Document Detail


Occurrence and Extent of Bruising According to Duration of Administration of Subcutaneous Low-Molecular-Weight Heparin: A Quasi-experimental Case-Crossover Study.
MedLine Citation:
PMID:  22760174     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Several authors have documented the role of low-molecular-weight heparin injection techniques in bruising. However, few researchers have measured the influence of injection duration on the occurrence and extent of bruising. PURPOSE:: The aim of this study was to evaluate the influence of different durations of subcutaneous heparin injection on the occurrence and extent of bruising. METHODS:: A quasi-experimental case-crossover study design was adopted in 2010. A consecutive series of patients admitted to 2 orthopedic units in a large (600 beds) teaching hospital located in northern Italy were eligible for enrolment. Injections were administered following a standard procedure. The manipulated variable was the duration of the injection, 10 seconds (treatment A) and 30 seconds (treatment B). The evaluation of bruise occurrence and extension performed after 48 hours and data analysis were conducted in a blinded fashion. RESULTS:: A total of 150 patients receiving their first and second subcutaneous heparin injections (300 injections) were enrolled. Eighty-seven bruises were observed out of 300 injections (29%): 57 of 150 (38%) after injections lasting 10 seconds and 30 of 150 (20%) after injections lasting 30 seconds (relative risk, 1.50; 95% confidence interval, 1.21-1.86; P = .00). Of the 87 bruises that occurred, 69 (79.3%) were small (2-5 mm) and 18 (20.6%) were large (>5 mm), with no difference in size between 10- and 30-second injections (relative risk, 0.91; 95% confidence interval, 0.39-2.12; P = .83). CONCLUSIONS:: Low-molecular-weight heparin injection should be administered over 30 seconds to decrease bruising. CLINICAL IMPLICATIONS:: There is a need to reflect on the feasibility of such a practice because injecting low-molecular-weight heparin at 30 seconds requires accuracy, a steady hand, the absence of tremor, a calm environment, and the ability to administer an infinitesimally small amount of liquid (eg, 0.4 mL) per second.
Authors:
Alvisa Palese; Elena Aidone; Angelo Dante; Federico Pea
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-29
Journal Detail:
Title:  The Journal of cardiovascular nursing     Volume:  -     ISSN:  1550-5049     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703516     Medline TA:  J Cardiovasc Nurs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Alvisa Palese, MNS, BNS Associate Professor in Nursing Science, School of Nursing, Udine University, Italy. Elena Aidone, BNS Clinical Nurse, School of Nursing, Udine University, Italy. Angelo Dante, PhD(c), MNS, BNS Professor in Charge, School of Nursing Trieste, Trieste University, Italy. Federico Pea, MD Clinical Pharmacologist, Institute of Clinical Pharmacology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, and Department of Experimental and Clinical Medicine, Medical School, Udine University, Italy.
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