Background: Pain and ecchymosis at the injection site are among the adverse effects of the subcutaneous anticoagulant enoxaparin. The patient may be unable to continue treatment due to the frequency of side effects. Pain and ecchymosis can be effectively managed with the right subcutaneous injection technique and cold application at the injection site. People can greatly lessen discomfort and potential adverse effects by using cold application and making sure that injection techniques are exact.

Aim of the study: Evaluate the effect of cold application and proper subcutaneous injection technique on pain intensity and ecchymosis extent among cardiac patients.

Design: Quasi-experimental research was utilized.

Subjects: A purposive sample of (120) patients.

Setting: Cardiac department at Minia university cardiothoracic hospital.

Tools: One tool and two scales, the first tool was a structured interview assessment sheet, the second was numerical pain rating scale and the third was Ecchymosis Formation Scale.

Results: mean average age among studied groups was nearly constituting (40.9±8.15years and 41.2±9.15years), respectively, there were a highly statistically significant among both groups regarding pain score and ecchymosis extent.

Conclusion: According to the study, patients who received SC enoxaparin injections using the correct SC injection method and after being chilled for five minutes before to the injection had less ecchymosis and pain than those who received standard nursing care