Site change

[mids1999]

I will be doing my first site change today and would like some input.
I am using 6mm insets with tagadern over the sets tape cause the set wouldnt stick.
Whats the best (least painful) way to get this thing out?

Also would appriciate if some of the pumpers would please post some site change tips and or tricks.

[RLK]

Personally, I just rip them off. The tegaderm feels like a band-aid, and you'll never feel the cannula move. If that sounds too painful, take a good hot shower first to soften the adhesive.
I always change sets before a meal (usually supper). That way, I know that I will be awake for at least a few hours more and I will be bolusing through the new set at least once. Never change a set right before bed- you won't know if it's bad until the next morning. By taking a bolus right away (after priming, of course), you "flush" the set, and it makes it that much easier to know if your new set is bad for whatever reason. Your BGs will let you know if the set isn't any good.
I'm sure that you'll do fine- let us all know how it goes!

[nshack]

When I first got set up I dreaded the seemingly complicated process of changing a set. It was daunting. I felt like I might do something out of order or something... now it's no big deal and I just grab the inserter and alcohol swab and quickly do the change.


I think some of the things that have really helped me with the set changes is:
- usng the same resevoir and tubing for 5 days and just changing the cannula
- this makes it so that 2 of 3 set changes are quck with no insulin handling involved.

When i heard tales of people having sets fail right away and having to put a new one in, I thought it was creepy and unfair. Now it's happened to me and I didn't like it, but it's just one of those unique problems with pumping that you have to deal with. I've had a bad box and had to do 5 in a day to get one to work. The company sent me 30 sets to make up for it.

Use your instructions from your pump the first few times and then you'll gain confidence and be able to do it freestyle.

[JediSkipdogg]

RLK brought up what I do quite often. Being a man and not wanting to shave my stomach, I just remove the set in the shower. It then allows me to clean where the old set was and where a new set will go. Then, once out of the shower, I sit around for 15 minutes to allow the skin to dry, then put the new one in. For me, total time disconnected is about 30 minutes.

Some words of advice are do not put a set in just before a shower or just after one. The "glue" doesn't have enough time to set up and may make the set fall off prematurely that way and since you use tegaderm, may also make that stick less.

In 4 years, I'd say I've only had 4 sets be bad on the first insertion or within the first few hours. So, probably expect one a year to go bad. Which, considering what we are doing, isnt' that bad.

After you get it down a few times, it'll be simple to do. Good luck.

[xMenace]

If I have sticky problems or expect some sweat, I'll dab it with some Friar's Balsam. It turns the mesh brown, but it really works well.

You'll be a pro in do time.

[Cyborg]

RLK brought up what I do quite often. Being a man and not wanting to shave my stomach, I just remove the set in the shower. It then allows me to clean where the old set was and where a new set will go. Then, once out of the shower, I sit around for 15 minutes to allow the skin to dry, then put the new one in. For me, total time disconnected is about 30 minutes.

Some words of advice are do not put a set in just before a shower or just after one. The "glue" doesn't have enough time to set up and may make the set fall off prematurely that way and since you use tegaderm, may also make that stick less.

In 4 years, I'd say I've only had 4 sets be bad on the first insertion or within the first few hours. So, probably expect one a year to go bad. Which, considering what we are doing, isnt' that bad.

After you get it down a few times, it'll be simple to do. Good luck.

Being a real man... I just peel up the adhesive around the Inset and then peel the set off. Total disconnect time, 3-5 minutes.

I haven't had any issues changing a set immediately before or after a shower. I've always used IV Prep and never had a problem with a set not sticking, except for the once or twice I forgot to remove the tape. :)

[JediSkipdogg]

Being a real man... I just peel up the adhesive around the Inset and then peel the set off. Total disconnect time, 3-5 minutes.

What the heck do you do? The russian mambo while pulling it off? In the shower, it comes off in about 2 seconds as the glus is so moisture soaked that it just wants to come right off. I find if I do it out of the shower, then I get red marks left of my skin, in the shower, no marks besides the hole from the canula.

