When are you finding these? When cartridge is almost empty and you are getting a new on ready? OR As you are putting a new cartridge with set in the pump?
If at beginning, you may be filling the cart. too vigorously. Try filling cart. as first step of site change. Then prep skin for new insertion. Now disconnect old set and rewind pump. NOW, check cart. for bubbles and clear any that are present before connecting infusion set. Then connect new set and place in pump, etc....
Hope this helps.
Yep - I see them too....I notice them when I am changing out the set for a new one.....I wondered what that was all about as well.
I do not have them in the tubing etc at the beginning but by the time I need to change out everything (About 3 days) ...they are there! I was thinking that maybe by the end of the 3 days....any and all air that is in the set gets pushed into the screw point?
Hi and thanks everyone for your input, Sneetch, thats when it happens here, after about 2-3 days and your explanation sounds feasible,
Fine bubbles caused by agitation of the insulin while filling the cartridge can congregate into larger bubbles which often lodge in the hub near the tubing . . . and they can go into the tubing and cause delivery of air rather than insulin. Cold insulin causes this as well . . . so use of room temperature insulin is important. Things I do to help prevent the formation of bubbles include: 1) Be certain all connections are tight before drawing up insulin. 2) Set the insulin vial on a counter or hard surface when injecting the initial volume of air, then turn the insulin vial over so insulin covers the needle before drawing up . . . In this way, large volumes of air do not get pushed directly into the insulin. 3) Pull back and fill the cartridge part way, and then slowly push all the insulin back into the vial. Do this a second time if needed . . . until all the air from the “dead space” of the hub is displaced and filled with insulin. 4) Connect tubing to cartridge securely and “hand prime” until insulin is pushed up into the tubing about 2 to 3 inches . . . In this way you can see if all the air has been pushed out of the cartridge. 5) Then, prime until no bubbles are visible in the tubing. In this way, I am almost always able to avoid tapping the cartridge . . . which creates more tiny bubbles . . . which become bigger bubbles. On occasion I have found an individual tubing set where the tubing itself projects into the hub far enough that bubbles get lodged in the hub and will not flow into the tubing at time of prime. When this happens I start with fresh tubing . . . as I am very sensitive to insulin and do not want to have ANY bubbles showing up later in the game!
I know that your post for this question is over a year old. But I am having major problems with air bubbles now. Every time I fill a new cartridge there is always a large air bubble the first time that I draw the insulin into the cartridge. It takes me several times of pushing the insulin back into the vial and then drawing it back into the cartridge to eliminate this big bubble.
When I push to get the dome of insulin at the mouth of the cartridge a large bubble (or bubbles) come out rather than a small dome. I then have to push out the large bubbles. Then when I twist the leur lock on the cartridge I often can see that there is still a bubble inside under the neck of the cartridge. I will untwist the lock and tubing and when I do this a group to the small champagne bubbles forms inside the leur lock. I have to flick it with my finger to get those small bubbles out. This is incredibly frustrating and time consuming as I am having to look for bubbles in the tubing or cartridge daily now. I am wondering how you are doing and if the suggestions that you made in this post continue to work for you. I hope that you see this and can reply. Thanks, Dancer1
A couple things come to mind... for one, I assume by your description that you are using an Animas pump, and without actually seeing your technique in filling the cartridge the following may be contributing to your challenge: 1) The needle leur, or leur of the tubing are not securely attached at time you draw up the insulin or try to eliminate the bubbles; 2) If the cartridge is expired, or has been stored in an environment that is NOT climate controlled, the lubricant in the cartridge can dry out and allow air to leak in from the bottom as you pull the plunger back and forth. Look for bubbles that start at the base of the rubber stopper; 3) If the bubbles are more of a problem after you attach the leur of the tubing, look to see if the tubing itself projects down into the luer, so you can see a nub around which bubbles get hung up. This has happened to me several times on occasional box and I throw out the tubing and get another as they are just difficult to work with… but I have extra from use of the Inset 30 which has the tubing separate from the site. If that is happening it would be good idea to call your pump manufacturer anyway. 4) And last but not least, call your pump manufacturer for help anytime you are having difficulty. Anima has trained professionals working their customer service lines, and their job is to help you figure out what is happening! If you end up calling, I’d love to hear what you find out!
Thanks for your reply. I do have an Animas Ping and have called the help line and they have reviewed the whole process and say that I am doing everything right. I am trying to meet in person with the clinical rep but this is a challenge. I am tightening the needle leur and and leur of the tubing extra tight. The bubbles do start at the base of the rubber stopper. I have my supplies them stored in a closet in the house. But I am now filling the cartridge the night before changing the infusion set and having it stand overnight to make sure that they are at the same temperature. So I am at a loss as to what it really is. I am going to try the hand priming that you suggested. Thanks again, Dancer
If you have large bubbles that act like an air stream coming up from the bass of the rubber stopper, it could be indication that 1) you are pulling the plunger down too fast; 2) there is not enough air in your vial of insulin… which creates suction as you draw back; 3) or a faulty seal around the rubber stopper… using samples from another box of cartridges could help decipher out that as a possibility. Ideally when you pull back on the plunger it glides easily and does not try to pull insulin back up into the vial. If the rubber stopper on top of your insulin vial is sucked inside there is not enough air; if it is bulging out there is too much air. I generally inject about half as much air into my upright vial as the amount of insulin I want in my cartridge.