Monday, January 10, 2011

Recipe for a site change

Site changes look very different in each family but many of the basics are the same.  Kind of like a family recipe of your favorite cookie.  Here is our recipe for a site change:

1 very precious little pumping 7 year old girl with Type One Diabetes
1 Animas Ping Insulin pump (pink of course)
1 Animas inset (pink is the color of preference)
1-2 alcohol pads
1 extra tubing
approximately 100 units of insulin (we prefer Novalog)
1 new insulin reservoir
1 One Touch test strip (if no error 5)
1 One touch meter and lancing device
1 Hershey's kiss
1 small prize

Begin by handing an alcohol wipe and new inset to precious 7 year old girl and retrieve pump from her.
 Now wipe down the insulin vial with an alcohol wipe.  You must wait until it dries to draw the insulin in to the reservoir (I have learned this the hard way and you'd think I would have gotten it the first time but I do it to myself time and time again.  If any alcohol gets into the insulin it causes the insulin to be less effective.)  Place the needle on the reservoir and draw up approximately 100 units (or at least enough needed for about 3 days).

Take off the needle and place in sharps container and attach new tubing.  Here is where the extra tubing comes in.  I have saved all of the "extra" tubing from practice sites and sites that get pulled out and don't need to use the tubing.  I keep it in a baggie.
It's new tubing and makes the site change go smoother for us.  While Bekah is pulling out the old site(using the alcohol wipe to loosen the adhesive) and inserting the new one, I can get the pump ready and primed.  Now you take out the old cartridge (rewind) and insert the new one with the tubing attached, prime the tubing and wait until 7 year old girl is ready to have the cannula primed.
Prime cannula and now 7 year old uses the One Touch meter, strip and lancing device to check her BG level and  to "test" the site a Hershey's kiss is given and bolused for.
Then a small prize is obtained from the prize box.  (I keep all kinds of crazy cheap little things in a box for her, squinkies, silly banz, card games, sugar free gum etc)  Today's prize was a card game.   Toss all of the garbage and take the needle out of the insertion device using needle nose pliers and place in sharps container. (Sometimes we keep the insertion device minus the needle to practice on stuffed animals etc) Two to three hours later, a recheck on the BG level is done to make sure it's good to go. 

 Ideally the old site will look a bit like this when it is removed.  A straight cannula with no blood.  (we usually have a little pink)
A happy girl showing off her prize for being super brave!


  1. Very cute! Wish they had contact detach in color. J wants blue..

  2. Awww! Bekah is amazing. Joe wants NOTHING to do with site changes yet. Great job Heidi!

  3. That is too sweet! We are not pumping, yet, but I am bookmarking this post for Ellie to read when we do. Neat idea about the prizes, too. You rock!!!!!

  4. Thanks for posting this, we are not pumping yet either but this was very informative and I love the little rewards you have for afterwards...GREAT IDEA MOMMA!