I haven't had any issues changing a set immediately before or after a shower. I've always used IV Prep and never had a problem with a set not sticking, except for the once or twice I forgot to remove the tape. :)

I do, I find if I change right before or after then I have premature set unstickiness and it wants to come off at which point I have to pull the 3000 tape stuff out and get that to hold it on the rest of the time.

[Cyborg]

What the heck do you do? The russian mambo while pulling it off? In the shower, it comes off in about 2 seconds as the glus is so moisture soaked that it just wants to come right off. I find if I do it out of the shower, then I get red marks left of my skin, in the shower, no marks besides the hole from the canula.

No mambo required. It does take about 5 seconds to peel the set off though. I remove my set and apply the IV Prep pad to the puncture wound until it is closed. Being a sticky antiseptic, it seems to help with the healing process.


I do, I find if I change right before or after then I have premature set unstickiness and it wants to come off at which point I have to pull the 3000 tape stuff out and get that to hold it on the rest of the time.

I always use IV Prep and the Unomedical Inset infusion sets... :hello:

[barbarac]

Several have mentioned just changing the site, not the infusion set with the insulin. Could someone give me a brief description of how to do that. I threw out a set yesterday that didn't seem to be working--full of insulin, but wasn't sure I knew how to change just the site. I take it you unhook the tubing, take out the old cannula, insert a new one, then what. You prime?, fill cannula?, rewind? or what. A quick step by step would be great. The animas people walked me through it once (when I had to change battery and everything went back to 0), but don't remember exactly what I did. Don't think I did the fill cannula. Would appreciate a short run-down that I could print out and save. Battery will need changing again one of these days. Could call again, but if I had something to refer back to I would like that.

[Gordonm]

Several have mentioned just changing the site, not the infusion set with the insulin. Could someone give me a brief description of how to do that. I threw out a set yesterday that didn't seem to be working--full of insulin, but wasn't sure I knew how to change just the site. I take it you unhook the tubing, take out the old cannula, insert a new one, then what. You prime?, fill cannula?, rewind? or what. A quick step by step would be great. The animas people walked me through it once (when I had to change battery and everything went back to 0), but don't remember exactly what I did. Don't think I did the fill cannula. Would appreciate a short run-down that I could print out and save. Battery will need changing again one of these days. Could call again, but if I had something to refer back to I would like that.


You just need to fill the cannula. The tubing will already be filled from the previous time so just fill the cannula.

[Cyborg]

You just need to fill the cannula. The tubing will already be filled from the previous time so just fill the cannula.

It depends on the type of infusion set and how it's being used. I was provided Insets by Animas and the trainer taught me to prime the new set before attaching.

[JediSkipdogg]

It depends on the type of infusion set and how it's being used. I was provided Insets by Animas and the trainer taught me to prime the new set before attaching.

IOf you use the tubing off the old set no need to prime the tubing on the new set. Just put the new inset in and then attach and fill canula. Yes, the amount may be off a tad, but not enough to notice a difference, probably .1 units at most.

Oh, and when I use the insets, I'm still in the habit of not priming first. With other canula based sets, you insert first, disconnect prime the tube, connect, then fill the canula. With the insets, you prime, insert, fill, and I can't get in that grove at all.

[barbarac]

I use the insets and also prime before attaching. So if I have a full res. and need to change site, what would I do. The couple of times I seemed to have a bad site, I just took it all off and threw it all out. Started fresh. But last night I had only had it on less than a day--still not sure if it was a bad site, or just a bad day for me!!

[Cyborg]

It depends on whether you insert wet or dry. If you insert without priming first, then no reason to use the new tubing. If you insert after priming you are wasting insulin. I have my prescriptions written out to cover these situations so I usually change out the tubing.

[RLK]

I use the insets and also prime before attaching. So if I have a full res. and need to change site, what would I do. The couple of times I seemed to have a bad site, I just took it all off and threw it all out. Started fresh. But last night I had only had it on less than a day--still not sure if it was a bad site, or just a bad day for me!!

