AboutKidsHealth

 

 

Enoxaparin: Injecting at homeEEnoxaparin: Injecting at homeEnoxaparin: Injecting at homeEnglishPharmacyToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NACardiovascular systemDrug treatmentCaregivers Adult (19+)NA2021-07-07T04:00:00Z7.1000000000000067.20000000000001619.00000000000Health (A-Z) - ProcedureHealth 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"> <iframe src="https://www.youtube.com/embed/iaHrD13O6ss" frameborder="0"></iframe> <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> <figure class="asset-c-100"> <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"> <figure> <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> <figure> <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"> <figure> <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>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>
L'énoxaparine : injections à domicileLL'énoxaparine : injections à domicileEnoxaparin: Injecting at homeFrenchPharmacyToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NACardiovascular systemDrug treatmentCaregivers Adult (19+)NA2019-03-22T04:00:00ZHealth (A-Z) - ProcedureHealth A-Z<p>Un guide étape par étape pour vous montrer comment administrer les injections d'énoxaparine à votre enfant.</p><h2>Qu'est-ce que l'énoxaparine? </h2><p> <a href="/article?contentid=129&language=french">L'énoxaparine </a> est un agent anticoagulant. Il fonctionne en influençant la façon normale dont le sang coagule. L'énoxaparine contribue à prévenir la formation de caillots indésirables ou le grossissement de caillots déjà présents dans le sang.</p><p>L'énoxaparine est vendu sous forme d'un liquide translucide injectable. </p><h2>À​ retenir</h2> <ul><li>L'énoxaparine est un agent anticoagulant.</li> <li>L'énoxaparine contribue à prévenir la formation de caillots indésirables ou le grossissement de caillots déjà présents dans le sang.</li> <li>Il est administré à votre enfant aussi longtemps qu'il en a besoin.</li> <li>L'énoxaparine peut être injectée dans la cuisse ou dans le bras (pour les enfants âgés de plus de 6 mois).</li> <li>L'on vous remettra aussi une ordonnance précisant le calibre des seringues. Il s'agit de seringues à insuline; elles sont graduées à 30, 50 et 100 unités.</li> <li>L'énoxaparine se conserve à température ambiante (moins de 25 °C); ce n'est donc pas nécessaire de la garder au réfrigérateur.</li> <li>Une fois ouvert, le flacon doit être utilisé dans les 28 jours suivants.</li> <li>1 unité indiquée sur la seringue à insuline = 1 mg d'énoxaparine.</li></ul> <h2>Pendant le traitement de votre enfant à l' énoxaparine </h2> <p>Il se peut que votre enfant saigne ou se blesse facilement.</p> <ul><li>Veuillez vérifier auprès de votre équipe médicale à propos d' activités permises à votre enfant. Il n' est pas recommandé de pratiquer des sports de contact.</li> <li>Si le traitement médical dure longtemps, votre enfant devra peut-être porter un bracelet MedicAlert. Vous pourriez en discuter avec l' équipe médicale. </li></ul> <h2>Suivi sur les résultats des analyses de sang </h2> <p>Vous pouvez parler à l'équipe médicale et à l'équipe de thrombose au sujet de l'endroit et l'heure de la réalisation des analyses sanguines. </p><h2>À quel moment devez-vous communiquer avec l'équipe médicale ou l'équipe des thrombopathies de votre enfant?</h2> <p>Vous devez communiquer avec l'équipe médicale ou de thrombose si votre enfant éprouve le suivant : </p> <ul><li>s'il se cogne la tête ou fait une chute</li> <li>il présente des lésions importantes ou inexplicables</li> <li>il a des saignements au nez (épistaxis) qui ne cessent pas</li> <li>il a des selles de couleur noire ou rouge</li> <li>ses gencives saignent lorsqu'il se brosse les dents</li> <li>une intervention ou une chirurgie médicale ou dentaire est prévue </li></ul><h2>À quoi s'attendre avant de retourner à la maison </h2> <ol><li>On vous fournira des renseignements expliquant pourquoi l'énoxaparine a été administré à votre enfant. </li> <li>L'infirmière ou le pharmacien vous montrera comment administrer les injections d'énoxaparine à votre enfant. Avant que vous ne retourniez chez vous, nous vous aiderons à apprendre comment administrer les injections d'énoxaparine à votre enfant. </li> <li>De plus, on vous remettra une ordonnance pour obtenir de l'énoxaparine. </li> <li>L'on vous remettra aussi une ordonnance précisant le calibre des seringues. Il s'agit de seringues à insuline; elles sont graduées à 30, 50 et 100 unités. Les ordonnances pour les seringues et le médicament se trouvent sur des pages distinctes, car certaines familles n'ont pas besoin de seringues. </li> <li>Dès que nous connaîtrons la date du congé de votre enfant, nous en informerons l'équipe médicale pour qu'elle passe vous voir. S'il lui est impossible de le faire (p. ex., si votre enfant quitte l'hôpital au cours du week-end), l'équipe communiquera avec vous dans la semaine qui suit. </li> <li>L'équipe médicale veillera à vous informer des rendez-vous pour les analyses de sang.