Members are discussing the proper administration site for Lovenox injections, with some mentioning that the abdomen is recommended by the manufacturer, while others have been told by drug reps to inject in the "love handles." There is debate about whether Lovenox can be given in the arms or thighs, with some members sharing personal experiences and preferences for injection sites based on comfort and bruising. Additionally, there is mention of varying dosages and the importance of avoiding expelling the air bubble in the syringe.
I was told by a seasoned nurse that Lovenox (enoxaparin) is never given anywhere but in the abdomen, especially not in the arm. My drug book simply says give only in abdomen (but doesn't say why not elsewhere), but my pharmacology text does not specify location, just that it is given SC. I have done a search on the web and find reputable journal articles showing that it is given SC in abdomen and arms.
I am trying to determine the pathophysiology against using the fatty tissue over the triceps. I need to understand why the arm is no good for Lovenox. I saw a patient with extensive bleeding in the arm from a Lovenox injection, but by his description of how much the injection hurt, I would guess it was not a SC but an IM injection.
I would appreciate being pointed in the direction of a source with the answer to this question. I'm trying to develop my practice based on evidence. Thanks!
I can imagine, from experience I know that the drug hurts it has a sting like you couldn't imagine. there were many times where I wish that they would have just put me back on heparin rather then this one, even if it meant that I had to inject it twice in the am and pm.
I was taught to ice the site for a few minutes before and after injection to minimize bruising and post injection bleeding. I've always given in the ABD.
Specializes in jack of all trades, master of none.
Ya' know, I was just thinking... it's late, I'm tired & rambly, BUT, we use alcohol to cleanse the injection site. I'm willing to bet most people don't allow a dry time & I wonder if the needle passing through the wet alcohol causes more of a stinging sensation. I'm sure I probably heard that somewhere & it's just popping into my head... but food for thought.
Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.
danigirl58 said:
I can imagine, from experience I know that the drug hurts it has a sting like you couldn't imagine. There were many times where I wish that they would have just put me back on heparin rather then this one, even if it meant that I had to inject it twice in the am and pm.
Often lovenox is given q 12hours too. One of the advantages of Lovenox (low molecular weight heparin) over regular heparin is that ptt does not have to be monitored.
I love it! another oxymoron for my collection: sterile abscess
Ya' know, I was just thinking... it's late, I'm tired & rambly, BUT, we use alcohol to cleanse the injection site. I'm willing to bet most people don't allow a dry time & I wonder if the needle passing through the wet alcohol causes more of a stinging sensation. I'm sure I probably heard that somewhere & it's just popping into my head... but food for thought.
I have received Lovenox injections while in the hospital and at home. I had an abdominal surgery, so I wouldn't let them give it in my abdomen, so they used my arms. When I got home, I did end up giving in the "love handle" area. And it hurts. I am a diabetic, and have needed insulin also. The insulin injections didn't hurt near as bad as the lovenox.
Lovenox, when it was first trialed on humans was only given sub q in the abdomen so therefore it is only FDA approved for that route.
Swtooth
OK, now I'm confused. I work on a busy tele floor which also gets overflow from medsurg. See a lot of post op surgical. Never thought I would enjoy that, but do. Anyway, that's besides the point. I do administer Lovenox to approximatley half of my pts on my team. Now, I always give it in the abdomen, and make sure that I grab a good handfull of skin and hold it. It seems to help the patients. They state that they can't feel the injection. OK. This is a good thing. Now, I'm thinking, I finally got this thing down to a tee and now I find out that I may have been injecting at the wrong site. So, is it the "love handles" or the "abdomen?" Would it be "wrong" to give the medication in the love handle area? Because if the rep and the pamphlet for the drug recommend it,then, it should be given there?
Specializes in Adult and Pediatric Vascular Access, Paramedic.
sorry I should have been more specific it is technically in the love handles.
BSN: Yes, the air bubble is suppose to be injected into the patient as it acts as a seal to prevent the medication from leaking back out after you remove the needle.
danigirl58
168 Posts
I can imagine, from experience I know that the drug hurts it has a sting like you couldn't imagine. there were many times where I wish that they would have just put me back on heparin rather then this one, even if it meant that I had to inject it twice in the am and pm.