| Enoxaparin: Injecting at home | 993.000000000000 | Enoxaparin: Injecting at home | Enoxaparin: Injecting at home | E | English | Pharmacy | Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years) | NA | Cardiovascular system | Drug treatment | Caregivers
Adult (19+) | NA | | 2021-07-07T04:00:00Z | | | | | | 7.10000000000000 | 67.2000000000000 | 1619.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>A guide on how to give your child enoxaparin injections. Find out the injection sites and how to discard the needle.</p> | <div class="asset-video">
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<br></div><h2>What is enoxaparin?</h2><p>
<a href="/article?contentid=129&language=english">Enoxaparin</a> is a blood thinner (anticoagulant). It works by changing the normal way the blood clots together. It helps prevent unwanted blood clots or existing blood clots from getting bigger.</p><p>Enoxaparin comes as a clear liquid for injection.</p> | | <h2>Key points</h2><ul><li>Enoxaparin is an anticoagulant (blood thinner).</li><li>Enoxaparin helps prevent unwanted blood clots or existing clots from getting bigger.</li><li>It is given for as long as your child needs it.</li><li>Enoxaparin can be injected into the thigh or upper arm (for infants older than four to six months).</li><li>You will be given a prescription for the right size of syringes. They are called insulin syringes and come in sizes of 30 units (3/10 mL), 50 units (1/2 mL) and 100 units (1 mL). The size of the syringe depends on the prescribed dosage.</li><li>Enoxaparin does not require refrigeration, and can be kept at room temperature.</li><li>Once opened the bottle can be used for 28 days only.</li><li>1 unit on the insulin syringe = 1 mg of enoxaparin.</li></ul> | | | | | | | <h2>While your child is taking enoxaparin</h2><p>Your child may bleed and bruise more easily.</p><ul><li>Please check with the medical team about what activities your child is allowed. Contact sports are not recommended. </li><li>Your child may need to wear a Medic Alert bracelet if on this medication for a long time. You can discuss this with the medical team.</li></ul> | | | <h2 class="pdf-page-break">When should you call your child’s medical or thrombosis team?</h2>
<p>Call the medical or thrombosis team if your child:</p><ul><li>hits their head or has a fall</li><li>has bruises that are large or cannot be explained</li><li>has a nose bleed that is hard to stop</li><li>has bowel movements that are black or red</li><li>has new bleeding from gums when brushing the teeth</li><li>will be having any medical or dental procedures or surgeries</li></ul> | | | | | | | | | | <h2>What to expect before going home</h2><ol><li>You will be given information that explains why your child is taking enoxaparin.</li><li>The nurse or pharmacist will teach you how to give your child the enoxaparin needles. They will help you learn to give your child’s enoxaparin needles by yourself before you go home.
<strong>Please note that the syringes used at the hospital may look slightly different from the ones you will pick up from a pharmacy</strong>.</li><li>You will be given a prescription for enoxaparin. </li><li>You will be given a prescription for the recommended syringe size. They are called insulin syringes and come in sizes of 30 units (3/10 mL), 50 units (1/2 mL) and 100 units (1 mL). The size of syringe you will need depends on your child’s dosage.</li><li>The medical team will arrange follow-up clinic appointments. The dates and the times should be on your discharge paperwork or you will receive notification of the appointments by phone or through the mail.</li></ol><h2>How long will your child need to take enoxaparin?</h2><p>Your child’s thrombosis team will decide how long your child needs to take enoxaparin, depending on the reason for your child’s treatment.</p><p>To decide when to stop your child’s treatment, the doctor may do follow-up imaging tests, such as an ultrasound, MRI, echocardiogram or a CT scan.</p><h2>Keeping track of blood work results</h2><p>You will discuss where and when the blood work will be done with the medical team and thrombosis team. </p> | <h2>Storing enoxaparin</h2><p>Enoxaparin does not require refrigeration and can be kept at room temperature (less than 25°C). Once you open the bottle, it can be used for 28 days only. After 28 days, the bottle must be thrown away, even if there is still medicine in it.</p><h2>How much to give</h2><p>Doses can be administered no sooner than 10 hours apart, and no later than 14 hours between doses.</p><p>Enoxaparin is available in several different strengths. The dosing information below applies to the 100 mg/mL (3 mL) multidose vials only.</p><p>Enoxaparin is usually injected using insulin syringes that are specially designed for injections into the skin. It is important to note that the volume is measured in "units" on an insulin syringe, and that one unit on the insulin syringe is equal to 1 mg of enoxaparin.