This leaflet provides information about how to self-administer a daily subcutaneous injection you need while stopping your warfarin medication for your endoscopy test. The injection is called tinzaparin. The reasons why you need to stop your warfarin medication will have been discussed with you at your preassessment appointment.
What is a subcutaneous injection?
A subcutaneous (sub = below, cutaneous = the skin) injection is giving medication using a needle and syringe into the fatty tissue just beneath the skin.
The injection must be given to an area where there is enough of a fatty layer to ensure the medication can be given into the correct area easily.
Suitable areas include:
- Upper arm
- Buttocks
- Top of the thigh
- Abdomen
Why do I need an injection?
You need to stop your warfarin medication for your endoscopy test, the reasons why will be discussed with you at your preassessment appointment.
The preassessment nurse will discuss the dose of tinzaparin you need to give yourself and the time you need to give it.
Are there any risks of subcutaneous (tinzaparin) injection?
Subcutaneous injections are very safe and most patients can manage to give the injections without any problems. Occasionally there may be discomfort, redness or swelling around the site where the injection is given. Very rarely patients can have an allergy to the medication, however if you develop a rash, bruising or unusual bleeding, use the contact numbers at the end of this leaflet to get further advice.
Why do I need to give myself an injection?
There are many benefits of giving your own injections. Injecting your own medication means that you can be in control and you can give the injection at the prescribed time, but in the comfort of your home without having to visit the doctor or nurse every day or wait for the district nurse to visit you at home.
How do I prepare for my injection?
Everything that you will need will be given to you by pharmacy. You will need:
- A pre-filled syringe which already contains the medication with a needle attached
- A yellow sharps bin to safely put the needles into after they have been used
- Gauze
How do I inject myself?
- Wash your hands with soap and warm water and dry with a clean towel.
- Make sure you have your syringe with needle attached the yellow bin and gauze.
- Choose a suitable site for injection (the nurse will advise you of this before you are discharged).
- Remove the cap from the needle.
- Gently pinch up the skin into a fold using your thumb and index finger (to lift the fat layer away from the muscle.)
- Holding the syringe the way you would hold a pen or pencil, insert the needle under the skin at a 90 degree angle to the pinched up skin (the needle should be completely covered by the skin).
- Inject the medication slowly.
- Once all the medication has been injected, keep the needle in place for five to ten seconds to ensure all the medication is absorbed.
- Remove the needle quickly and apply pressure to the site with gauze but do not rub.
- Do NOT try to put the cap back on the needle and put the syringe into the yellow sharps bin straight away.
- Mark the date and time on the record sheet to show that you have taken the injection.
Tips
- It is best for you to use a different injection site for each injection. For example if you use the left leg thigh for your first injection use the right leg thigh for your second
- Give injections at least 1.5 inches (3cm) away from the last injection site
- If you are giving the injection into the thigh try to keep your leg muscles relaxed
- Try to keep the needle straight as it goes in and comes out
Who can I contact if I need help?
Most patients can give the injections without any problems however if you experience any of the following, please contact a health professional on one of the numbers below:
- You are unable to give yourself the injection (for whatever reason)
- The injection site continues to bleed
- There is a lot of pain
- You inject the medication into the wrong area
- You get a rash
- You develop a fever (high temperature) or signs of an allergic reaction
- You develop pain or swelling in the legs, chest pain or breathing difficulties
The Endoscopy Department (Mon – Fri 8.30am to 5pm) 0191 445 2586
Accident and Emergency Department (QEH) 0191 445 2171
Your GP or district nurse
If you require any further advice or information regarding your tinzaparin injection please contact:
The Endoscopy Department 0191 445 2586
Monday to Friday (8.30am to 5pm)