How to Give Yourself an Injection Under the Skin With Blood Thinning Medication in a Prefilled Syringe

This information describes how to prepare and give yourself an injection (shot) under the skin with blood thinning medication in a prefilled syringe.

With this kind of medication, you use a small, short needle to give the medication into the fat right under your skin. A prefilled syringe has the medication already in it. You will practice preparing and giving yourself an injection with your nurse. When you’re at home, use this resource the first few times you give yourself the injections.

Medication Information

Medication: _______________________________________

Medication schedule: _________________________________

Dose and amount: ___________________________________

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Gather Your Supplies

  • Pre-filled syringe and 27 gauge, 1/2-inch needle
  • Pre-filled syringe with the needle attached
  • Alcohol pads
  • Disposable sharps container, such as an empty plastic bleach or detergent bottle with a cap, labeled “Home Sharps-Not for Recycling”.
  • 2 x 2 gauze pad or cotton ball
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Prepare the Injection

  1. Prepare a clean area to set up your supplies, such as a kitchen table. Don’t use the bathroom as a work area.
  2. Clean your hands:
    • If you’re washing your hands with soap and water, wet your hands, apply soap, rub them together thoroughly for 15 seconds, then rinse. Dry your hands with a disposable towel, and use that same towel to turn off the faucet.
    • If you’re using an alcohol-based hand sanitizer, be sure to cover your hands with it, rubbing them together until they’re dry.
  3. Tear off any 3 edges on a sealed alcohol pad. Hold the packet at an edge you did not tear. Carefully open the packet to expose the alcohol pad, but don’t take it out. Set the open packet on your work area. You will use this alcohol pad to clean your skin just before you inject the medication.
  4. Check to see if the needle is attached to the syringe. If the needle is not attached to the syringe:
    • Remove the black cap on the syringe.
    • Remove the needle from its package.
    • Twist the needle onto the syringe using a clockwise motion.
  5. Check to make sure that the syringe has the correct amount of medication. Do not worry about tiny amounts of air.
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Give the Injection

  1. Choose an injection site from the areas shown in Figure 1. Remove or fold back any clothing that covers the injection site. Keep track of which site was used last and rotate the sites. Do not use an area that is less than 2 inches from a scar.
    Figure 1. Choosing an injection site
  2. Take the protective cap off the needle with your non-dominant hand (the hand you do not write with). Do not let anything, including your fingers, touch the needle. If anything touches the needle, it must be discarded in the sharps container. See the instructions under “If Anything Touches the Needle.”
  3. Point the needle up.
  4. Use the alcohol wipe to clean the area where you are going to give the injection. Let it air dry. Do not fan or blow on the area.
    Figure 2. Giving the injection
  5. Pinch a 1 to 2 inch fold of skin between your thumb and first finger. Hold the syringe with your dominant hand (the hand that you do write with) as you would hold a pencil or dart. Holding the syringe firmly, quickly push the needle into your skin. Use a 45 degree angle so the needle will go through the skin and in the fat (see Figure 2).
  6. Take the needle out of your skin at the same angle you put it in. Put the syringe and needle into the sharps container to throw away.
  7. Put firm pressure on the site using a sterile gauze pad or cotton ball. After the bleeding has stopped, put a dry gauze or bandage on the site. Do not rub the area or press very hard. Injecting blood thinning medication can cause a lot of bruising.
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If Anything Touches the Needle

  • If you are using a syringe with a built-in needle, discard it in your sharps container. Start the process again with a new prefilled syringe.
  • If the needle and syringe were not attached, change the needle using the following steps:
  1. Figure 3. Twisting the hub
    Open the package with the fresh needle but do not take out the capped needle. Put it on your work area.
  2. Remove the old needle from the syringe by twisting the hub counter-clockwise (see Figure 3). If you have trouble twisting the hub, carefully recap the needle. Then twist it again. After you remove it, place it in your sharps container. Do not let anything touch the exposed hub of the syringe.
  3. Take the new capped needle out of the package. Attach it to the syringe by twisting it clockwise.
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Discarding a Pre-filled Syringe

If you need to discard a prefilled syringe, you will need to replace it. Call your doctor for a prescription.

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How to Store and Dispose of Your Home Medical Sharps

Storing Your Medical Sharps

  • Use an empty plastic container with a screw-on cap, such as a laundry detergent bottle.
    • It should be strong enough that needles cannot poke through the sides and it should not be breakable.
    • Do not store your sharps in glass bottles, soda bottles, milk jugs, aluminum cans, coffee cans, or paper or plastic bags.
  • Clearly label the container “Home Sharps-Not for Recycling.” Keep it away from children and pets.
  • Put the sharps in the container point-first as soon as you use them.
  • Do not overfill the container. When it is more than half full, wrap the cap with strong tape to create a more secure seal and prevent leakage.
  • Keep the container separate from trash that will be recycled.

Disposing of Your Medical Sharps

  • If you live in New York City, you can place the sealed container in with your regular trash for collection. Do not put it in with your recyclables. If you live in a different county, check with your local department of health for instructions.
  • You can also bring the sealed container to:
    • Your nurse at your next clinic visit
    • Any nonfederal hospital in New York State
    • A local pharmacy
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