Giving a Heparin Shot to Your Child: Care Instructions

Your Care Instructions

Heparin is an anticoagulant medicine given as a shot. Your child's doctor may have prescribed a type of heparin called low-molecular-weight heparin, such as enoxaparin (Lovenox). Anticoagulants are often called blood thinners. They don't actually thin the blood. But they increase the time it takes a blood clot to form. They help prevent new blood clots from forming and help keep existing clots from getting larger.

You will inject the medicine once or twice a day. The doctor will tell you how long you need to give the shots.

At first, you may be nervous about giving your child a shot. But soon you'll be more comfortable giving the shot.

How do you inject blood thinners?

Follow the doctor's instructions for how often to inject the medicine, which will likely be in prefilled syringes. You may need to give your child a shot once or twice a day. It is very important to give the shots at the same time each day.

Giving the shot

1. Gather your prefilled syringe and an alcohol wipe or a cotton ball dipped in alcohol.
2. Wash your hands with soap and running water. Dry them well.
3. Choose a place to give the shot. Use a place where there is enough fatty tissue under your child's skin to pinch a fold of skin. Typical places are the backs of the upper arms, the upper thighs, or the belly. For the belly, choose a spot that is at least 2 inches off to the side of the belly button.
4. Use alcohol to clean the skin before you give the shot. Let it dry.
5. Remove the cap from the needle. Hold the syringe like a pencil close to the site, keeping your fingers off the plunger.
6. Slightly pinch a fold of skin between your fingers and thumb of one hand.
7. Place the syringe at a 45-degree angle to the shot site. This angle helps you insert the needle into the fatty tissue under the skin. You might also be taught to place the syringe at a 90-degree angle to the shot site, standing straight up from the skin.
8. Quickly push the needle all the way into the pinched-up fold of skin.
9. Push the plunger of the syringe all the way in so the medicine goes into the fatty tissue.
10. Be sure to hold the skin fold as you give the shot. This will help make sure you do not inject the medicine into muscle.
11. Take the needle out at the same angle that you inserted it. Let go of the skin fold.
12. If the site bleeds a little, apply pressure over the shot area with your finger, a cotton ball, or a piece of gauze. To help avoid bruising, do not rub the area.
13. Dispose of the needle safely. Don't use the same needle more than 1 time.
14. Slightly change the spot where you give the shot each time you do it.

Other instructions for using blood thinners

• Call your doctor if you think your child is having a problem with his or her medicine.

If your child misses taking a dose

• Call the doctor if you miss a dose and are not sure what to do. Your doctor can tell you exactly what to do so your child does not take too much or too little blood thinner. Then your child will be as safe as possible.
• Some general rules for what to do if your child misses a dose:
  • If you remember it in the same day, give your child the missed dose. Then go back to your regular schedule.
  • If it is the next day or is almost time to take the next dose, do not give your child the missed dose. Do not double the dose to make up for the missed one. At the next regularly scheduled time, give the normal dose.
  • If your child misses a dose for 2 or more days, call the doctor.
• To help you stay on schedule, use a calendar or your phone to remind you when to give your child a shot. Note when you give the medicine.

When to call for help

Call 911 anytime you think your child may need emergency care. For example, call if:

• Your child coughs up blood.
• Your child vomits blood or what looks like coffee grounds.
• Your child's stools are maroon or very bloody.
• Your child has a sudden, severe headache that is different from past headaches.

Call your doctor now or seek immediate medical care if:

• Your child has new bruises or blood spots under the skin.
• Your child has a nosebleed.
• Your child's gums bleed when brushing his or her teeth.
• Your child has blood in his or her urine.
• Your child's stools are black.
• Your child has blood in his or her stools.
• Your child has vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what your child is used to.
• Your child has an injury from a fall.

Watch closely for changes in your child's health, and be sure to contact your doctor if:

• You have trouble giving your child the shots.
• Your child does not get better as expected.