</p><p>Your child has been prescribed _______ mg of enoxaparin for each dose. This dose is equivalent to _______units on an insulin syringe.</p><h2>Drawing up enoxaparin</h2><p>Before giving your child enoxaparin, you first need to draw up the medicine from the bottle. Make sure to check the date on the medication bottle to make sure it has not expired.</p><p>You will need:</p><ul><li>Enoxaparin bottle (100 mg/mL)</li><li>Insulin 30 unit (3/10 mL), 50 unit (1/2 mL) or 100 unit (1 mL) syringe, depending on the dose. Use only insulin syringes. You must use a new needle and syringe each time.</li><li>Alcohol swab</li><li>Cotton ball</li><li>Sharps container </li></ul><div class="caution"><h3>Precaution</h3><p>Make sure that the concentration of the enoxaparin is 100 mg/mL and that you check that you are using the correct size of syringe for your child’s dosage. Take a look at the pictures below. If you are unsure if the size of the syringe is correct, contact your pharmacy or your child's thrombosis team.</p></div>
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<span class="asset-image-title">Out-patient insulin syringes: Enoxaparin dosing</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/InsulinSyringes_OutPatient_EnoxaparinDosing.jpg" alt="Photos showing three different doses of enoxaparin in different-sized syringes" />
<figcaption class="asset-image-caption">The syringe your child is prescribed will depend on their dosage of enoxaparin. Because the syringes look very similar, it is important for you to double check the type of syringe you have before giving enoxaparin to your child.</figcaption> </figure>
<p>To draw up enoxaparin:</p><ul><li>Wash your hands.</li><li>Clean the rubber stopper on the medicine bottle with an alcohol swab. Wait 30 seconds for the alcohol to dry.</li><li>Remove the cap from the needle and syringe. Put the needle through the rubber stopper on the medicine bottle at 90 degrees.</li><li>Turn the bottle upside down with the syringe in it. Ensure the tip of the needle is in the solution.</li><li>Slowly pull down on the plunger of the syringe until you have a bit more than the required number of units. If you have trouble pulling out the medicine, inject a bit of air into the bottle, and try again.</li><li>Check the syringe for any air bubbles. Tap the syringe to make any air bubbles float to the top.</li><li>Slowly push up on the plunger to the desired amount. If you have pushed out too much, pull back again on the syringe to the correct volume. Recheck for air bubbles.</li><li>Lift off the medicine bottle from the syringe. Be sure not to touch the exposed needle to any surfaces. It is now ready to be given to your child.</li></ul><h2>Where to inject enoxaparin</h2><div class="asset-2-up">
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<span class="asset-image-title">Subcutaneous injection with insulin syringe (90-degree angle)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_layers_EQUIP_ILL_EN.jpg" alt="Cross-section of skin, subcutaneous tissue and muscle with needle injected at a ninety-degree angle" /></figure><figure><span class="asset-image-title">Subcutaneous injection with insulin syringe (45-degree angle)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_BDsyringe_layers_EQUIP_ILL_EN.jpg" alt="Cross-section of skin, subcutaneous tissue and muscle with needle injected at a 45-degree angle" /> </figure> </div><p>Enoxaparin is injected into the fatty layer just below the skin. This is called the subcutaneous (SC) layer. Safe areas of injection are: thighs and upper arms. Do not use the buttocks.</p>
<ul class="akh-steps"><li>
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<span class="asset-image-title">Thigh injection site</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_site_baby_thigh_EQUIP_ILL_EN.jpg" alt="Lower body of baby with marking on thigh for injection" /></figure>
<p>Thighs: Top front side and outer parts of thigh only. Do not use the inner thigh or back of the thigh. Divide the thigh into thirds; the injection site is in the middle third section.</p></li><li class="pdf-page-break">
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<span class="asset-image-title">Upper arms injection site</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_triceps_sideback_EQUIP_ILL_EN.jpg" alt="Upper body of child with marking on upper arm for injection" /> </figure>
<p>Upper Arms: Fatty area on the side and back of the arm. This site is only for infants older than four to six months. Divide the upper arm into thirds; the injection site is in the middle third section.</p></li><li>
<figure><span class="asset-image-title">Abdominal injection site</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_tinzaparin_abdomen_EQUIP_ILL_EN.jpg" alt="Upper body of child with marking on lower abdomen" /></figure>
