correct placement of sq Lovenox

[Arlenec]

I need to give Lovenox 100mg sq q 12hr and my patients abd is getting sore and he is requesting a diffent location. I know the proper technique but can not find anywhere if using upper arms or mid thighs is approved using of course the same technique.

[icuRNmaggie, BSN, RN]

Lovenox is only given in the anterolateral fat pads (love handles), not the arms or stomach.

[0.adamantite]

Lovenox is only given in the anterolateral fat pads (love handles), not the arms or stomach.

I've never heard this before!

[KelRN215, BSN, RN]

In pediatrics, we almost never use the belly for any subqs. I give lovenox in the arms and thighs and via insuflon catheter all the time. We check low molecular weight heparin levels and, guess what? These kids have therapeutic levels with the injections being administered in the arms and legs.

Another pediatric site that recommends the arms and legs: Enoxaparin: Injecting at Home - AboutKidsHealth

[SouthernPoint]

Lovenox is only given in the anterolateral fat pads (love handles), not the arms or stomach.

Incorrect. Upper Arms and Tighs.

[btab3]

I think I heard that it is best absorbed in the love handle area. I heard 2cm diameter around the navel is a no no and if given must be outside that radius.

[icuRNmaggie, BSN, RN]

The manufacturer recommends the anterolateral fat pads only for safety and because it burns terribly and there are not as many nerve endings in that area.

If enoxaparin is given in to a muscle a hematoma will form. We used to see some really bad retroperotoneal bleeds from Lovenox when it was first introduced because the dose was not adjusted for creatinine clearance. Please refer to the Sanofi Adventis website to read the administration instructions. If a nurse gave my family member lovenox any where but the anterolateral fat pads I would file a complaint.

[0.adamantite]

The manufacturer recommends the anterolateral fat pads only for safety and because it burns terribly and there are not as many nerve endings in that area.

If enoxaparin is given in to a muscle a hematoma will form. We used to see some really bad retroperotoneal bleeds from Lovenox when it was first introduced because the dose was not adjusted for creatinine clearance. Please refer to the Sanofi Adventis website to read the administration instructions. If a nurse gave my family member lovenox any where but the anterolateral fat pads I would file a complaint.

Well that would be impossible for me, I am quite thin and do not have love handles. I would prefer the injection in my thigh, my "meatiest" part of the body.

[icuRNmaggie, BSN, RN]

A quick literature search revealed nothing about giving lmwh in the extremnities. I did find some policies that indicate this is an accepted practice in a few facilities.

I did find info on a life threatening bleed known as rectus sheath hematoma from anticoagulation injections given into the abdominal muscle and the google images were very disturbing.

If anyone has a link to any research articles regarding the safety of anticoagulation injections in underweight adults I would appreciate the info. Thx.