Lovenox(enoxaparin) SQ

  1. Where do you inject it? I was told ALWAYS SQ in the abdomen. If given other areas can cause bleeds and hematoma.
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  2. Poll: Where do you inject Lovenox SQ

    • Abdomen

      91.31% 1,460
    • Deltoid area (SQ)

      4.88% 78
    • Other

      3.81% 61
    1599 Votes
  3. 68 Comments

  4. by   live4today
    Hi Shar,

    You were taught correctly!
  5. by   sharann
    Thanks Renee!
    I wondered about this for some time. I couldn't find info in the detailed description package insert about it. Also, do you aspirate or not when giving this? I usually do not, again, it was how I was taught by several nurses.
  6. by   live4today
    No, you do not aspirate. Just withdraw the needle. Don't rub the injection site, either. This medication is given in the same manner as insulin is given. It's given SQ in the abdomen, no aspiration necessary, withdraw the needle, and leave the site alone.
  7. by   Brownms46
    Boy Renee... you're so correct. To the person who voted for deltoid please read:

    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 placed 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

    Recently I have been in hospitals where pts. have objected to abdominal injections, and some nurses have given Heparin and Lovenox in the deltoid. Not me..of course..

    sharann...I'm glad you were taught the correct way....
  8. by   misti_z
    Originally posted by Brownms46
    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.
    I had not heard this before, but I makes sense. thanks!! :kiss
  9. by   kewlnurse
    It can, like anyother subq injection be given in any of the normal subq spots, there is absolutly no real data to confirm that the abdomen is the best spot, and by golly if i just had abdominal surgery and your gonna stick me there, your gonna regret it. I have seen nurses do this, thats just plain old stupid.
  10. by   Brownms46
    Originally posted by kewlnurse
    It can, like anyother subq injection be given in any of the normal subq spots, there is absolutly no real data to confirm that the abdomen is the best spot, and by golly if i just had abdominal surgery and your gonna stick me there, your gonna regret it. I have seen nurses do this, thats just plain old stupid.
    Please click on the following links for accurate information..

    http://www.lovenox.com/patients/administer.htm

    http://www.lovenox.com/prescribing/p...bing_frame.htm

    Since I believe in reading product information, AND following the manufacturers information on how to give THEIR drugs. As far as giving it to a pt...who doesn't want it given as prescribed....YOU have a choice...you can refuse...and I go about my merry way...AFTER advising you of the risks of your decision...and charting your refusal....then calling your MD and let him/her deal with it. ...
    Last edit by Brownms46 on Mar 19, '02
  11. by   kewlnurse
    I read that info on the sites you provided, and maybe i missed it but where does it say why you give it in tha abdomen? I emailed them and asked for some clinical evidence as to why that site was chosen. And as far not giving it in the abdomen to someone who refused, you would rather not give it than give it in the arm? Would you really call the doc? Every attending I know would rip you a new one for wasting his/her time and then tell you to give it in the sq site of their choice. Very interesting.
    Last edit by kewlnurse on Mar 19, '02
  12. by   kids
    When I worked in rehab...

    I always gave it in the abdomen except when the Docs specifically order it to be given SQ in the thigh on abd. surgeries.

    Also...(in rehab) we almost never gave insulin an the abd, we used the sites that the patient has trouble reaching when giving it to them selves at home...backs of arms, lateral thighs and the 'love handles'.

    -nancy
  13. by   Brownms46
    Originally posted by kewlnurse
    I read that info on the sites you provided, and maybe i missed it but where does it say why you give it in tha abdomen? I emailed them and asked for some clinical evidence as to why that site was chosen. And as far not giving it in the abdomen to someone who refused, you would rather not give it than give it in the arm? Would you really call the doc? Every attending I know would rip you a new one for wasting his/her time and then tell you to give it in the sq site of their choice. Very interesting.
    That's funny...because I had the VERY same thing happen just last year...and guess what happened??? The pt started taking the injections in the ABD from everyone....and then...starting giving them to himself the same way......beside because the manufacturer instructs to give it in the abd....please see the first link...gives you a step by step instrucition...second one gives you the same....and is from the drug company that makes Lovenox.

    Plus if I ever end up in court for something...I want to know I was within hospital policy, and I was following the policies in everything I did. This is my way...my license..

    Ok...here is my rational for not giving it in the arm. Where is a pt...even one lying in bed...most likely to get hit or bumped at...arm...abd?? Ok...lets say you gave Inj in the arm...and CNA comes behind you...and does a BP with a nurse on a stick??? Did you ever have one of those things squeeze you soo hard you wanted to snatch it off?? Do you get my rational now???


    kids-r-fun - Also...(in rehab) we almost never gave insulin an the abd, we used the sites that the patient has trouble reaching when giving it to them selves at home...backs of arms, lateral thighs and the 'love handles'.


    I totally agree with Insulin the above...but I also have had pts state that having it in the abd...is much less painful to them. So with Insulin I go where ever the pt wishes...as long as we are rotating the sites. But in the case of insulin.....abd is not the preferred or only place to give it as per manufacturers direction.

    Last edit by Brownms46 on Mar 19, '02
  14. by   Brownms46
    Also there is NO ONE who could get me to do ANYTHING I feel strongly about NOT doing... And I have NO problem with standing toe to toe with an MD on more than a one occassion... ...including one Head of Surg...and stating how I feel...and finally in his case...proving my point..
    Last edit by Brownms46 on Mar 19, '02
  15. by   nursedawn67
    Originally posted by Brownms46


    Please click on the following links for accurate information..

    http://www.lovenox.com/patients/administer.htm

    http://www.lovenox.com/prescribing/p...bing_frame.htm

    Since I believe in reading product information, AND following the manufacturers information on how to give THEIR drugs. As far as giving it to a pt...who doesn't want it given as prescribed....YOU have a choice...you can refuse...and I go about my merry way...AFTER advising you of the risks of your decision...and charting your refusal....then calling your MD and let him/her deal with it. ...

    Thanks for the sites, very informative.

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Lovenox(enoxaparin) SQ