Injection of enoxaparin in the end whether to discharge the bubble inside?

Patient, male, diagnosed as “dilated cardiomyopathy”, the nurse was given “enoxaparin sodium injection 60mg subcutaneously once a day according to the doctor’s order. The platelet count and coagulation series were normal, and the nurse carried out according to the doctor’s order. The third morning, when the nurse injected the patient again, he found subcutaneous ecchymosis at the injection site yesterday. Such cases should be common in clinical practice. However, by asking nurses about the injection operation process and checking the instructions of enoxaparin injection in detail, it was found that the instructions of enoxaparin sodium injection clearly pointed out that “there is no need to exhaust the bubbles in the syringe before injection”, but in clinical practice, nurses often have to empty the bubbles in the syringe. < / P > < p > originally, the injection devices for enoxaparin sodium injection were all pre encapsulated injections, that is, they did not need to be prepared or extracted from the medicine bottle. Each syringe contained about 0.1-0.2ml of air, which did not need to be discharged. There are two reasons: < / P > < p > if bubbles are not excluded, the liquid can be completely injected into the body. After the injection, it can seal the injection to the subcutaneous liquid, so that the liquid will not seep from the needle eye, and the local bleeding of the needle eye can be reduced. This technique has a professional term called “indwelling bubble technology”. It is a new method applied to intramuscular injection. After a proper amount of liquid medicine is aspirated with a syringe, 0.1-0.2ml air is inhaled. When all the liquid medicine is injected, air is injected. < / P > < p > our indwelling bubble is generally 0.1ml, which is very small and does not directly enter the blood vessels. These gases only exist under the skin and will be absorbed by the human body soon, so it will not cause adverse reactions. < p > < p > 3. The injection site should be the abdomen as the first choice, with the navel as the center, and the area within 10 cm outside the radius of 5 cm should be selected, and the distance between the two injection points should not be less than 2 cm. The injection site was performed alternately. Avoid skin damage, induration, spot, nevus and other places. 2% Anil, 75% alcohol or iodophor were used to disinfect the injection site. The disinfection range was about 5 cm in diameter and the puncture point was the center. Disinfection was twice. The pre installed syringe can be used directly. Before injection, it is not necessary to discharge the air bubbles in the syringe, and reserve 0.1ml, and then the bubble can be bounced above the liquid medicine. After the injection, it plays the role of “gas seal” to avoid the exudation of drug solution and increase the risk of subcutaneous hemorrhage. During injection, the needle should be vertically inserted into the skin folds, and should not be angled. Press the plunger to inject the liquid medicine. During the whole injection process, the skin was lifted and pinched throughout the injection process, and the injection was slowly injected. After 10 seconds of injection, the solution was basically diffused before pulling out the needle. Avoid injecting too deep into the muscle layer and too shallow into the skin. Observe whether the injection site has ecchymosis, induration or other abnormalities, and make records to prevent omission or repeated injection. < p > < p > references [1] Zhang Wanxiang, Zhang Lin, Ding Qinghua. Observation on the effect of indwelling bubble technique in subcutaneous injection of low molecular weight heparin calcium [J]. Contemporary Chinese medicine, 2010,17:115-116. < A= target=_ blank>08/16/2020