Blood thinners (enoxaparin, Lovenox, Coumadin) injections

Josephine

NURSE DIRECTOR EMERITUS
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Enoxaparin (also called Lovenox or Coumadin) are tiny, prefilled syringes with a very short, fine needle that patients are given to bring home and give themselves in order to prevent deep vein thrombosis or blood clots. They come in prefilled syringes so no worries about dosage.


syringe packed.JPG

Giving yourself this injection is really easy. The needle is so fine, it barely hurts to puncture the skin with it so please don't get anxious about it. The ward nurses should instruct you before you leave hospital but just in case they didn't or you've forgotten, here is the procedure:


First prepare:
1. get the syringe and the alcohol wipes ready on a clean counter top. Peel off the peel wrap from the syringe blister pack and place it clean side up on the counter, leave the syringe in the blister until you are ready

2. wash and dry your hands carefully

3. when you open the pre-loaded syringe and eject the air bubble, make sure you flick your finger at the syringe to knock off the drip on the end of the needle (the blue bit); that's part of the reason why it hurts, because the fluid stings if it comes into contact with the superficial layers of skin

syringe prefilled 1.JPG
syringe use 1-horz.jpg

4. take a tip from diabetics and vary the places you inject yourself, even if it's only a centimetre or so away.


The injection

5. tear open the antiseptic wipe and leave it on the syringe blister's peeled off cover or a clean tissue/kitchen paper towel


6. bare the part of your stomach where you are going to give the injection, making sure the clothes are not going to drop down at an inconvenient moment!

7. at the point of the injection, wipe the area well with the antiseptic wipe and replace on the peel wrap strip. When you use the sterile wipe to clean the skin, make sure you give it a good firm rub. This makes the sensory nerves fire. Sensory nerves go into a passive stage after firing which gives you about a 5 second window during which they cannot fire again meaning you won't feel it

unsheathing needle-horz.jpg

8. pick up the syringe, unsheath the needle (1) and hold it as illustrated (2)

9. firmly take hold of a small amount of the prepared skin, with the underlying fat, between your thumb and fingers. Hold the syringe vertically or near vertically to the skin and firmly push it in to the hilt until the needle guard is activated

injection site.jpg
made safe 2.jpg

10. drop into the yellow sharps box you have been provided with (4)
11. check the injection site - if it bleeds or is leaking the drug, use the antiseptic wipe to apply pressure for a few seconds until it stops. No dressing should be needed.
 

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