|
ADAPTIVE INSULIN PUMP TECHNIQUES����
���������������������������� ���������������������� by Tom Tobin ��������������������� ���� I use the
MiniMed 507 insulin pump, and I make use of its audible bolusing feature, which provides audible feedback when programming a bolus.� It can be set for either half‑unit or full‑ unit increments. ���� With respect
to filling the pump's syringe, I have developed a system that works well for a blind person, without any sighted assistance. ���� First,
when filling the syringe, I pull down on the plunger until the bottom of the syringe barrel and
the plunger are about the distance from the tip of my index finger to my first knuckle; as a measuring device,
you always have your knuckle. ���� Then, just
as with a regular syringe, I tap the sides of the syringe barrel, and then push the insulin back
into the vial.� I
repeat this step until I cannot hear any "bubbles" escaping when pushing the insulin
back into the vial; there should be a "smooth" sound. ���� Since air
may trap at the top of the syringe itself, next I pull a little air into the syringe and push
up on the plunger ever so slightly, until insulin comes out the
tip of the needle; just a little push.� That completes filling the syringe. ���� Next, while
holding the syringe in my left hand, I take the infusion tubing and remove the cover at the end
of the tubing that goes over the neck of the syringe, where
the needle once was.� Make
sure that there is a snug fit as you tighten down the collar of the infusion set over the
neck of the syringe. (I sometimes use my teeth to make sure
it is really tight.) ���� Then I
put the plunger of the syringe on a flat surface, usually a table top, and begin pushing down
on the barrel of the syringe, thus filling the infusion set.�
I want to stress that this should be done very slowly,
to avoid any air pockets in the tubing.� If it is done right, there should be no air bubbles at all in the tubing.
Letting a drop of the insulin fall on the back of your
hand is fine, although I put the needle guard at the other
end of the infusion set between my teeth and use my tongue
to feel when the drop falls.� Whatever works for you. ���� I am using
MiniMed's softset infusion set, which has an introducer needle that you remove after the cannula
is properly inserted.�
If using regular bent needle infusion sets, you� merely
need to develop a system of inserting the needle.� However,
with these softsets, I strongly recommend using the "soft‑serter" device which
is a similar in concept to a lancing device, with a spring loaded mechanism,
which will properly insert the softset.� Basically, after you fill the syringe, attach the infusion set and prime it;
then you put the syringe into the pump and prime the pump so
the "arms" on the pump (which push up on the
syringe plunger) are set properly. ���� Then load
the soft‑serter, by placing in it the end of the infusion set with the introducer needle, and "cock"
the soft‑serter.�
Remember, keep the tubing of the infusion set pointing "out" (toward your hip rather than
your belly‑button), as this makes dealing with the
tubing easier. ���� Make sure
before you insert the infusion set, that the "feet" of the soft‑serter are flat
against your stomach. This will give you a "clean" entry for the
introducer needle. ���� Note: Before
I inject the introducer needle, I have my tape all ready to go, usually held between my teeth.�
Once you "pull" the trigger of the soft‑serter,
you will want to make sure you keep downward pressure on the needle
as you guide the tape over the introducer needle and tape
it down around the "wings" of the infusion set.�
It can be somewhat tricky to remove the soft‑serter from the top
of the introducer needle, but with practice you should be
able to do it.� Remember,
don't pull up on the soft‑serter when taking it off the introducer needle!� Also, keeping downward pressure on the introducer needle is very crucial,
so the cannula cannot "creep" up and possibly become
dislodged, as this would result in no insulin delivery.� It will take some practice; but over time, you should be able to learn
the acrobatics of holding the needle down while putting
the tape on.� Be patient
with yourself ‑‑ it does take a lot of time and practice to get it right.� Once the tape is properly in place, then you can remove the introducer needle, and
you should be OK. ���� I just
taught a Cleveland Sight Center client this technique and, three months later, she is now doing
all of it on her own, with tremendous success and better overall control. |
�����������������������������
��������