</li></ol> <h2>Pendant combien de temps votre enfant devra-t-il prendre de l'énoxaparine? </h2> <p>L'équipe des thrombopathies de votre enfant décidera de la durée du traitement avec de l'énoxaparine en fonction du motif du traitement dans le cas de votre enfant. </p> <p>Afin d'arriver la décision concernant la terminaison du traitement de votre enfant, le médecin peut réaliser des examens au moyen de l'imagerie médicale, comme l'IRM, l'échocardiogramme, l'ultrason ou le tomodensitogramme. </p> <p>L'équipe médicale s'occupera des rendez-vous à la Clinique des thrombopathies et vous communiquera les dates et les heures. </p><h2>Conservation de l'énoxaparine </h2><p>L'énoxaparine peut se conserver à température ambiante (moins de 25 °C) et ne nécessite pas de réfrigération. La bouteille doit être utilisée dans les 28 jours suivant l'ouverture. Après les 28 jours, le contenu de la bouteille ne peut plus être utilisé même s'il en reste. </p><h2>Dosage </h2><p>L'intervalle entre des doses ne peut être moins de 10 heures ou plus de 14 heures. </p><p>Le médicament est disponible en plusieurs titres. L'information sur le dosage indiquée ci-dessous s'applique à des ampoules multidoses de 100 mg/ml (3 ml). </p><p>L'énoxaparine est normalement injectée au moyen de seringues à insuline qui sont spécialement conçues pour l'injection cutanée. Il est important de noter que sur une seringue à insuline, le volume est mesuré en « unités » et qu'une unité de seringue à insuline équivaut à 1 mg d'énoxaparine. </p><p>Votre enfant a été prescrit _______ mg par dose d'énoxaparine. La dose équivaut à _______ unités sur une seringue à insuline. </p><h2>Aspirer de l'énoxaparine</h2><p>Avant d'administrer de l'énoxaparine à votre enfant, il faut d'abord aspirer le médicament à partir de la bouteille. Vérifier la date d'expiration sur la bouteille. </p><p>Voici les articles qu'il vous faut : </p><ul><li>une bouteille d'énoxaparine</li><li>une seringue à insuline graduée à 30, 50 ou 100 unités (n'utilisez que des seringues à insuline). À chaque fois, vous devez utiliser une nouvelle aiguille ou seringue.</li><li>un tampon d'alcool</li><li>un tampon d'ouate</li></ul><p>Pour aspirer de l'énoxaparine : </p><ol><li>Lavez-vous les mains. </li><li>Nettoyer le bouchon de caoutchouc sur la bouteille du médicament au moyen du tampon d'alcool. Attendez 30 secondes pour que l'alcool sèche. </li><li>Enlevez le capuchon de l'aiguille ou de la seringue. Mettez l'aiguille à travers le bouchon de caoutchouc sur la bouteille du médicament. </li><li>Tournez la bouteille à l'envers avec la seringue insérée. Assurez-vous que le bout de l'aiguille est immergé dans la solution. </li><li>Appuyer sur le piston de la seringue jusqu'à ce que vous ayez un petit peu plus que le nombre requis d'unités. Si vous avez du mal à aspirer le médicament, injectez un peu d'air dans la bouteille et réessayez. </li><li>Vérifier s'il y a des bulles d'air dans la seringue. Taper sur la seringue pour que des bulles d'air flottent vers le haut. </li><li>Tirez sur le piston pour aspirer la quantité désirée. Si vous en avez retiré trop, poussez sur le piston pour rajuster le volume. Vérifier de nouveau s'il y a des bulles d'air. </li><li>Séparer la bouteille du médicament de la seringue. Assurez-vous que l'aiguille exposée ne touche à rien. On est maintenant prêt à l'administrer à votre enfant. </li></ol><h2>Où injecter l'énoxaparine</h2><div class="akh-series"><div class="row"><div class="col-md-12"> <figure><span class="asset-image-title">Injection sous-cutanée avec une seringue d'insuline <img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_layers_EQUIP_ILL_FR.jpg" alt="Le peau, le tissu sous-cutané et le muscle avec une aiguille insérée à un angle de quatre-vingt-dix degrés" /> </span></figure> <p>L'énoxaparine s'injecte dans la couche grasse qui se trouve juste au-dessous de la peau appelée la couche sous-cutanée. Les endroits sécuritaires pour l'injection sont les cuisses et les bras. N'injectez pas dans les fesses.