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Query on Lovenox Administration

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traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 27 years experience.

It is given in the love handle area. In my hospital this is defined as lateral abdomen, slightly above the level of the umbilicus. I wanted to find a site with pictures, but couldn't so this is what the Lovenox site states:

Lovenox Injection is administered by SC injection. It must not be administered by intramuscular injection. Lovenox Injection is intended for use under the guidance of a physician. Patients may self-inject only if their physician determines that it is appropriate and with medical follow-up, as necessary. Proper training in subcutaneous injection technique (with or without the assistance of an injection device) should be provided.

Subcutaneous Injection Technique: Patients should be lying down and Lovenox Injection administered by deep SC injection. To avoid the loss of drug when using the 30 and 40 mg prefilled syringes, do not expel the air bubble from the syringe before the injection. Administration should be alternated between the left and right anterolateral and left and right posterolateral abdominal wall. The whole length of the needle should be introduced into a skin fold held between the thumb and forefinger; the skin fold should be held throughout the injection. To minimize bruising, do not rub the injection site after completion of the injection.

And the URL is: http://www.aventis-us.com/PIs/lovenox_TXT.html#Dosage%20and%20Administration

We give it in the lateral aspects of abd.

But......................that being said...........................

it's always interesting how we get in these debates that "you can ONLY use it this way or ONLY put it here" for different drugs/treatments and then in a year or two they have another use/site/route for the same thing that we could ONLY do one way.

Amazing, isn't it?

General E. Speaking, RN, RN

Specializes in floor to ICU.

whewww! Glad that is settled. For a minute, I thought I was going to have to separate TammyWilson808 and New CCU RN. They're already fighting and we haven't even left the driveway yet!!! :icon_chee

Don't "burp" the air bubble out either....unless you want to cover your patient in bruises.

Not to sure why anyone would stray from what is recommended as best practice..... if you already read the insert then obviously your question is answered isn't it?

Several posts mention to look at the Lovenox inserts--where do you get this? In our meds room, I've never seen the actual inserts. How you supposed to know? Thanks,

I give Lovenox in the lateral aspects of the abdomen because that's what the insert says is the proper administration. I have seen fellow nurses giving it in the lower abdomen as well as in the back of the arms just like insulin. The PTT's seem to back up that it is working just as well either way.

Nope, the PTT will not "back up" any such conclusion. The low molecular weight heparins (of which Lovenox is one) cause little or no increase in PTT values. The anti-Xa level is obtained if you are attempting to determine how these are "working".

I have seen the aftermath of a Lovenox injection given subq in the lateral aspect of the arm by a very new nurse, she really did not know how to give the drug and did not think to ask. It was not absorbed properly and there was a whopper of a bruise. I always given Lovenox in the lateral aspects of the abdomen, do not burp bubble, and do not rub afterwards. I have been told I give a pretty good injection, any type, so I guess following the recommended insert does make a big difference.

Lovenox=Lovehandles. Pt should lies flat if possible for injection into sc lovehandle. Lying flat for 10-15 minutes after seems to help bruising. Don't know why this is, but it works.. Hate to see pt given lovenox injections into stomach.......

What do you mean "don't burp the bubble". I think I did this one time; because, I felt and heard it. I felt that something wasn't right and felt bad about it. Prayed all night that she wouldn't bruise. This was in Level 2 clinicals. I never did find out if she got a bruise.

I have a buddy of mine that works on the Med/Surg. Unit where I work and is very interested in sites for Lovenox admin. She says she was taught that Lovenox equals love handles and should be admin. in the lateral aspects of abd. What is some other peoples' opinion? There are some RNs that think that ALL insulin injection sites may be used for Lovenox. What do you think?

Anywhere you can give insulin, give lovenox...

starcandy

Specializes in tele stepdown unit.

What if a pt has major abd surgery, with the drsgs and abd tenderness what would be the options?? :uhoh3: I had this problem with heparin SQ and was told to give in the posterior arm.

I have a buddy of mine that works on the Med/Surg. Unit where I work and is very interested in sites for Lovenox admin. She says she was taught that Lovenox equals love handles and should be admin. in the lateral aspects of abd. What is some other peoples' opinion? There are some RNs that think that ALL insulin injection sites may be used for Lovenox. What do you think?

I personally rec'd a lovenox injection. The nurse who gave it to me gave it to me in the sq tissue in the left upper arm. I ended up w/ a huge bruise that took weeks to fade. I was taught that lateral abd sites are best.

VineYdBabe

Specializes in telemetry, labor and delivery, insurance. Has 22 years experience.

Thank you all very much. I've been out of the hospital for a few years and my mom is coming home from the hospital today needing Lovenox injections. I came here for a refresher and I got it. love handles, no burping, no rubbing (knew this!) Sue

AngelsRN

Specializes in PACU. Has 8 years experience.

I always give it in the abdomen, unless ordered otherwise. I had a doctor order it to be used in the upper extremities only bec of the severe edema and other issues a woman had in her abdomen and lower extremities

Of course the inserts state that the injections "should" be given in the abdomen. However, I just had a patient return to me with an absolutely grotesque abdomen - a result of improperly rotated sites, rubbing, etc. We, at my facility, have confirmed with 3 separate Pharmacists that while the abdomen is the preferred site for Lovenox injections, any subcutaneous site MAY be used, so long as the sites are rotated. Certainly the abdomen would employ the best absorption, but sometimes, in some situations...that is just simply contraindicated. So go nuts. Lovenox: It's not JUST for bellies anymore!!! :typing

veronica butterfly, ADN, RN

Specializes in Med/Surg, Urg Care, LTC, Rehab. Has 10 years experience.

I've always given it in the abdomen in a good pinch of subq tissue. However, we recently had a patient who was in the hospital for a week with diverticulitis, then ended up perforating and had a colon resection. By day 10 he was begging us to put it in his arms. He was a big enough guy and had enough fat to give in the back of his arm so we did. It felt very strange. That was a lot of liquid compared to a few units of insulin....

ok....I have this question regarding Lovenox administration....I know that we give it on the lateral aspect of the abdomen...but what if the patient receiving it is a post op abdominal surgery patient (like TAH or hemicolectomy etc)? I had a patient yesterday who was a 2-day post op TAH and stat lovenox shot was ordered (for suspected MI), I wasn't too sure if I should give it via her abdomen but I still gave it anyways...not I'm questioning myself? What do you guys think?

ginger58, ASN, RN

Specializes in Palliative Care, NICU/NNP.

TammyWilson 808

As a gentle reader of this thread I really find your use of "Dear" condesending to the OP, as well as anyone else you might use it on. Spare us.

My original understanding from our Lovenox rep was that other sites run too much of a risk of hitting muscle. Lovenox was described as a "surgical knife" if injected into muscle.

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