Blood Clot and Giving Shots

[Smokin Joe]

My wife just developed a spontanious blood clot in her superfical femoral. The Mother F**king E.R. missed it too.

I have to give her 5 shots of Lovenox (enoxaparin sodium injection) as well as she is now on cumiden (sp?).

Tonight I gave her the shot in her left abdomen. She complained of some pain during and after the shot. She can be a whimp when it comes to pain. But to make sure I'm not screwing up I figured I would ask you all.

Here is a pic of the syringe I used. I disinfected the area and placed the needle about half way in at a 45 degree angle.

What tips do you have for giving shots?

[NousDefionsDoc]

1. The Doc told you to give it to her in the abdomen?
2. Are you using alcohol to disinfect?
3. You are doing fine. You want to insert with the bevel of the needle up where you can see it and aspirate (pull back on the syringe a bit like when you put the drug in the syringe) to make sure you aren't in a vessel. You don't need to pull it hard. If you don't get any blood in the syringe, you're good to go. If you do, pull it out a bit and change the direction and try again. Don't worry about the blood, you can inject it back in.

There's not much you can do about the pain.

[Sacamuelas]

Luvenox is brandname form of heparin. It is given subcutanous... you dont' have to give it "deep" as you are going for the fat layer just under the skin but not all the way into the muscle and vasculature. For best results, give her the shot at the same time(s) each day, as prescribed by your doctor. She is on both heparin and coumadin for the same reasons, yet the coumadin takes a while to take effect therefore the heparin is used for immediate results. See MAB32 cardioversion thread as this is being discussed in that thread as well.

My HH6 was put on heparin when on strict bedrest for several weeks during her pregnancy.

AS NDD stated, aspiration is always a good idea, but it looks like you have a fairly short needle on your little kit so you shouldn't be into the vascular layer under the fat. Also, depending on the gauge of the needle, it may be so small a lumen that a red blood cell can't actually be pulled up into the carpule portion so aspirating may be unnecessary and a waste. Here is what I would do and had to do with my wife:

1. Squeeze an inch of skin between your thumb and two fingers, pulling the skin and fat away from the underlying muscle. (If you use a 5 millimeter needle to inject, you don't have to pinch up the skin when injecting at a 90° angle; with this shorter needle, you don't have to worry about injecting into muscle.)
2. insert the needle
3. Hold the pinch so the needle doesn't go into the muscle.
4. Push the plunger in to inject in the heparin.
5. Release the grip on the skin fold.
6. Remove the needle from the skin.

Good luck and my sympathy to your wife for having to have Mr. Heavy hands aka Torguewrench Joe perform medicine on her after your display with the aimpoint mounts. LOL

[Smokin Joe]

Originally Posted by Sacamuelas

1. Squeeze an inch of skin between your thumb and two fingers, pulling the skin and fat away from the underlying muscle. (If you use a 5 millimeter needle to inject, you don't have to pinch up the skin when injecting at a 90° angle; with this shorter needle, you don't have to worry about injecting into muscle.)
2. insert the needle
3. Hold the pinch so the needle doesn't go into the muscle.
4. Push the plunger in to inject in the heparin.
5. Release the grip on the skin fold.
6. Remove the needle from the skin.

Good luck and my sympathy to your wife for having to have Mr. Heavy hands aka Torguewrench Joe perform medicine on her after your display with the aimpoint mounts. LOL

I disinfected with an alcohol wipe, let it dry, then preformed the above by the numbers tonight but forgot to place it in the original post. However I did not aspirate

I would guess that the needle is approximately 10mm long so rough estimate is I placed 5mm into the abdomen, and the Doc directed me to give them to her in her abdomen, even though I sort of pushed for the arm or butt. But he wouldn't hear of it and said they could only be given in the abdomen.

Thanks for the sympathy Saca I feel for her too. The Doc originally wanted her to give the shots to herself (Ya, right) so I had to step up. I'm an all the way type of guy (you know do or do not there is no try) so its difficult for me to preform finess tasks such as giving shots....I need one of those air gun thingys to give shots.

In the future I might try and aspirate just to make sure that I'm good to go but I feel bad using her as a pin cushin. Hell it would be easier to do it to myself then to my wife.

Thank you for the help and feed back guys. It makes me feel more confident in what I have to do.

[ccrn]

The shots can be administered into the abdomen as previously advised. Make sure you rotate sites on the abdomen never administering any closer than one inch to the umbilicus.

I have run into surgeons who insist on low weight molecular heparin being given into the leg as shown. I would consult your Doc to see if this is ok. Rotate legs if you are to do this.

Aspiration is typical of intramuscular injections (IM route) and is not necessary with SubQ (subcutaneous) but cant hurt-

[Roguish Lawyer]

I gave myself allergy shots for an extended time period. Administered in the thigh. Found that it was easier if I just popped the needle in fast, but without slamming my leg. Prepped area with alcohol swab.