Effect of Cold Application on Local Problems among Patients Receiving Subcutaneous Enoxaparin

Abstract

Background: Subcutaneous enoxaparin administration often causes problems such as pain; bruise and hematoma at the injection sites. In terms of these problems, cold application has been found to have various therapeutic benefits as relieve pain by produce localized anesthetic effect and controls bleeding by causing vasoconstriction. Aim of the study: To investigate the effect of cold application on local problems among patients receiving subcutaneous enoxaparin. Design: Self-controlled trial design was utilized. Setting: The study was carried out in general surgery department, orthopedic surgery department, and chest Intensive Care Unit at Beni-seuf University Hospital. Study subjects: A purposive sample of 60 patients was included in the study. Data collection tools: Data were obtained through Patient assessment tool, Bruising Category Scale, Visual Analogue Scale for pain and Hematoma Formation Scale. Results: All studied patients had pain and more than half developed bruise at injection site when they received enoxaparin without cold application but more than three quarter of studied patients had pain and less than one quarter developed bruise when they received injection with cold application. Meanwhile, the majority of the studied patient did not develop hematoma whether cold applied at injection site or not. Conclusion: The pre-injection cold application at enoxaparin injection site was effective in reducing the occurrence of pain and bruising. Moreover, there was statistically significant relation between the patients' pain intensity, the size of bruising and their demographic characteristics; age and gender. Recommendations: Cold application should be included in standard protocol for the administration of SC enoxaparin and providing ongoing and regular in-service educational programs about it for nurses.