ALERT: What type of syringe is used for subcutaneous injections of low molecular weight (LMW) heparin?
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
ALERT:
Use the appropriate size insulin syringe and double check the dose when administering subcutaneous Low-Molecular Weight Heparins (LMWH).
SITUATION:
A child has recently been re-admitted due to a 10x dosing error of enoxaparin in home care. This mistake was likely made due to the use of a different type of syringe at home than in hospital. No patient harm has resulted, but, we are aware that family caregivers and their home care nurses sometimes feel unsure about how to safely administer LMWH at home.
BACKGROUND:
Low-molecular weight heparins (LMWH) such as enoxaparin and tinzaparin are high-alert medications requiring careful preparation
ASSESSMENT:
The preparation of LMWH can be complicated. Family caregivers are typically taught to administer LMWHs for their child, or they may rely on home care nurses for this support. From hospital to home, there can be differences in the concentration of LMWHs and types of syringes dispensed. Mistakes in delivery of LMWH may lead to serious safety events that are preventable.
Use of 1 ml syringes are discouraged as their use increases the risk of error when preparing LMWH for SC injection.
RECOMMENDATION:
When preparing low-molecular weight heparins for subcutaneous injection, the following are always recommended:
Use the prescribed size of insulin syringe (e.g. 30 units, 50 units, 100 units)
Verify the correct concentration of LMWH based on the order for home
Have your preparation of LMWH double-checked for accuracy, and
Administer injection at 90° angle SC for all insulin syringes
Here is more up to date, evidence based information on administering Enoxaparin and Tinzaparin
STOP and THINK before giving any LMWH
For safe administration of LMWH at home, double check your dose with a family caregiver, pharmacist, nursing colleague or consult Connected Care Live!
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