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having trouble with bubbles

A

ams162

Well-Known Member
Messages
572
Location
devon
Type of diabetes
Type 1
so after a month with no problems we have now starting getting bubbles in the tubing of the set, last night for example dylan went to bed with a reading of 6.1, i went to bed just over an hour later an did my routine test to find he had shot up to 17.3 :shock: i examined the tube and there was a big fat bubble sat in the middle of the tube so i primed it out and gave a bolus an hour later he was back down to 9.3.

this also happened last week and we dealt with it in the same manner but my question is how do we avoid these bubbles are there any tips to avoid it happening in the first place all we were told by the dsn was take the insulin vial out the fridge the day before set change and to make sure there were no bubbles in the reservoir before connecting. is there anything else i should be doing ??

any help appreciated as im doing so many tests a day to check for it poor dylan needs a break lol

anna marie
 
So far I've learnt:

Take the insulin vial out the fridge more than 24 hours before it's needed. I've found if it's out 48 hours before then bubbles are less of a problem. Last time I had all those bubbles I don't think the vial had been out the fridge long enough.

When you load air into the cartridge and inject it into the vial, make sure the vial is standing upright and the needle is facing downwards and isn't in the insulin, otherwise as you push the air into the vial it pushes bubbles through the insulin filling it with air.

Draw up the insulin into the cartridge and tap out all the visible bubbles. Leave the cartridge to stand upright for a couple of hours. After 2 hours we usually see a few more bubbles which can be tapped out.

Once the cartridge goes into the pump as a routine take it out after about 8-12 hours and check for more bubbles. We use a steel pen to knock against the cartridge quite firmly to knock them into the neck of the cartridge before pushing them out through the tubing (make sure the tubing is disconnected from the infusion site before doing this!). Reload the cartridge into the pump.

After doing this we're pretty much bubble free.
 
I used to get bubbles at the point of connecnting the tube to the cartridge...I had done all the tapping etc, and cleared all the little buubbles..only to find a massive bubble when I connected it all up. I now take the cartridge, clear it of bubble, put the connector on the cartridge, connecnt the tubing, and then ;aod the whole lot onto the pump in one go...not sure why this makes a difference, but it did for me! Not infallable alas, but much better.
 
We do the same as Sophia except for removing it after so long. We have had the occassional bubble but they don't appear very often. If there is a change in temperature that can increase the risk of bubbles. I don't think that there is a pump on the market that is completely bubble free.
If the insulin is at room temperature before you fill the cartridge it helps a lot. Also getting the right technique is an art in its self.

Harry
 
hi harry

we have the vial at room temperature everytime, we had been so lucky with no problems but bubbles in last 2 set changes but have done nothing different. we love dylans pump and wouldnt change it for the world just not sleeping properly because im worrying so much he shoots up so fast. thanks for ur advice

anna marie
 
Hazza said:
We do the same as Sophia except for removing it after so long. We have had the occassional bubble but they don't appear very often. If there is a change in temperature that can increase the risk of bubbles. I don't think that there is a pump on the market that is completely bubble free.
If the insulin is at room temperature before you fill the cartridge it helps a lot. Also getting the right technique is an art in its self.

Harry
Click to expand...

Hi Harry

Although not available as yet through the NHS via PCT funding, the Cellnovo pump is bubble free. You can't even inject insulin containing a bubble in a syringe into the cartridge. The insulin gets through but the bubble is prevented. It is an amazing piece of technology.
 
Hi Harry

Although not available as yet through the NHS via PCT funding, the Cellnovo pump is bubble free. You can't even inject insulin containing a bubble in a syringe into the cartridge. The insulin gets through but the bubble is prevented. It is an amazing piece of technology.
Click to expand...

Wow, sounds like a great piece of kit.
I know that when we are priming the combo pump that we have to bash h*ll out of the bottom to dislodge any remaining bubbles but we usually manage to get them all out. I have noticed that occassionally we get a bubble in the cartridge after a couple of days which wasn't there before. I've no idea where they come from but they seem to stay in the cartridge and not go through the tubing.
Now I've said that we will probably be plagued with them :D


Harry
 
I'm also the same Harry. Unless I see a the bubble appearing in the tubing I just leave it in the cartridge and remove the cartridge when it gets down to the last 10-20u and inject the bubble back into the vial or flush the insulin down the sink. I don't like wasting insulin and am grateful that I'm not having to buy it myself otherwise I don't think I could afford to pump.
 
I know exactly what you mean about wasting insulin. We only put in 250 although the cartridge will hold 310. This is because Lily is not on a great amount and we get 4 refills instead of 3 otherwise. We also leave the bubbles alone unless they are in the tube and then we prime them out, so far we have only had to do it once, maybe we are just lucky but I think a lot depends on how the pump is worn, ie not with the tube upwards.

Harry
 
Lily usually wears hers sideways but we did a set change at tea time and she wanted to wear the one that I made her which is with the tube to the top. We will need to keep an eye on it tonight.

Harry
 
Glad to hear I´m not the only one with all this bubble trouble!
Am I right in concluding that a few of you are confident that a bubble in the cartridge can be left?
I have never dared to leave one but it does seam a waste of insulin and hassle for my son Matteo.

Sus
 
sus matteos mum said:
Glad to hear I´m not the only one with all this bubble trouble!
Am I right in concluding that a few of you are confident that a bubble in the cartridge can be left?
I have never dared to leave one but it does seam a waste of insulin and hassle for my son Matteo.

Sus
Click to expand...

Bubble trouble is normally down to user error :) With practise things will get better. 1 inch of bubbles are equv to 1 unit of insulin.
If you do end up with any bubbles in the tubing keep an eye on them and as soon as they get near the cannula then remove tubing and prime out. It's very simple to do and takes seconds :)
 
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