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When changing out the resevoir in MM pumps..

Discussion in 'Parents of Children with Type 1' started by PseudoJenn, Sep 5, 2009.

  1. PseudoJenn

    PseudoJenn Approved members

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    do you ever find that there are a lot of bubbles sitting in it???? :eek:

    We're very diligent in getting all of the bubbles out of the resevoir and priming them out the tubing.. yet, everytime I'm doing a site change on DS, I seem to find that the resevoir is full of them!!!
    He's so sensitive to insulin, that this makes a huge difference if the air goes through to the tubing instead of insulin.

    I even took a picture if I'm not explaining it quite right...

    Am I doing something wrong when we first fill the resevoir? DOES it matter if the insulin is cold or room temp? We take it straight from the fridge, insert air into the vial, draw out insulin into the resevoir, take the vial off, attach the tubing, tap (whack) the vial until we see ALL VISIBLE bubbles rise to the top... visually inspect it to make sure there aren't any more hidden bubbles/air anywhere.. and push the plunger up while holding the tubing straight up.. and watch the air travel up out of the resevoir, into the tubing until we see some good drops of insulin coming out the end of the tubing (after we've seen the air bubbles go out first).

    Then.. it looks fine for a day or two, but then I notice bubbles starting to accumulate around day two and on day three of site change.. sometimes there are a lot. :confused:

    Anyone?

    Thanks!!!
     
  2. Flutterby

    Flutterby Approved members

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    I think you'll get less bubbles if the insulin is room temp. it sounds like you are doing everything right, bubbles just happen though. We always use room temp insulin, unless its a new vial and its just coming out of the fridge, and sometimes we still get bubbles. If the weather is warmer we tend toget more bubbles as well. If I notice we are getting more bubbles than usual I just take out the resevoir get all the bubbles to the top, rewind the pump and then reprime, when I prime I hold the pump sideways, so the reservoir is standing straight up, to make sure the bubbles are on top and leave.
     
  3. twicker1

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    Do not use cold insulin. We were told to always make sure it is room temperature. If you keep your insulin in the fridge, just draw it up, and let it sit somewhere for about 20 minutes or so. Then do what you normally have been doing. If I can remember, I will do a tube bubble check once a day.
     
  4. PseudoJenn

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    OOOOOOokay dokie! I will try the room temp insulin! I'll draw it up and let it sit in the resevoir while the EMLA cream is working.. that should work!

    Thanks for your replies. :cwds:
     
  5. MsBeckaroo

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    Oh my! In all these years, I've never heard of letting the reservoir sit at room temperature before using! :eek:

    I always worry about that when we have to prepare one to take with us somewhere because we usually don't keep it chilled.

    I always have issues with those darn air bubbles, which is why I hate, hate, hate when we end up having to change it at bedtime. It always "looks" okay, but I can pretty much count on a bg of 200ish in the morning.

    Thanks for the great info! I'm going to do this from now on. ;)
     
  6. Sarah Maddie's Mom

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    Do you push the plunger up and down to lubricate with those cartridges?? I know it's a big part of what helps to keep the bubbles down on ours ( Cozmo). Also, I think drawing room temp insulin into the cartridge makes a big difference. I just let a vial warm up a bit - if I'm in a rush I actually stick it in my bra :eek: and then fill 3 cartridges at a time. Works for us.;)
     
  7. shekov

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    Since I don't know how to link things (I'm a computer idiot) I copied this from another thread. Abby Dabby Doo wrote this in response to a similar question. It helped me a lot. And I still get bubbles, more during the summer. I check for them every day and rewind then prime them out.


    I have two suggestions for you, since we don't have the same pump I don't know if one of these options will make since.

    First suggestion is easy... Fill the reservoir and let it sit over night (don't remove the plunger), the next morning push the air out with the plunger.

    Second suggestion is... Pull the plunger back and forth, back and forth, and then farther than you need it filled. Example we fill Abby's reservoir with 100 units, but when I pull the plunger back I go to 180 to 200 units. THE INSULIN IS STILL SETTING ON THE COUNTER when I do this next step. Attach the reservior to the vial of insulin, push the air out of the plunger and into the vial of insulin. With pressure, holding the plunger down (so no air can get in the reservior) flip the vial over (so the insulin is upside down) and let the reservior fill itself up. The more full the vial of insulin is the faster the reservior will fill up. A big bubble will form on it's own and float to the top. When it is done moving on it's own- VERY SLOWLY, can't stress that enough, slowly pull back the plunger to 20 more units than what you need. At this point I look for obvious bubbles (9 times out of 10 I have NONE). Gently tap the side with a pen, your not playing the drums, so just gently tap them. The harder you tap it can cause surface bubbles and those are a pain. Push up on the plunger until you are where you need to be, and those bubbles should be gone!

    Good luck!!!
     
  8. tandjjt

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    Not sure if anyone else said this or not, but when the pump tubing is disconnected, are you suspending the pump?

    We were having the bubble trouble thing and I believe it was someone here that said not to suspend when disconnected and it would help. It seemed to work, but we still have bubble issues sometimes.

    We always make sure the insulin is room temp before using it to fill the resevoir too. Absolutely move the plunger in and out several times before you draw the insulin too - that seems to help us as well.
     
  9. MsBeckaroo

    MsBeckaroo Approved members

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    Hmm...okay. I'm a little unclear now. I thought we're supposed to fill reservoir with insulin right out of the fridge, then let the RESERVOIR sit at room temp before using. Do we instead, let the INSULIN VIAL sit at room temp before using??

    I've never suspended the pump while filling the reservoir, but I do whack it pretty hard with the pen :eek:. I was told by our endo nurse not to be afraid to whack it hard, but I do always get those tiny white bubbles, almost like champagne bubbles at the top!

    I do pull back farther than the amount I need then push some back in, but never back and forth, back and forth BEFORE putting it on the vial.

    Phew! 7 years and so much to learn! :) I definitely feel like I've gotten rusty.

    Thanks for the post! ;)
     

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