Details are important, but you can drive yourself nutty worrying about too many small things. Not everything is critical, there is some flexibility, and some days some things just simply work better than other days.
- Small bubbles in your cartridge or infusion set are o.k. If a bubble in the tubing gets too large it can result in less insulin being delivered. A one inch bubble in the tubing represents approximately 1 unit of insulin which won't get delivered.
Clearing bubbles in reservoirs, cartridges and tubing
- Tap the reservoir / cartridge while you are filling it to help move the bubbles to the top, where they can be dislodged during priming;
- Tilt the reservoir / cartridge while you are filling it and try to make one large bubble out of many small ones. This will allow you to dislodge the large bubble during priming;
- Try to let the insulin warm to room temperature before filling your cartridge / reservoir. If you fill your pump with cool insulin, bubbles will appear when the insulin warms.
- Fill the reservoir / cartridge slowly and ensure you do not purge air from the reservoir back into the insulin vial by "squirting it" through the insulin remaining in the bottle. This just causes more bubbles.
If you find a large bubble in the tubing after you are connected, try to watch it's progress. You can judge how far it moves with each pump "click" or "pulse", and estimate when it will arrive at the infusion site and pass into you. If necessary, an adjusting bolus can then be administered to compensate for the missed insulin. Believe it or not, this is not really that big a deal - your numbers might just look funky until the adjusting bolus kicks in ;-)