Heparin Injection

[Nurseboy1]

OK everybody, here's a quick question for you. I know in school that the instructors were adamant that all heparin, lovenox injections were to be given within a 2 inch radius of the umbilicus. However, on my unit I have seen other nurses giving SQ heparin in other SQ sites such as the thigh or the back of the arm. Has anyone else heard of doing this?

[RNKPCE]

The drug rep for lovenox(enoxaparin) said it could also be given in the "Love handles" I still always use the abd site.

OK everybody, here's a quick question for you. I know in school that the instructors were adamant that all heparin, lovenox injections were to be given within a 2 inch radius of the umbilicus. However, on my unit I have seen other nurses giving SQ heparin in other SQ sites such as the thigh or the back of the arm. Has anyone else heard of doing this?

[AmyB]

We were taught to avoid the 2 inch circle around the umbilicus. We could inject anywhere else a regular SQ shot could be given. Abdomen, though, is the preferred injection site for heparin/lovenox.

[luvbug]

Yes, we were also taught to avoid the 1-2 inch area around the umbilicus. (more muscles, etc there, not enough fatty tissue).

[truern]

fragmin outside a 2" area around the umbilicus, but within a hand's width from that area...and lovenox in the "love handles"....

check your facility's procedure policy.

[RN92]

sub-q is sub-q. In home health, we taught pt to give their own injections - so we would use the belly because it was easy to get to.

[txspadequeenRN, BSN, RN]

I always give it in the abd,just because of the bruising it can cause....

[P_RN, ADN, RN]

Re: Bruising. Many years ago (About 1990) I took part in a research study of heparin sites, techniques etc. The final conclusion was to use a 5/8" 25g needle, use any appropriate subcutaneous site-not only the abdomen but also the thigh, upper outer arm, flank etc- not change needles, not aspirate and not massage.

When I personally started adhering to these techniques, I noticed I had very few bruise sites.

[txspadequeenRN, BSN, RN]

ok, I adhere to those rules as well, but it still happens. I work with alzheimers patients , they have alot of therapy alot of movement and tend to fight more than the Hatfields and McCoys.....

Re: Bruising. Many years ago (About 1990) I took part in a research study of heparin sites, techniques etc. The final conclusion was to use a 5/8" 25g needle, use any appropriate subcutaneous site-not only the abdomen but also the thigh, upper outer arm, flank etc- not change needles, not aspirate and not massage.

When I personally started adhering to these techniques, I noticed I had very few bruise sites.

[TiffyRN, BSN, PhD]

I worked cardiac telemetry until a couple of years ago and the lovenox rep had just been by giving inservices on injection sites. He said only love handles. I started to comply once I was educated. Previously I had always given all injectable blood thinners into the lower fat pad on the abdomen. Unless the patient insisted on getting in the arm even after being educated about the risk of increased bruising. I didn't stay long enough to see if there was less bruising with the love handle site. We all (tele nurses) noticed how the patients could get extensive bruising in the abdomen even with supposed proper technique ('course I wasn't there to witness each injection). Now that I think of it I don't remember ever seeing any significant bruising on the love handle sites.

[jemb]

I just checked 3 different drug books, and each one says if given in the abdomen,do not give within 2 inches of the umbilicus! Your instructor needs a referesher course.

[DaleB]

Hi P_RN where could I find a copy of the clinical research you did on Heparin?