Injection Techniques to Reduce Adverse Effects of Subcutaneous Low-Molecular-Weight Heparin Among Patients With Cardiovascular Diseases: A Scoping Review.
Arkers Kwan Ching Wong, Rachel Yui Ki Chu, Ying Nan and 14 others
PMID 39323021WHAT IT FOUND
Slow subcutaneous LMWH injection over 30 seconds and abdominal injection sites were associated with less pain and bruising in the included studies, but pressure and cold timing varied, and no single technique was established.
Key findings
01Three of four injection-site studies favoured the abdomen, but one study favoured the deltoid to minimise bruising.
02Four reviewed injection-duration studies reported that slow injection reduced pain or bruising, but one found no association.
03Applying pressure for 60 seconds after injection was associated with less bruising than pressure for 3 seconds.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only English-language sources, so relevant non-English studies may have been missed. The included studies varied widely in interventions, comparators, outcomes and measurement tools, so the authors could not combine them in a meta-analysis. The review did not critically appraise the quality of the included studies, so the strength of the evidence for any technique is uncertain. The included studies were quasi-experimental as well as randomised trials, and one injection-duration study found no difference between faster and slower injection. The review mapped techniques but did not establish a universally applicable protocol for injection site, duration, pause time, pressure or cold application.
Declared interests
The authors declared no conflicts of interest. The paper lists the Joanna Briggs Institute group as the funder.
The easy way to misread this
Do not read this scoping review as proof that one injection technique is superior. The included studies were heterogeneous, not critically appraised, and one duration study found no difference, so changes should be made through local protocol review and patient assessment.