title: Effect of syringe size on bruising following subcutaneous heparin injection.
abstract: BACKGROUND
  Bruising and induration associated with subcutaneous heparin injection often result in sustained tenderness and severe ecchymosis at the injection site. Research-based practice guidelines for subcutaneous heparin administration are needed to reduce these adverse effects.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the effect of syringe size (1-mL vs 3-mL) on postinjection-site bruising and induration following the administration of subcutaneous heparin.
  
  
  METHODS
  A convenience sample of 29 subjects receiving 5000 units of subcutaneous heparin at least twice a day was recruited from a large urban hospital. Subjects received their regularly scheduled subcutaneous heparin injections with a 3-mL or a 1-mL syringe in a randomized sequence using a standardized procedure. Injection sites were assessed for bruises and induration at 24, 48, and 72 hours after injection.
  
  
  RESULTS
  The incidence of injection site bruising with 1- and 3-mL syringes was 79% and 69%, respectively. The use of a 3-mL vs 1-mL syringe resulted in significantly smaller bruises at 48 and 72 hours after injection. Induration at the injection site occurred in three patients.
  
  
  CONCLUSIONS
  Findings suggest that 3-mL syringes are preferable to 1-mL syringes for heparin administration. The effect of other injection-related variables should be studied with the use of the 3-mL syringe, and tested on various populations.
authors.affiliation: School of Nursing, San Diego State University, Calif, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Hadley
authors.forename: M
authors.initials: M
authors.lastname: Chang
authors.forename: K
authors.initials: K
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015400:Clinical Nursing Research; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012494:Sampling Studies; D013594:Syringes
chemical_list: D006493:Heparin