Giving Your Child an Anticoagulant (Blood Thinner) Shot Using a Prefilled Syringe: Care Instructions

Some anticoagulant medicines are given as a shot (injection). Anticoagulants are often called blood thinners. They don't actually thin the blood. But they help prevent new blood clots from forming and help keep existing clots from getting larger. Your child's doctor may have prescribed a type of anticoagulant called low-molecular-weight heparin, such as enoxaparin (Lovenox).

Anticoagulants can also make your child more likely to bleed. So it's important to take them safely. Have your child take medicines exactly as prescribed. Be sure to get and follow instructions about how to give this medicine safely. With care, you can help prevent bleeding and keep your child safe while letting them play and be active.

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.

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.

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. Follow the manufacturer instructions for safely disposing of the needle and syringe. 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.

• Call your doctor if you think your child is having a problem with a medicine.
• Talk to the doctor before you start or stop giving your child any medicines, vitamins, or natural remedies. This includes prescription and over-the-counter medicines, including pain relievers such as ibuprofen (Advil, Motrin). Medicines may affect how blood thinners work.
• Have your child wear medical alert jewelry. This lets others know that your child takes a blood thinner. You can buy it at most drugstores.
• Tell your child's doctors, dentist, and pharmacist that your child is taking a blood thinner. Also tell the people who care for your child, such as relatives, babysitters, and the school nurse. Let them know what to do if your child has a cut or bruise and when to call for help.

• 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.