I've never used Insets, but I use Quick-sets and they're very similar, I think.

I would just insert the new set, remove the new tubing, and reconnect the old tubing to the new set. Then prime to fill the cannula- the little package insert that comes with the insets should tell you how much is needed to prime the cannula only.

I have never primed a set before inserting it. I just prime the tubing until I see a drop of insulin at the connector, attach, and prime to fill the cannula according to the set manual. YMMV.

[Cyborg]

I've never used Insets, but I use Quick-sets and they're very similar, I think.


The instructions for the Insets do say to prime before insertion. I wonder if it really makes a difference?

[RLK]

The instructions for the Insets do say to prime before insertion. I wonder if it really makes a difference?

Yeah, so do the instructions for the Quick-sets. But they also include the amount for a "cannula-only prime"- go figure. I've never bothered with it nor had a problem by not priming before insertion.
I think this is one of those things that falls under the "to each his own" category....

[mids1999]

Thank you for the great information.
Considering that I will be doing a site change in about 2 hours I was playing with the tagaderm tape around its outside edges.
This stuff wants to come off much easier then I expected.

It seems like it will be as easy to remove as a Band aid and not like one of those super band aids either.
For some reason I was expecting some kind of super bond between the tagaderm and the skin.

How much bleeding is normal from removing the site?

[Cyborg]

How much bleeding is normal from removing the site?

Sometimes none, most times a drop or two...

[mids1999]

My first site change went well and was much easier then expected. Thanks everyone for the tips.
Didn't even bleed.

Only messed up in one aspect.
I have the tubing upside down as in where the insulin is comming in from the top instead of the bottom or side as I was instruted.

[Funnygrl]

It depends on the type of infusion set and how it's being used. I was provided Insets by Animas and the trainer taught me to prime the new set before attaching.
You still need to fill the cannula after you attach.

[melissata]

You still need to fill the cannula after you attach.

We use the Quicksets and always used to fill the cannula. Then, she started having lows right after a set change so we stopped doing it. It seems as if a new site just causes her to be more sensative to the insulin. I have heard of others that never do it either, and don't hae a problem. It really isn't any different that disconnecting for a shower, and we don't give a bolus to make up for that insulin either. We would if her bg was higher than target, but it never is.

[Cyborg]

Only messed up in one aspect.
I have the tubing upside down as in where the insulin is comming in from the top instead of the bottom or side as I was instruted.

I was never aware of that being an issue...

[Gordonm]

I was never aware of that being an issue...

Me either. I try to put mine in from the side but I never thought it mattered.

[JanTx]

I put mine in so that the tubing comes out in relation to the pump - I generally wear it clipped to my waistband on the left side - so if the site is farther back - the tubing comes out on the right, if the site is below - tubing on the top. Makes sense to me!

Did the first change this morning where I didn't change the tubing or reservoir. SO much faster!

And thanks for the advice on using a light touch on turning the connector thingy. I practiced with the set I had just taken out and finally feel like I can do it smoothly. I was trying too hard!

[mids1999]

I was not told that it was an issue but rather during training my trainer stopped me from installing it that way by saying "you dont want it to be pointing up do you?" I did not ask why not.

[jenet]

I don't remember any instructions on this, but I put mine with the tubeing coming out sideways. Water doesn't collect on the connection side like it might if it were facing up in the shower, and it seems to be a good compromise as far as reducing tension on the connection when I'm moving around.

cheers,
j

[JanTx]

I feel like I've reached a landmark! Did a site change without following the book step-by-step. Didn't even realize it until I was through! So .. 2 weeks of pumping - changes every 2 1/2 days or so - finally comfortable enough to go solo. Whew!

I've been following a suggestion I read on here of using the IV prep pad to clean off the old site after I've used it to prep the new one. That sure seems to make a quicker, cleaner healing. So thanks again - information here that comes from nowhere else!