User's Manual

109
APPENDIX D Precautions and general
procedures
Special note and precautions
Before beginning the implant, refill, stroke volume measurement, rinse/flush, or
pressure measurement procedure, carefully read this Appendix and keep the
information in mind as you perform each procedure.
1. All procedures should be performed using ASEPTIC TECHNIQUE.
2. Air in the Pump System has been shown to be a significant contributing
factor to aggregation of insulin. Proper degassing of all solutions that enter
the Pump is essential. Read the insert in the refill kit packaging about the
degassing procedure.
3. When using the refill kit, never release the syringe-locking ring while there is
a vacuum within the refill syringe. The plunger of the syringe will snap back
forcefully and may rupture the syringe and eject the contents.
4. It is important that the syringe needle is perpendicular to the fill port to
prevent binding when entering or exiting.
5. The Side Port Catheter attachment site contains up to 20 units of INSULIN.
The distal portion of the Catheter and the tubing can contain up to 13 units of
INSULIN. However, the INSULIN in the Pump fluid pathway and the side
port receptacle can be cleared by following the procedure to pull RINSE
BUFFER through the side port. During a flush procedure to push out a
catheter tip blockage, the 13 units in the distal catheter will be delivered to
the patient. The 13 units can be managed by programming continuous bolus
amounts prior to the procedure, or with the use of oral or IV glucose as
needed during the procedure. Individual patient response to INSULIN bolus
amounts must be considered.
6. Patient blood glucose monitoring must be performed during, and up to one
hour after the procedure. Oral and intravenous glucose should be available
for glycemic management.