My Dexcom Insertion process:Part A, preparing the siteStep #1:
If you're doing this on the bathroom counter, put down a fresh
clean towel before dong anything else. Bathroom counters are FILTHY, but you need access to a sink.Step #2:
Put the following items down on the towel: The opened Sensor package (Sensor still inside); a Skin-Prep wipe (not
I.V. Prep); a two washcloth; a hand towel, and a hairdryer.Optional Step:
If you're ultra-finicky, you can also set down down a bottle of PVI, along with and some q-tips to apply it. This is the orange stuff used by MDs and Emergency medics. (It's available in pads too, but the pads are more messy to use; they're made for covering larger areas. You're only going to rub over a 1/2" area at the actual point of insertion. And for use at home, a bottle is much cheaper to use in the long run.)Step #3:
Wash your hands thoroughly, scrubbing hard with that fresh
washcloth. "They" say 20-30 seconds, and I recommend the same (although I actually only do about 10). Then, scrub your target area the same way: scrubbing hard enough to cause some redness. You need to scrape off the loose skin at the surface, which gets penetrated by "bugs". If you haven't turned a bit red from the scrubbing, you're not pressing hard enough.
Don't discard that washcloth yet, and leave the water running!Step #4:
Now, twist the washcloth to get nearly all the water out. (It's still soapy.) Firmly wipe the hair dryer handle and the "high/low/air/off" control switch to clean them up. (Because the hair dryer handle is probably almost as bad as the Countertop before you do this.) If you are going to use PVI, wipe the PVI bottle (especially the lid) in the same way. The water is still
Now, hold that washcloth under the water again to get a lot of "rinsing" water in it. This rinses your hands too, of course. Rinse your target area. If it still seems soapy, even a little bit, then repeat.Step #6:
Now, use the washcloth to turn off the tap. (Don't touch the handle directly.)Step #7:
Use the hand towel to dry the target area and your hands, rubbing firmly.Optional Step, If using PVI:
Load up one of your q-tips with PVI, and rub the wire insertion point of your target, plus about 1/2" in each direction (a circular area). Note the exact location carefully, because you will NOT be able to use the colored circle as a guide later. Let it dry, and then reload the Q-tip and re-wipe the area as needed, in order to get at least 30 seconds of LIQUID contact with your skin. (Keeping it wet might take several repeats.)Step #8:
Using the hand towel, plug in the hair dryer and turn it on "low". The purpose of the hair dryer is not to "dry" the Skin-Prep; the reason why you MUST have a hair dryer is that the Skin-Prep liquid starts out extremely runny, and gravity will make it flow downwards (from the top of the wiped area into the bottom of the wipes area). This leaves the protective film too thin at the top edge, and the top edge is where Dexcom's Adhesive Pad usually comes lose first. You will use the hair dryer, pointed upwards, to keep the Skin-Prep fluid in place while it dries into an even
Your Hair Dyer May Vary ("YHDMV"), so you might want to use the "air" setting instead. But definitely not "High". The gravity-induced flow happens so quickly that you won't have time to turn on the hairdryer after you wipe -- you need to have it ALREADY RUNNING, and ALREADY IN YOUR HAND as you wipe (with the other hand).Step #9:
Open your Skin-Prep wipe, and pull it out of the foil. Pick up the hair dryer with the other hand, and put it about 6" away from the target area-- but don't point it AT the target until the wipe is done, and your hand holding the wipe is well away. Wipe thoroughly in a circular motion. (And of course, make sure that the Skin-Prep area is bigger
than the size of the Dexcom adhesive pad.)
After a few seconds, remove the wiping hand from the area and IMMEDIATELY tilt the hair dryer to counter-act gravity while the Skin-Prep dries. When the Skin-Prep has dried, re-wipe gently and re-dry. This time, be careful to dry your Skin-Prep coating to the level which works best with Dexcom: Dry, with tiny cracks, but not BIG cracks. The tiny cracks look like a "shimmering" effect. Then proceed directly into Part B, Attaching the Sensor Assembly.
. If the cracks have gotten too big, just re-wipe a third time.
Special notes for users of PVI antiseptic: If you used PVI, then you will have noticed that the Skin-Prep application pretty much wiped it off. This harmless, because Skin-Prep is another fairly decent antiseptic solution itself; your hands are clean; and the PVI has already killed any "really bad" stuff in the vicinity of the puncture site. (Yeah, something could theoretically be wiped from the wider Skin-Prep area into the puncture site without being killed... but this is already better than 99.9% of insertion procedures being used by Dexcom users. If you want more safety, just wipe PVI over the entire adhesive pad area -- or maybe install an Operating Theater in your House?)Part B, Attaching the Sensor Assembly.
(to be edited soon....)