Where should the BUBBLE Be

The plunger part - opposite from the needle.

ok..regarding lovenox injections....where should the air bubble be...

I was told the TOP...but what exactly is that.....top meaning bottom of plunger?

OR

TOP meaning part where the needle is?

No, i am not a nurse yet.

When you inject the lovenox you want the bubble of air to go in before the medication. So it means the air bubble is at the end closest to the needle.

The air bubble should be up at the plunger. The rationale is that the injection of the small amount of air after the medicine will ensure the entire volume is delivered to the patient.

When you inject the lovenox you want the bubble of air to go in before the medication. So it means the air bubble is at the end closest to the needle.

Um... i thought you wanted the bubble to follow the med.. so that the incidence of bruising is decreased... pushing the med further into the SQ tissue.... ??

At least that was the reasoning i was taught... whatever the reason.. you want the bubble to go in after the med...

The plunger part - opposite from the needle.

No, the air goes in first, the air helps to distribute the medication evenly into the subcutaneous tissue.

WOW...even the RN's arent sure,,,and I am supposed to know as a student?????????

I just read the manufacturer's guidelines for administrating and the only mention of the air bubble is to not expel it before the giving the injection...it doesn't say that it should precede or follow the med. I was taught that it follows the med to ensure the whole dose is given.

WOW...even the RN's arent sure,,,and I am supposed to know as a student?????????

I agree. Since I'm the only one saying the air goes in first, heck I may be wrong but I remember the first time I gave it, probably 5 years ago, the package insert said the air goes in first. I'll check on it and get back to you. Sorry for all the confusion.

No, the air goes in first subcutaneously. Sorry Medic.

I have always done the air last. All of my instructors made sure to remind us of that before we gave our lovenox injections. This helps to keep the med in the med in the subq tissue. I don't understand how injecting the air first would help prevent the loss of the med.

I just read the Lovenox site for injection. It doesn't say one way or the other, it just says doen't dispell the error so not to waste any medication. But I swear I remeber reading the literature that said to dispel the air after the medication to minimize bruising.

I was taught and I also read on the insert (not recently though) that the air bubble follows the med. Not to be stupid, but usually the pt is laying down, therefore when you give the injection, wouldn't the air bubble automatically move toward the plunger? If you can't tell, I don't give a whole lot of lovenox.

I don't understand how injecting the air first would help prevent the loss of the med.

The way I understood it was that the air being injected first creates a small pocket in the SQ tissue which causes the lovenox to be absorbed more quickly, hence not losing it and is distrubuted more evenly. I may be wrong. That's how I remember reading it when I first started giving it. Perhaps it's changed over the years. You know it's hard to teach an old dog new tricks. :uhoh21: