pump approved

[Minnie45]

Have you tried leaving a small gap between the top of the piston and the bottom of the cartridge when you insert the cartridge into the Veo and then by advancing the piston through load cartridge or prime, that should then allow the piston to engage with the bottom of the cartridge to push insulin through the tube. This might work as I had similar problem with the Combo even with getting the bubble out of the cartridge before loading it in the pump.

Thanks will give that a go

 

[iHs]

The only thing with leaving a small gap, is that the pump might sound the occlusion alarm when the cartridge gets empty as it won't know that a small gap has been left as it will think that a blockage is preventing the piston from being able to push any more insulin through the tube but it's nothing to worry about as all it will mean is that the cartridge is empty and with any luck, you might find this bubble problem is no more.

Another thought is injecting air downwards into the vial. Is there a chance that you didn't flip the vial up the other way quick enough and ended up drawing air into the cartridge with the insulin? If this happened and you injected the air and insulin back into the vial, the bubble will always appear in the cartridge when you try to fill it.

 

[irrationalJohn]

I don't tend to get any problems the first few hours after filling a reservoir, it tends to happen later the same day or overnight. I always ensure the insulin is room (preferably body) temperature,

How long do you leave the insulin at room temperature? It can take the day or two you mentioned for air which is dissolved in the insulin to come out of solution and show up as bubbles. On the rare occasions when I can get myself to think ahead, I will fill the reservoir and let it sit at room temperature for a day or preferably two before using it. This gives any air in solution a chance to emerge.

It might also help to attempt to equalize the air pressure in both your insulin vial and any pre-filled reservoir. I add an extra step to try to accomplish this.

First, I remove the reservoir as Medtronic suggests by holding the vial upright with the Medtronic reservoir connector still attached to it. This allows any excess air pressure in the vial to escape/equalize. The pic below from the Medtronic "Filling Your Reservoir" instructions illustrates this.

[Updated 10/25]
In the past at this point I would then use the blue "Transfer Guard" connector to equalize the inner & outer air pressure of the reservoir. But after thinking further, I have decided to instead discard the detached "Transfer Guard" and simply pull back the reservoir plunger a gradation or two before allowing the reservoir to sit upright on the plunger at room temperature for 12 hours or longer.

My thinking is that pulling back the plunger of the sealed reservoir will lower the air pressure at the "top" of the reservoir. This will hopeful encourage more dissolved air coming out of solution beyond what would have precipitated just from the reservoir insulin warming to room temperature.

Finally, when I attach and fill tubing with this reservoir, I always "prime out" any precipitated bubbles (and hope I won't get more later as I use the reservoir).

I don't know how much the above helps, but it's the approach I take to filling a reservoir.

Have you tried leaving a small gap between the top of the piston and the bottom of the cartridge when you insert the cartridge into the Veo and then by advancing the piston through load cartridge or prime, that should then allow the piston to engage with the bottom of the cartridge to push insulin through the tube.

For some reason I can't figure out what you are suggesting here. There is always a gap between the pump piston/plunger when I put in a new reservoir since I've rewound the pump. And of course, that gap has to be closed for the pump to work. I'm just not understanding the suggestion.

 

[Minnie45]

Thank you again everyone for the advice, will put that into practice and see how it goes

 

[iHs]

How long do you leave the insulin at room temperature? It can take the day or two you mentioned for air which is dissolved in the insulin to come out of solution and show up as bubbles. On the rare occasions when I can get myself to think ahead, I will fill the reservoir and let it sit at room temperature for a day or preferably two before using it. This gives any air in solution a chance to emerge.

It might also help to attempt to equalize the air pressure in both your insulin vial and any pre-filled reservoir. I add an extra step to try to accomplish this.

First, I remove the reservoir as Medtronic suggests by holding the vial upright with the Medtronic reservoir connector still attached to it. This allows any excess air pressure in the vial to escape/equalize. The pic below from the Medtronic "Filling Your Reservoir" instructions illustrates this.

After doing this I rotate the reservoir 180 degrees so that the reservoir connector end is now "up" and the plunger end is "down". I then reattach the blue "Transfer Guard" connector to the reservoir to let the air pressure in the reservoir equalize. Doing this briefly is probably enough. But since I don't expect any "contamination" is going to get into the insulin via the needle in the blue "Transfer Guard" I have also just left it on while waiting the day or two before using the reservoir.

I don't know how much the above helps, but it's the approach I take to filling a reservoir.



For some reason I can't figure out what you are suggesting here. There is always a gap between the pump piston/plunger when I put in a new reservoir since I've rewound the pump. And of course, that gap has to be closed for the pump to work. I'm just not understanding the suggestion.

My experience with leaving a gap was to do with a Combo pump and cartridge filling. By leaving a small gap between the top base of the piston instead of advancing the piston up to be at the same fill rate on the cartridge before inserting it, prevented the appearance of the bubble at the top. Everytime I got rid of the bubble first and then advanced piston to be at the same fill rate as on cartridge, the bubble always appeared. Now that I'm using a Vibe which has a narrow diameter cartridge which helps to make getting rid of any bubbles easier, I haven't had any problems. Must be the way some pumps are designed or maybe my one was faulty.....who knows