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Re: [IPk] alarming pumps

Di ,
Are you cycling the insulin reservoirs ?
Basically this means moving the piston up and down a couple of times before
filling with insulin .
This spreads the lubricant evenly around the reservoir and dramatically
reduces chances of no delivery .

I agree with John that it would be ideal to get the reservoir and line
checked for bubbles once or twice weekly at your GPs .
It would only take a minute and would reduce your anxiety and risk of hypers
I have no experience of storing full seringes and catheters in the fridge
but cannot imagine that this would affect the insulin stability as the
catheters as all materials used are ' insulin friendly '
I will talk to my US colleagues to check but this sound like a good solution
to me .

I'm concerned that you may be getting A35 alarms which can occur if you
manually turm the leadsrew during insertion of the reservoir .
Turning the leadscrew accidentally by hand indicates to the pump that
delivery may be too fast and causes the pump to turn off , alarm and display
a A35 alarm which is a safety system to prevent overdelivery .
As you know the Minimed cannot overdeliver as it has a solenoid motor and I
think that you may be triggering this safety feature .
Call if you want to discuss .
-----Original Message-----
From: Diana Maynard <email @ redacted>
To: email @ redacted <email @ redacted>
Date: 30 April 1999 15:18
Subject: Re: [IPk] alarming pumps

>Hi John
>I'm not particularly concerned about it.
>It was definitely a case of air in the tubing.
>I'm waitng for the 506 manual (as I'm still wiating for the
>silhouettes - asked Donna to order them but I rang up the clinnic
>yesterday (since she's away in GLasgow) and apparently nothing had
>been done. (I got Disetronic to send me 6 sample Tenders so am OK for
>now on that one).
>As for the checking procedure:
>I fill the reservoir and tubing, get it all working, get someone to
>check it and then keep it until I need it, so when I need to change it
>it's all ready.
>However, I did that, it all appeared to be fine when I changed it this
>morning, but then the bubbles appeared. But even when I asked Julia
>(the woman at the Braille class who's daughter has a pump and who is
>used to dealing with them) to check the tbe she couldn't see any air
>bubbles, yet there were definitely some there later. Usually I do some
>test boluses every so often just to check that everything is still OK
>or if I am the slightest bit suspicious. I can't really see what more
>I can do. Anyway, it wasn't a huge problem. I should probably put a
>lot more insulin through the tube to clear any potential bubbles
>before I attach a new tube, I guess. And I suppose I could always keep
>doing some test boluses the first few hours afterwards. Once I know
>there's aproblem it's easy to fix, but as you say, better to prevent
>it or catch it early.
>I don't like the full reservoir method as the sticking out bit digs
>into me, especially if I have it anywhere except in my pocket or on my
>> Di -
>> You might want to keep cool on this one. I've been through periods of
>> having a lot of no delivery alarms, and then they disappear for no
>> reason. I've never worked out why they come in phases. It's possible
>> that you have an old box of cartridges that are getting sticky. My new
>> ones certainly seem smoother. Or it may be stress related where the body
>> isolates and blocks the tip of the cannula.
>> Get Minimed to send you a proper 506 manual if you haven't one already,
>> and work out a fool-proof method of clearing the alarm. The buttons on
>> the Minimed pumps are a bugger. They bounce sometimes, or don't respond
>> other times.
>> Have you not sorted out a procedure for checking the system for air? It
>> seems a bit dumb to be waiting for a mega-high bg in order to notice
>> you're pumping air. If you use the 3ml full-fill method, you can get
>> away with one cartridge change a week possibly. Can you not have the
>> nurse at your doctor's surgery check it over every Monday morning? It
>> may involve a slight loss of independence, but since one reason for
>> going on the pump is to improve your control in the long-run, and stop
>> yourself going any blinder, it would seem a sensible compromise.
>> Or could they pre-fill 4 or 5 cartridges and infusion lines for the
>> month, and you store them in your fridge. Not sure what the implications
>> are for crystalisation in the tube, or degradation in the cartrige.
>> Minimed team? Ideas?
>> John
>Insulin Pumpers website http://www.insulin-pumpers.org/
>for mail subscription assistance, contact: HELP@insulin-pumpers.org

Insulin Pumpers website http://www.insulin-pumpers.org/
for mail subscription assistance, contact: HELP@insulin-pumpers.org