heparin and lovenox?????

heart queen · Oct 12, 2004

the small amount of heparin that you are flushing in the catheter for patency will stay in the catheter, assuming that you withdraw a 5 or 10 cc discard and flush with NS prior to med administration or blood draw, the amount depends on policy.

The lovenox is for DVT prophylaxis period, due to immobility or a high risk patient. The heparin in the line does not meet the patient and will not give any anticoagulation protection for the patient. It is completely safe to do both.

You would never have a patient on both SC heparin and lovenox or IV heparin and SC lovenox... this is what would cause concern.

hope this helps.

rose28164 · Oct 13, 2004

the small amount of heparin that you are flushing in the catheter for patency will stay in the catheter, assuming that you withdraw a 5 or 10 cc discard and flush with NS prior to med administration or blood draw, the amount depends on policy.
The lovenox is for DVT prophylaxis period, due to immobility or a high risk patient. The heparin in the line does not meet the patient and will not give any anticoagulation protection for the patient. It is completely safe to do both.
You would never have a patient on both SC heparin and lovenox or IV heparin and SC lovenox... this is what would cause concern.
hope this helps.

YES!!!!!!!!!! This helps. I am a new grad (well a nurse of 7 months) and I am usually so carefull with what I do. I have been worring about this for days! I just dont want to get written up or get my liscence taken away.

Tweety, BSN, RN · Oct 13, 2004

Good advice here. Glad you learned something. :)

I might add that you will see patients recieving two blood thinners at once sometimes. Especially if someone is on a heparin drip and they are trying to find a coumadin dose that is therapeutic. They will be on the heparin and taking coumadin at the same time.

jemb · Oct 14, 2004

Something about the OP's question had been bothering me, and I finally pinpointed it. Since so many facilities now use saline flushes instead of heparin flushes, and many doctors order Lovenox instead of heparin sq, I wanted to clarify something for Rose and any other new nurses that might not be very familiar with heparin.

You said that your policy is to flush with 2.5cc of Heparin, but you did not indicate the strength. Generally Heparin flush solutions are marked as such and the strength can be 100 units/cc to 500 units/cc.

Heparin which is given sq is generally 5000 units/cc, but might be 10,000-40,000/cc. That concentration should never be used as a flush for lines.

I would guess that the OP is using a heparin flush solution, but since she was concerned that the patient was receiving both Heparin and Lovenox, she may not have been aware of the differences in flush solutions and higher doses for medicating.

apaisRN, RN, CRNA · Oct 14, 2004

Good point. I have heard of mix-ups due to misunderstandings about the various concentrations of heparin and their uses.

My hospital no longer stocks heparin flushes, so it's pretty much impossible to make a mistake with those. I believe the heparin we give SC is 10,000 units per cc, and we usually give 0.5 cc to make 5000 units. The heparin we give IV push to bolus before starting a drip is 1000 units per cc. The premixed heparin drips are 100 units per cc. Anyone confused yet? Heparin makes me a little nervous, because of the many different concentrations and just because math has never been my strong point. I'm always afraid I'll misplace a decimal point and give the patient a whopping dose. Always good to double-check.