Heparin Inj

Daytonite, BSN, RN · Dec 17, 2008

i looked at a number of drug sites. they all say that heparin can be given in the abdomen and some say that the arm is also acceptable. however, one site did say the following:

http://www.globalrph.com/druginforx.htm

- "a different site should be used for each injection to prevent the development of massive hematoma." it was referring to the abdomen.

my interpretation of that would be that the advantage of the abdomen is that it provides a greater surface area. heparin usually has to be given every 6 hours so that is 4 shots a day. people getting these injections get pretty poked up and a lot of site rotation is needed. the abdomen provides a lot of available surface area. having given a lot of heparin over my years of practice i would say that sounds reasonable. people getting heparin get pretty bruised up looking at the injection sites after a lot of injections. it just happens because of the effect of the drug being an anticoagulant.

AirforceRN, RN · Dec 17, 2008

My medical guess would be that there is more fat in the abdomen and therefore less chance of accidently hitting deeper tissue, especially in skinny or older patients.

My personal guess...heparin causes bruising...nobody likes to visit Grandma in the hospital and see bruises all over her arms. Giving the shot in the abdomen, which is usually covered, solves this problem nicely.

Music in My Heart · Dec 17, 2008

My instructor told me that it was specifically to avoid an accidental IM injection.

luckygirl131 · Dec 17, 2008

thank you for the replies!!! i tried asking a few people in my clinicals and they really couldn't come up with an answer ha. i'm so glad i found this site to ask other nursing students! some (MOST!) of the students in my clinicals aren't very helpful!

have a great nite everyone =]

nsgstudent007 · Dec 18, 2008

aside from the facts listed above, it has been my understanding that heparin injections are given in the abdomen to reduce bruising. giving the injection in the arm or various other sites used for subcutaneous injections are more susceptible to bumping into things, therefore causing bruising. (you hit your arms more than you would your abdomen, most often) in the case of an obese client with a distended abdomen, it has been recommended that the injection be given on the anterior aspects of the upper thigh. (for the same reason).

angelgreg · Dec 22, 2008

I believe because it has the fastest rate of absorbtion.

jmgrn65, RN · Dec 22, 2008

It is the best place for absorption as angelgreg posted. Also patients don't bruise as much if you leave the needle in place for a count of ten, you don't drag heparin out with the needle.

eku_mommy · Dec 28, 2008

Fomr what I understand it has to be in the fatty tissue..as far as why i'm not really sure....could it be rate of absorption? I'm about to read on and see what everyone else says.

UM Review RN, ASN, RN · Dec 29, 2008

In addition to the other replies, I was taught that muscle tissue has a lot more blood than fatty tissue, thus the potential to cause a hematoma from the injection site is reduced.

ChristineN, BSN, RN · Dec 30, 2008

Ok, So now I have a question. I have had numerous pts on Lovenox that have had massive abdominal surgeries, to the point that there was no way you could have given them a shot of anything in the abdomen. The one pt told me that at home he always did it in his thigh, which is what I did, but I wondered if that was the best spot. If you couldn't use the belly, where would it go? Does it matter arms vs legs?