</p></div></div><div class="row"><div class="col-md-12"> <figure><span class="asset-image-title">Site d'injection sur la cuisse <img src="https://assets.aboutkidshealth.ca/akhassets/Injection_site_baby_thigh_EQUIP_ILL_FR.jpg" alt="Le bas du corps d’un bébé avec une marque sur la cuisse" /> </span></figure> <p>Cuisses : Uniquement le côté supérieur avant et les parties extérieures des cuisses N'utilisez pas l'intérieur ni l'arrière de la cuisse. Si on divisait la cuisse en trois sections égales, le point d'injection se trouve au milieu de la troisième section.</p></div></div><div class="row"><div class="col-md-12"> <figure><span class="asset-image-title">Site d'injection de la partie supérieure du bras</span><img src="https://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_triceps_sideback_EQUIP_ILL_FR.jpg" alt="Le haut du corps d’un enfant avec une marque sur la partie supérieure du bras" /></figure> <p>Bras : la région plus épaisse du côté et de l'arrière du bras. Utilisez ce site uniquement pour les enfants âgés de plus de 4 à 6 mois. Si on divisait le bras en trois sections égales, le point d'injection se trouve au milieu de la troisième section.<br></p></div></div></div> <br><h2>À l'hôpital SickKids</h2><h3>Équipe des thrombopathies </h3><p>L'équipe des thrombopathies de l'hôpital SickKids travaille 24 heures sur 24, 7 jours sur 7, pour répondre aux appels urgents des familles des enfants et des adolescents. Pour les situations nécessitant une attention immédiate, veuillez appeler au (416) 813-7500 et demander à la réceptionniste d'alerter le membre de garde de l'équipe des thrombopathies. </p><p> L'infirmière coordonnatrice en matière de thrombopathies s'occupe des rendez-vous à la Clinique des thrombopathies et vous communiquera les dates et les heures. La famille peut appeler au (416) 814-5859 (clinique des thrombopathies) si la coordinatrice n'a pas appelé dans les 2 à 3 semaines après que la famille a obtenu l'heure du rendez-vous.</p><h3>Le suivi des résultats des analyses de sang</h3><ul><li>L'hôpital SickKids effectue des analyses de sang. Vous pouvez parler à l'infirmière coordonnatrice en matière de thrombopathies au sujet de l'endroit et l'heure de la réalisation des analyses sanguines. Après une semaine suivant le congé de l'hôpital, veuillez communiquer avec l'infirmière coordonnatrice en matière de thrombopathies pour prévoir la prochaine analyse de sang.</li><li>Avisez l'équipe de thrombose le jour de la réalisation de l'analyse sanguine de votre enfant en communiquant avec l'infirmière coordonnatrice en matière de thrombose au (416) 813-5859 du lundi au vendredi. Dès la réception des résultats, l'équipe de thrombose communiquera avec vous pour vous indiquer des changements, au besoin. Vous devriez recevoir un appel de l'équipe de thrombose au sujet d'éventuelles modifications​​.</li></ul>

 

 

 

 

Enoxaparin: Injecting at home993.000000000000Enoxaparin: Injecting at homeEnoxaparin: Injecting at homeEEnglishPharmacyToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)NACardiovascular systemDrug treatmentCaregivers Adult (19+)NA2021-07-07T04:00:00Z7.1000000000000067.20000000000001619.00000000000Health (A-Z) - ProcedureHealth 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"> <iframe src="https://www.youtube.com/embed/iaHrD13O6ss" frameborder="0"></iframe> <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> <figure class="asset-c-100"> <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"> <figure> <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> <figure> <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"> <figure> <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> <figure> <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> <figure> <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> <figure> <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"> <figure> <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> <figure> <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>injectenoxaparinhttps://assets.aboutkidshealth.ca/akhassets/Injection_subcutaneous_insulinsyringe_layers_EQUIP_ILL_EN.jpgEnoxaparin: Injecting at homeFalse

Thank you to our sponsors

AboutKidsHealth is proud to partner with the following sponsors as they support our mission to improve the health and wellbeing of children in Canada and around the world by making accessible health care information available via the internet.

Our Sponsors