Heparin injection sites

[Birdy2]

So I usually give heparin in the abdomen, but sometimes have given in the patients arm depending on if they were severely emaciated. I figure if they have no subcutaneous tissue on their abdomen and it's supposed to be injected into fat then choose the next best thing, like their arm...if there is more fat there. However, a nurse I work with who has been nursing for over 15 years says that it is against hospital policy to give heparin anywhere except for the abdomen. The hospital I work at has the most unclear policies I've ever seen, but I have never been told that was a rule. I tried searching new guidelines, but everything is out of date. What is the policy at your facility?

[AJJKRN]

Look in the drug book you have available. Administration should be covered in the topics. Enoxaparin/Lovenox states in Micromedex that it should only be given in the abdomen. Can't remember about fondaparinux/arixtra because I haven't given it in a while.

I've always given heparin in either the back of the arms or in the abdomen depending on what the patient prefers. If they have lovenox then I educate to give only in the abdomen.

[LovingLife123]

I give myself lovenox injections twice daily and it's always to go in the abdomen. Are you talking true heparin or Lovenox?

[BellsyNurse]

Anticoags are given in the abd bc the tissue by comparison doesn't move all that much. Our typical patient on bid heparin or whatnot is getting it for dvt prophylaxis, due to illness/immobility as well.

So for the average mobile person, an arm would likely bruise more bc it's manipulated more. A subq site will absorb the same no matter where you stick it, but it'll bruise easier if it's being manipulated-movement, blood pressure cuffs going off, etc. same reason why you don't rub it in after it's given.