient asked me "Can't you just give it in my arm? That's what the nurse did yesterday." It had never even crossed my mind that it could be given anywhere except the abdomen. I said sorry, but it really had to be in the abdomen. Does anyone know if there's a similar guideline for Epogen? Or is it okay to give in the back of the arm?
Jan 4, '07When I first started in nursing I was taught to give Lovenox 2-3 in around the umbilicus. However the drug rep came to my hospital in the last 2 years or so and said that actually lovenox should be given more in your "love" handles. further out from the umbilicus. You need to tell your patient that it will burn I know from personal experience. Most of the prefilled lovenox syringes come where you can withdraw the needle back into the syringe to prevent needle sticks. DONT do this with the needle in your patient. You will not only bruise them but they can get hematomas.
Jan 5, '07always follow manufacturer advice:
aventis: lovenox administration
lovenox injection is a clear, colorless to pale yellow sterile solution, and as with other parenteral drug products, should be inspected visually for particulate matter and discoloration prior to administration.
the use of a tuberculin syringe or equivalent is recommended when using lovenox multiple-dose vials to assure withdrawal of the appropriate volume of drug.
lovenox injection is administered by sc injection. it must not be administered by intramuscular injection. lovenox injection is intended for use under the guidance of a physician. patients may self-inject only if their physician determines that it is appropriate and with medical follow-up, as necessary. proper training in subcutaneous injection technique (with or without the assistance of an injection device) should be provided.
subcutaneous injection technique: patients should be lying down and lovenox injection 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.
lovenox injection prefilled syringes and graduated prefilled syringes are available with a system that shields the needle after injection.
*remove the needle shield by pulling it straight off the syringe. if adjusting the dose is required, the dose adjustment must be done prior to injecting the prescribed dose to the patient.
*inject using standard technique, pushing the plunger to the bottom of the syringe.
*remove the syringe from the injection site keeping your finger on the plunger rod.
*orienting the needle away from you and others, activate the safety system by firmly pushing the plunger rod. the protective sleeve will automatically cover the needle and an audible "click" will be heard to confirm shield activation.
*immediately dispose of the syringe in the nearest sharps container.
*the safety system can only be activated once the syringe has been emptied.
*activation of the safety system must be done only after removing the needle from the patient's skin.
*do not replace the needle shield after injection.
*the safety system should not be sterilized.
*activation of the safety system may cause minimal splatter of fluid. for optimal safety activate the system while orienting it downwards away from yourself and others.
complications and drug interactions at above link. karen
Jan 8, '07In some cases, you can't give it in the abdomen because of extensive wounds and/or dressings--what then?
Jan 10, '07I work in peds and have recently had a pt who had Lovenox ordered and because of being underwt, did not have adequate SQ tissue in the abdomen to adm the injection (14y/0 male 5' 3" and 84 lbs) therefore, we used the posterior upper arms. Once he gained enough wt to have some abd SQ to give it in, we started using that site. Also, the dose was 46mg so we had to draw from a multidose vial and give with an allergy syrine - In this case, i would need to be documented the reason for site selection and a doctor's order to give in sites other than the abdomen.