Injection questions, Insulin, Lovenox

[Epona]

Hello... just wanted to verify... Insulin is always given SQ and so is Lovenox, correct?? I usually give Insulin and when needed, Lovenox near the belly-button abdomen area SQ. I hear that Lovenox can be given in the love-handle area.. is that true?? Thanks!! :)

[Asystole RN]

According to Sanofi (the manufacturer), the sites to be used are the left & right anterolateral and left & right posterolateral abdominal walls.

[LouisVRN, RN]

yes they are both given subq. Our policies says lovenox may be given in the abdomen or thigh but not behind the arm. No mention of the lovehandle area.

[SweetseRN]

I am sure you probably know this but insulin can sometimes be given as a drip, Heparin too. I just wanted to clarify, that is the only time it's not SQ.

[Cuddleswithpuddles]

Hello epona,

Insulin may also be given via IV in addition to SC.

enoxaparin (Lovenox) may be given in the abdomen, upper thigh and buttocks.

My source is the Davis Drug Guide. I highly recommend it or find a drug guide that works for you. :)

[SweetseRN]

I love Davis. It is very nurse friendly and you can even have it on Android and iPhone and likely other devices too.

[Cuddleswithpuddles]

I love Davis. It is very nurse friendly and you can even have it on Android and iPhone and likely other devices too.

I love it too. No other drug guide compares.

I have Epocrates on my HTC Incredible simply because I do not want to pay for the Davis twice . It is not nearly as nurse-friendly. It does not have nursing interventions and specifics on how to administer the drugs, but it is an excellent resource that can be had for free.

[nerdtonurse?, BSN, RN]

I had a patient who was hysterical about getting a shot in his belly (lovenox). Wanted the med, but was completely grossed out by the idea of a needle going into his belly. Called the doc and asked what was the best second site. He told me if it wasn't in the belly to put it in the fatty tissue of the upper arm (guy was pretty fluffy, so no worries about hitting muscle). Wrote the order to give lovenox in posterior aspect of upper arm sub-q. Made a bruise 2 inches across. I felt horrible, but the guy just wouldn't take it in the belly.

[xtxrn, ASN, RN]

I had a patient who was hysterical about getting a shot in his belly (lovenox). Wanted the med, but was completely grossed out by the idea of a needle going into his belly. Called the doc and asked what was the best second site. He told me if it wasn't in the belly to put it in the fatty tissue of the upper arm (guy was pretty fluffy, so no worries about hitting muscle). Wrote the order to give lovenox in posterior aspect of upper arm sub-q. Made a bruise 2 inches across. I felt horrible, but the guy just wouldn't take it in the belly.

I doubt that was your fault. I had Lovenox for a little over a week, and about 3 days after I got home, my entire abdomen looked like I'd had an eggplant graft. Doc said it was to be expected Would have been nice to know I hadn't popped something important

[CapeCodMermaid, RN]

Love the word "fluffy" to describe someone with more than enough

When I was a brand new nurse, one of the docs ordered Insulin IM. The pharmacy said it was perfectly acceptable. That was the only time I'veseen insulin given any way other than sc or IV drip.

[Cuddleswithpuddles]

Love the word "fluffy" to describe someone with more than enough

When I was a brand new nurse, one of the docs ordered Insulin IM. The pharmacy said it was perfectly acceptable. That was the only time I'veseen insulin given any way other than sc or IV drip.

Whoa. Never heard of that. What was the reason it was ordered IM? Is there an advantage over SC or IV in this case? Did your pharmacy say if there were any special side effects you needed to look out for?

[CapeCodMermaid, RN]

Honestly it's hard to remember the details since I was a new nurse and it was the early '80's. I remember checking the woman's blood sugar every hour and I remember she thanked me every time I stuck her with the IM needle which was a bit odd but very polite.

I just did a google search since now I am curious. AAFP in 2005 had a paper explaining the use of IM insulin in severe diabetic ketoacidosis.