lovenox injections

I have a patient that gets lovenox injections. As ordered, I must waste 5 mg of his pre-filled syringe. So, the lovenox is on the needle prior to giving the injection. I know this is very irritating. I can recall switiching needles when we drew up heparin from a multi-dose vial.

The patient appears to tolerate injections well. However, I know they are uncomfortable. I would like to ease the pain as much as I can. Any suggestions on the pre-filled syringes?

You are doing this the same way we do. It's a pain in the butt to do it with those pre filled syringes but it's a necessary evil when vte is a real threat to the pt.

Give the syringe a quick gentle flick using your middle finger and thumb to remove any drop that might remain at the tip of the needle, this, after you waste carefully not to let anything run up the outside of the needle.

This is a fantastic question! I have always wondered what is the official/most correct way to deal with wastes.

Another issue in my mind is the bubble in prefilled syringes. I have always been taught that the bubble is desirable and is not to be removed... But if I need to waste obviously I need to.

The Lovenox FAQ says it is OK to get rid of the bubble for dosage adjustments but would it be OK to draw back a little to make a new air bubble after a waste?

LOVENOX®- Questions About Treatment & DVT Blood Clots

Another issue in my mind is the bubble in prefilled syringes. I have always been taught that the bubble is desirable and is not to be removed... But if I need to waste obviously I need to.

Not necessarily. Hold the syringe with the needle pointed down so the bubble goes to the top of the liquid. Waste the amount you need and give the med as ordered.

Why are you wasting 5 mls? We use the prefilled syringes but we don't do that.

The dose is weight based. If you need x-mg/kg and you have too much in the syringe you have to waste. We do it a the time. We get 20mg,40mg,60mg syringes. If you need anything in the middle you have to waste.

Yes, in my facility if we have to waste Lovenox they have us make SURE to create a new air bubble before administering the injection

Oh! OP you brought back memories of the good ol' days when I use to administer Lovenox, and for what is worth your doing just fine, therefore, continue your well recommended method, your patients are aware that the medication itself can be a bit uncomfortable, however, they also know that you mean well... wishing you the best always... Aloha~

I was on Lovenox for a week or so. Nothing you do will make it comfortable. The shot itself sucks. So keep doing what you are doing and the patient will appreciate you keeping them alive!