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Subject: [IP] doing sils for first time / blood

Hi Ruth,
What Jenna does with the little plastic cap for Sils - is pitch them
immediately, and never use them.  Both ends are sealed, and there really
isn't any serious risk of contamination.  But the insulin can drip out if
you do put the cap on the end of the tube while the pump is off, so there's
no backup problem.  We don't re-prime whether Jenna's turned the pump off,
or whether she just laid it on the sink, still running, while in the tub.

Every once in a while, you just hit a little vein when you put in a sil.
Too bad Murphy's law ruled and it happened to you on your first try.  Our
experience is that, with the low flow rates of a kid, the blood clots in the
Sil, and soon the sugars are too high.  When it happens, we just change it
out right then and there.  Jenna uses EMLA before insertion, so we can still
use the same numb circle even to put in the new one.

Nancy Morgan

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