Do's & don'ts: Administering Subcutaneous heparin

Nursing, Jun 2000 by McConnell, Edwina A

USE THESE TECHNIQUES to inject low-dose heparin and protect your patient from clotting problems related to surgery.

DON'T

Don't inject heparin within 2 inches (5 cm) of the umbilicus, to avoid the large umbilical veins.

Don't inject into a muscle, which could result in hematoma, pain, and irritation.

Don't aspirate, which could cause bleeding into the tissues.

Don't rub the injection site, which could cause bruising.

DO

Assess your patient for conditions that may contraindicate the use of subcutaneous heparin, such as kidney or liver disease, blood dyscrasias, or bleeding tendencies.

Wash your hands.

Select a prefilled cartridge containing the appropriate dose.

Put on clean gloves.

Select an area on your patient's lower abdominal fat pad, 2 inches beyond the umbilicus and between the right and left iliac crests. If she needs multiple injections, administer each one in a different site.

Clean the area with alcohol, using a circular motion and moving from the center outward about 2 inches. Allow the site to air dry.

Holding the syringe in your dominant hand, uncap the needle. With the thumb and forefinger of your other hand, gently grasp the area you've prepared to make a fold.

Holding the skin fold, insert the needle at a 90-degree angle into the subcutaneous tissue; then slowly press the plunger to inject the heparin.

Quickly pull the needle straight out and release the skin. Without recapping the needle, discard the syringe in the appropriate container.

Apply gentle pressure to the site with a piece of gauze. Remove your gloves and wash your hands.

Document the injection as required by your facility and sign and date the entry.

Each month, this department illustrates key clinical points for a common nursing procedure. Because of space constraints, it's not comprehensive. Edwina A. McConnell, RN, PhD, FRCNA, is an independent nurse-consultant in Gorham, Me.