Lovenox Questions

TweetiePieRN · Apr 1, 2004

I have some questions regarding Lovenox...
Do you aspirate? Why or why not?
Do you *always* leave the air bubble in? I understand that to avoid the loss of drug when using the 30 and 40 mg prefilled syringes the air bubble should be left in. What about the 60, 80, 100 mg prefilled syringes?
I've looked at http://www.lovenox.com and cannot seem to locate information regarding this. Perhaps I'm overlooking it?
Melissa

Hi. I am a nursing student in my last semester. I have given lovenox and have been told to not aspirate. Just like you would not aspirate Heparin. I guess if you aspirate it will increase the chance of leaving a bruise. We were also told to leave air bubble in. I cannot remember the rationale for leaving the bubble in...but I know it was a good reason. Hope this helps! :)

Brownms46 · Apr 1, 2004

The site states you don't expel the air from 30 and 40mg prefilled syringes only to prevent loss of medication. If you look at the 30 and 40mg prefilled syringes you will notice they are not graduated...meaning there aren't any lines for you to determine how much med you may have expelled. The 60,80. 100, and 150mg prefilled syringes are graduated.

http://www.lovenox.com/professional/about/dosing.do

sharann, BSN, RN · Apr 1, 2004

and never give anywhere but the abdomen if humanly possible to avoid hematoma and bleeding.

Noney · Apr 1, 2004

A rep told me that you weren't supposed to expel thje air from any size. It helps prevent bruising. Alot of the bruising is caused by the medicine leaking back. Also inject very slowly it hurts less and causes less bruising.

Noney

mkfunk · Apr 1, 2004

A rep told me that you weren't supposed to expel thje air from any size. It helps prevent bruising. Alot of the bruising is caused by the medicine leaking back. Also inject very slowly it hurts less and causes less bruising.
Noney

I am also a nursing student and graduating in May of this year... I asked because I have been taught not to aspirate, and never to expell the air because the air is pushed in last and keeps the Lovenox where you want it.

The whole reason that I brought this up was because yesterday, I had personal experience receiving Lovenox... The RN who administered the Lovenox expelled the air, and I flipped! I asked why she was expelling the air and she said you always expell air with injections. I informed her that this was not the case with Lovenox. She was really defensive and said it was not necessary. Further more, she told me as she was injecting into my abdomen that she was aspirating, and that would give me the air bubble that *I wanted*. I was so mad! The injection hurt so bad! I had pain at the injection site for hours.

After the injection, the RN basically told me that wherever you go to work things will be different from school, and that's something that I need to learn *right now*. She totally reprimanded me for calling her on it, and made me feel like I didn't know what I was talking about.

Grrrr... I'm still mad about.

Melissa

opalmRN · Apr 1, 2004

I have some questions regarding Lovenox...
Do you aspirate? Why or why not?
Do you *always* leave the air bubble in? I understand that to avoid the loss of drug when using the 30 and 40 mg prefilled syringes the air bubble should be left in. What about the 60, 80, 100 mg prefilled syringes?
I've looked at http://www.lovenox.com and cannot seem to locate information regarding this. Perhaps I'm overlooking it?
Melissa

OK Now I have a question too. I was told do not aspirate, makes sense BUT I was told to bring the air bubble to the top (or tip) and then inject.

Anyone have any info on this?

BBFRN, BSN, PhD · Apr 1, 2004

There's an insert that comes with our Lovenox pre-filled syringes. You don't aspirate, and you do leave the bubble in- it serves as an airlock once the med is injected.

opalmRN · Apr 1, 2004

After the injection, the RN basically told me that wherever you go to work things will be different from school, and that's something that I need to learn *right now*. She totally reprimanded me for calling her on it, and made me feel like I didn't know what I was talking about.
Grrrr... I'm still mad about.
Melissa

Oh yeah BTW, you mentioned "you" were receiving the Lovenox. Then the nurse needs to be reminded, reprimanding and patient education are not synonymous. Even IF (and your not) you were incorrect, this is no way to treat a patient period. Ahhh how quickly some forget the basics of good nursing!

Thanks for posting this question. :)

opalmRN · Apr 1, 2004

There's an insert that comes with our Lovenox pre-filled syringes. You don't aspirate, and you do leave the bubble in- it serves as an airlock once the med is injected.

Do you leave the bubble at the bottom or manipulate it to the top before injecting?

TKS :)

sbic56, BSN, RN · Apr 1, 2004

A rep told me that you weren't supposed to expel thje air from any size. It helps prevent bruising. Alot of the bruising is caused by the medicine leaking back. Also inject very slowly it hurts less and causes less bruising.
Noney

This is exactly the reason I learned for leaving the bubble in. Plus, just a tiny drop on the tip of the needle causes needless stinging. Good enough reasoning to leave it as it is for me!

plumrn, BSN, RN · Apr 2, 2004

The way I learned it many moons ago: Pinch up the skin gently. No aspiration.

Inject below the umbilicus,@ a 90 degree angle

w/the air @ the plunger end (to 'push' the med

in where you want it, & keep it from tracking

back up the needle tract,preventing bruising).

No massaging of the area afterward (also to pre

vent bruising).