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Re: [IP] How to Avoid Bubbles

Great tips, Andrew.  This is exactly what I do and have never had air
bubbles in 5 years of pumping.  Thanks for writing this up!

I also, with the insulin bottle still attached and the needle UP, flick the
reservoir several times with my index finger to dislodge any air.
Sometimes, even when it looks fine, there can be tiny bubbles still present.
This brings them into the neck of the needle and they can be pushed back
into the insulin bottle.  Then, slowly withdraw a bit more insulin to fill

Once the set is attached (reservoir still in the up position, I slowly push
the syringe to fill the tubing, and at times have had to flick the reservoir
to make sure no bubbles remain where the tubing and luer attach.  I too,
hold the tubing up to the light and check for ANY bubbles, then load the
reservoir into the pump.

I have found that if I take my time and do this the same way every time,
that sometimes, when priming, much less than 5 units are needed before
insulin starts to appear from the SoftSet needle.


ICQ#: 3822759

> I haven't had any problems with bubbles in the infusion set tubing, but I
> can certainly understand how they could happen. Here's what I do to avoid
> them (using a Minimed 507C with a 3 ml reservoir). Of course, as in all
> things diabetic, YMMV:
> First of all, bubbles aren't magic. They're present because either they
> were _pushed_ into the tubing (from trapped air) or _pulled_ into the
> tubing (from a loose fitting).
> 1. Before filling the reservoir, pull (not all the way) and push on the
> plunger a couple of times to distribute the lubricant already inside. This
> will reduce the possibility of air leaks around the plunger while filling
> the reservoir in step 4.
> 2. Before filling the reservoir, twist the filling needle with the plastic
> cover so it's *tight*. This will minimize air leaks through the needle in
> step 4.
> 3. Withdraw the plunger to fill the reservoir with air and then inject
> air into the insulin bottle. If this step is omitted, the insulin bottle
> will be under a vacuum and air will be sucked into the reservoir from
> around the plunger in the next step.
> 4. Fill the reservoir from the insulin bottle with the needle pointed *up*
> so that air floats to the top of the reservoir. When the reservoir is
> withdraw it from the insulin bottle. Holding the needle *up*, tap sharply
> on the reservoir so that the air around the plunger is knocked to the top.
> Then, hold the reservoir up to a bright light and push the air (and any
> insulin trapped between air pockets) out of the reservoir. Stop pushing on
> the plunger when insulin starts to flow out the needle and no bubbles are
> left in the reservoir.
> This step is NOT included in the "Instruction for Use" of the Minimed 3.0
> ml Reservoir (REF MMT-103). Instead, Mimimed advises you to get rid of the
> air after you connect the infusion set (step 6). However, it's much easier
> to manipulate the reservoir without the infusion set attached and I
> yet filled a reservoir without seeing some air at this point. IMHO, this
> the single most important step listed for eliminating bubbles.
> 5. Holding the reservoir with the luer connection *up*, unscrew the
> needle with the plastic cover, and attach the new infusion set connector.
> Screw it on *tight*.
> 6. Holding the reservoir with the luer connection *up*, push on the
> until the insulin comes out the needle. Once insulin starts coming out,
> there should be no bubbles visible anywhere at this point. If you see
> bubbles, get rid of them before going any further. Try to figure out how
> they got there. THERE IS A REASON.
> 7. Insert the plunger into the pump and (gently) push the driver arms
> against the plunger to minimize the priming quantity.
> 8. Prime the pump. 5 units should be more than sufficient. If insulin
> doesn't appear at the needle tip after 5 units, look for leaks and bubbles
> and try to figure out what went wrong. THERE IS A REASON.
> Any suggestions for improving this procedure would be appreciated.
> ----------------------------------------------------------

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