Administering heparin do you need 2 needles?

[tsm007]

My school uses a preceptor model and the clinical coach I was paired with said I needed two needles - one to draw it up and one to give it. I don't remember seeing or reading this anywhere in my reading, but will admit I could have missed something. Is this standard practice and if so what is the rationale for this? The one to draw up was a smaller gauge needle that what she administered with. I can see the rationale to using a larger gauge needle for administering, but couldn't figure out why I couldn't just use that needle to draw it up. I didn't think to question her about the rationale for this at the time, but now that I'm home I'm sitting here wondering if this is a personal preference thing.

[emtb2rn, BSN, RN, EMT-B]

We use a 26ga tb syringe. Draw, recap, admin. Otherwise it's simply easier to draw with a large gauge, 18 being the best.

[tsm007]

Are you giving it subcut or ivp?

Subcutaneous

[ChristineN, BSN, RN]

My school uses a preceptor model and the clinical coach I was paired with said I needed two needles - one to draw it up and one to give it. I don't remember seeing or reading this anywhere in my reading but will admit I could have missed something. Is this standard practice and if so what is the rationale for this? The one to draw up was a smaller gauge needle that what she administered with. I can see the rationale to using a larger gauge needle for administering, but couldn't figure out why I couldn't just use that needle to draw it up. I didn't think to question her about the rationale for this at the time, but now that I'm home I'm sitting here wondering if this is a personal preference thing.[/quote']

The rationale for using two needles is the needle you use to draw up the medication can get a little dull, so if you swap out needles you will be assured a clean, easy entry for administration, as with using the same needle that could be dull you may have more resistance and it may make for a more painful experience. That being said, I generally don't swap out needles for sub q shots like Heparin, but I always swap out for IM injections since those can hurt more and are going deeper in.

[Esme12, ASN, BSN, RN]

If you use the same needle to draw up meds and give them .....the needle can become sufficiently blunted and in the case of heparin cause more busing.

[203bravo, MSN, APRN]

Heparin is given deep subQ --- you administer at 90 degrees instead of 45 degrees and would change the needle after drawing (just like changing needles for IM injections) because any medication that may be left on the needle could irritate the tissue as you as inserting the needle.

[4boysmama]

we were intructed to change needles because any residual heparin that might be on the needle can cause bruising at the injection site, which can be quite painful.

[tsm007]

Thanks for all the feedback. That makes perfect sense.

[Esme12, ASN, BSN, RN]

You're welcome!

[turnforthenurse, MSN, NP]

I always use a plastic needle to draw up my medications and then switch to the appropriate size/gauge needle for administration.