For The Love Of Lovenox!

[KungFuFtr]

Hi

I administered Lovenox last week and the instructions are that the patient is to lay flat. Why is this? The website didn't give any explanations nor did my two drug books. My clinical instructor has been giving it for years without doing so. What's the reasoning?

Thanks in advance!

[emtb2rn, BSN, RN, EMT-B]

As I've been taught, Lovenox should be administered subcut in the abdomen. I've had to give it to quite a few patients over the last 2 semesters and always have the patient supine. Makes it really easy.

[SmilesHeal101]

Hello!!

I had administered Lovenox subQ in the adomen alternating injection sites. The first time I forgot to pinch the skin, and then the second time I accidently sprayed some in the patient's eye trying to pull the needle as my clinical instructor told instead of pushing it. I hope it didn't stink. But, I needed a good laugh to share with the other students. I am thankful the patient was understand, but I did feel really dumb....Do you guys have any funny stories to share????

[nrswnabee]

Hello!!

I had administered Lovenox subQ in the adomen alternating injection sites. The first time I forgot to pinch the skin, and then the second time I accidently sprayed some in the patient's eye trying to pull the needle as my clinical instructor told instead of pushing it. I hope it didn't stink. But, I needed a good laugh to share with the other students. I am thankful the patient was understand, but I did feel really dumb....Do you guys have any funny stories to share????

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the first time i did it sub-q, i couldn't, for the life of me, get myself to dart the needle thru this sweet old lady's belly! the second time, i had my index finger on the plunger as i pushed (duh!). the third time, i finally did everything right including the pinching, stabilizing, etc but my instructor pointed out that i forgot to pull the sheath back after injecting (it was some special needle that had that this protection vs needlestick.). i feel a disaster on the floor but in lab and the mannequins, things looked easy.

[Daytonite, BSN, RN]

I've never heard of such a thing! I've been giving Lovenox for years to post-op hip and knee replacement patients and never saw any kind of information requiring the patient to be lying flat while the injection was administered. I would think that if this were a requirement, there would be warnings posted all over the packaging that the syringes come in and I have NEVER seen any warnings like that.

[iHeartNICU]

We were at first tought to do it in the abdomen only but they could be sitting if they wanted. Then this semester we had a woman that didn't want any injection in her abdomen and when I asked my instructor abiut this she said it's fine if you do it in the arm....only catch is that it should be done in just the arms, just the legs, just the abs, etc so absorption is the same.

[MrChicagoRN, RN]

From the Literature:

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.

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My guess is that if the patient is laying down, they are relaxed, muscles least likely to be tensed, won't move out of the way, etc. If they move you may not get it deep SQ

[kellyskitties]

All I can think of is that it's so you can get to the abd better. I, however, have given it to a standing pt as they were up to head outside to smoke and I did good to catch them at all. They didn't turn orange plaid or pass out or anything from getting it standing up.

My biggest advice on Lovenox is the stuff burns like crazy, unless injected very slowly. Especially bigger doses. Put the needle in fast but inject the Lovenox slow.

[m_rlopez]

I received Lovenox injection close to the belly button while sitting up in bed. I didn't feel the needle at all.