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[IP] Avoiding Bubbles (was "resouvir [reservoir] question")

Hi, Lyra.

Since I've been on the pump, I've had no problems with bubbles. Here's what 
I do, but 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 pull 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 on 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 this 
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 full, 
withdraw it from the insulin bottle. Holding the needle *up*, tap sharply 
several times 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 haven't 
yet filled a reservoir without seeing air at this point. IMHO, this is the 
single most important step listed for eliminating bubbles.

5. Holding the reservoir with the luer connection *up*, unscrew the (tight) 
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 plunger 
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 much more than sufficient (2 will 
usually do). 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 

regards, Andy

At 19:29 5/22/00 -0700, you wrote:
>I had a really hard time getting all the air bubbles out of the
>syringe. I've tried using pens, and other things trying to get rid of the air
>bubbles, and it seems not to work. Anyone have any ideas, suggestions,

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