<p>Abdomen: Inject at least 2 inches to the right, left or bottom of the belly button. Avoid areas near the waistband.</p></li></ul> | <h2 class="pdf-page-break">When giving your child the injection</h2><ol class="akh-steps"><li>
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<img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_wash_skin_EQUIP_ILL_EN.jpg" alt="Cleaning upper arm with sponge and soapy water to prepare for injection" /> </figure>
<p>Choose the injection spot. Clean the skin with soap and water (you do not need to use alcohol swab). Try to change injection sites with each injection you give. For example, inject into the left thigh in the morning and right thigh at night.<br></p></li><li>
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<img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_pinch_tissue_EQUIP_ILL_EN.jpg" alt="Pinching skin of upper arm at injection site" /> </figure>
<p>Gently squeeze up a well-defined fold of skin and fat with the thumb and index finger.</p></li><li>
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<img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_angle_EQUIP_ILL_EN.jpg" alt="Inserting needle into upper arm at a ninety-degree angle" /></figure>
<p>Hold the shaft of the syringe in a dart fashion, insert needle directly through the skin at a right angle (90-degree angle) quickly just into the fatty layer. The needle can be inserted at a 45-degree angle in areas that have little subcutaneous fat.</p></li><li class="pdf-page-break">
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<img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_inject_EQUIP_ILL_EN.jpg" alt="Placing finger on plunger of needle inserted at a ninety-degree angle" /></figure>
<p>Move hand into position to direct plunger. Do not move needle tip once it is inserted.</p></li><li>Give drug slowly to reduce stinging, firmly push plunger down as far as it will go.<br></li><li>Pull the needle out gently at the same angle you put it in. As you take out the needle, let go of the skin roll.</li><li>
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<img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_avoid_bruising_side_EQUIP_ILL_EN.jpg" alt="Holding cotton ball to upper arm after injection" /></figure>
<p>Apply firm pressure with a cotton ball to the injection site for three to five minutes following each injection to reduce the chance of bruising. Do not rub the area as it may irritate the skin.</p></li><li>Put the needle and syringe in a thick, plastic bottle or sharps container with a lid. This is for safety. When the container is full, bring it to your local pharmacy. They can safely dispose of it for you. Do not put it in your regular garbage.</li></ol> | | | | <h2>At SickKids</h2>
<h3>The Thrombosis Team </h3>
<p>The Thrombosis Team at The Hospital for Sick Children operates 24 hours a day, seven days of the week to respond to urgent calls from families of children and teens. If you need immediate attention, please call <strong>(416) 813-7500</strong> and ask the switchboard operator to page the Thrombosis team member on call.</p>
<p>The Thrombosis Nurse Coordinator will arrange Thrombosis clinic appointments and call you with the dates and times. Families may call <strong>(416) 813-5859</strong> (Thrombosis Clinic) if they have not heard from the coordinator within two to three weeks after leaving the hospital with an appointment time.</p>
<h3>Keeping track of blood work results</h3>
<ul>
<li>Blood tests can be done at SickKids. You will discuss where and when the blood work will be done with the Thrombosis Nurse. Please call the Thrombosis Nurse in one week after discharge to arrange next blood work.</li>
<li>Notify the Thrombosis Team on the day your child has had blood work done by calling the Thrombosis Nurse at <strong>(416) 813-8514</strong> on Monday to Friday. The Thrombosis team will call you when they have received the results and will let you know if anything needs to be changed. You should receive a call from the Thrombosis Team whether or not changes are required.</li>
</ul> | <h2 class="pdf-page-break">Personal stories about the use of low molecular weight heparins</h2><p>Two families share their experiences with using low molecular weight heparins. This video will help to answer any questions you may have if you or someone you know will be taking this medication.</p><div class="asset-video">
<iframe src="https://www.youtube.com/embed/iMp8r3hKmGU?rel=0" frameborder="0"></iframe> </div><p>If you are using a printout of this page you can watch two videos at
<a href="/article?contentid=993&language=english">www.aboutkidshealth.ca/injectenoxaparin</a>.</p><h2>Thrombosis Learning Hub</h2><p>For more information on thrombosis, post-thrombotic syndrome and the management of these conditions, please visit the
<a href="/thrombosis">Thrombosis Learning Hub</a>.<br></p> | | | | injectenoxaparin | | | | | https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_layers_EQUIP_ILL_EN.jpg | Enoxaparin: Injecting at home | | False | | | | | | | | |
