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  • Introduction

    Now that you know how to fill an insulin cartridge and choose an infusion set, you are ready to learn how to insert the cartridge into the insulin pump and connect and prime (also known as "fill") the infusion set. You will need to do this every time the insulin cartridge is close to empty. The insulin pump will give you a warning when the cartridge has about 20 units of insulin left in it. This gives you the time you need to plan for a cartridge change. Inserting a new cartridge and connecting the infusion set are easy to do. Let's learn how!

    Ensure that the infusion set is NOT connected to your body when removing air bubbles, while filling the cartridge or priming the infusion set.

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    Starting insulin delivery
  • Goals

    At the end of this lesson, you will know how to:

    • Connect your pump's insulin cartridge, adapter and infusion set
    • Insert the insulin cartridge into your pump
    • Prime the infusion set
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  • Before you start

    The cartridge comes with a luer connection and holds the insulin for your pump. The infusion set enables the transfer of insulin from the insulin reservoir placed in the insulin pump to the cannula inserted into the subcutaneous tissue of your body.

    First, take a moment to learn the names of all the items you need.

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  • Before you start

    Wash your hands thoroughly. Dry your hands. Have the following items ready:

    1. A filled Accu-Chek Spirit 3.15 ml cartridge system with luer connection
    2. An Accu-Chek insulin pump adapter
    3. A new Accu-Chek infusion set
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    Starting insulin delivery
  • Connecting the cartridge, adapter and infusion set: step 1

    In the lesson "Preparation and start up pump reparation and start up pump - filling the cartridge", you learned how to fill the cartridge. Now take this cartridge and remove the protective cap from the cartridge.

    To prevent contamination, make sure that you do not touch the insulin cartridge tip.

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  • Connecting the cartridge, adapter and infusion set: step 2

    Push the adapter (thread-part first) all the way onto the cartridge tip to the stop position.

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    Starting insulin delivery
  • Connecting the cartridge, adapter and infusion set: step 3

    Carefully prepare a new Accu-Chek infusion set, following the instructions that come with your set.

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    Starting insulin delivery
  • Connecting the cartridge, adapter and infusion set: step 4

    Attach the luer-lock connector to the pump by screwing it firmly into the pump adapter.

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  • Returning the piston rod

    The piston rod is the part of the pump that pushes the plunger in the insulin cartridge. You need to return the piston rod to the starting point every time you insert a new cartridge.

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    Starting insulin delivery
  • Returning the piston rod: step 1

    Make sure your pump is in STOP mode and the infusion set is disconnected from your body. If there is a cartridge in the pump, ensure the infusion set tubing; cartridge and adaptor are all still firmly connected together. Position your pump diagonally downwards (with the adapter and tubing pointing downwards) and remove the cartridge by unscrewing it carefully. Do not pull the cartridge out until it is completely unscrewed.

    If there is no cartridge in your insulin pump then continue to step 2.

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  • Returning the piston rod: step 2

    Press Icon to move to the CARTRIDGE CHANGE screen. Press Icon to select.

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    Starting insulin delivery
  • Returning the piston rod: step 3

    Press and hold Icon for three seconds, until you hear a melody.

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    Starting insulin delivery
  • Returning the piston rod: step 4

    The piston rod begins to return.

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    Starting insulin delivery
  • Returning the piston rod: step 5

    When the piston rod has returned completely, the CARTRIDGE VOLUME screen displays the maximum volume, 315U (315U = 315 units of insulin).

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 1

    Now that the piston rod has been returned to the starting point, you are ready to insert the filled insulin cartridge.

    Hold the pump upright. Hold the new, filled cartridge so that the connected adapter and infusion set point upwards, parallel, and close to the cartridge compartment.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 2

    Make sure that the top edge of the threaded part of the adapter is level with the top part of the cartridge compartment.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 3

    Press Icon or Icon to move the piston rod forward until the end plate of the piston rod is level with the bottom of the cartridge plunger.

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  • Inserting a new insulin cartridge: step 4

    As the piston rod pushes the plunger forward in the cartridge, the CARTRIDGE VOLUME decreases accordingly on the pump screen.

    To prevent air bubbles in the cartridge, move the piston rod to at least 310 units if you are inserting a full (3.15 ml) cartridge.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 5

    Position your pump diagonally downwards (with the adapter pointing down). Insert the cartridge into the cartridge compartment.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 6

    Twist (do not push) the adapter clockwise until it is correctly seated against the cartridge compartment.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 7

    The cartridge is correctly inserted when the end plate of the piston rod is correctly seated against the cartridge plunger.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 8

    If the end plate of the piston rod is not correctly aligned with the cartridge plunger, remove the cartridge from the cartridge compartment and repeat steps 1 to 7.

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  • Inserting a new insulin cartridge: step 9

    Check that the infusion set luer connector is still correctly connected to the adapter. Tighten the infusion set by hand clockwise until it sits tightly in the adapter.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 10

    Press Icon after correctly inserting the cartridge. Your pump will perform a self-test.

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    Starting insulin delivery
  • Inserting a new insulin cartridge: step 11

    When the self-test is finished, the INFUSION SET PRIMING screen is shown. You are now ready to move to the next step, priming the infusion set.

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    Starting insulin delivery
  • Priming / filling the infusion set

    Priming the infusion set means filling the tubing with insulin and pushing any air bubbles out of it. If you're in STOP mode and try to use the pump without first priming the infusion set, you'll get an E11 Error (Set not primed). Press the Icon twice to confirm and cancel the error message. Air bubbles in the cartridge and infusion set may result in the infusion of air instead of insulin. If this happens, your body will not receive the required amount of insulin. Ensure that the infusion set is NOT connected to your body then remove air bubbles from the cartridge and the infusion set.

    Follow the pump User's Manual to prime the transfer set. Never prime an infusion set that is connected to your body as you risk uncontrolled insulin delivery into your body. Always follow the instructions for the infusion set you are using.

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  • Priming / filling the infusion set: step 1

    Make sure that your pump is in STOP mode and the infusion set is not connected to your body. Press Icon to move to the INFUSION SET PRIMING screen. Press Icon to select. The priming amount of 25 units of insulin will be pushed through the tubing.

    The priming amount of 25 units is the default amount. You will learn how to change this in the Advanced Training Module.

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    Starting insulin delivery
  • Priming / filling the infusion set: step 2

    Press and hold Icon for three seconds, until you hear a melody. The priming process begins.

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    Starting insulin delivery
  • Priming / filling the infusion set: step 3

    Always hold your pump upright when priming. This position helps with removing air bubbles. Gently tap the bottom part of the pump with the palm of your hand.

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  • Priming / filling the infusion set: step 4

    The priming amount is shown on the screen, which tells you how much insulin is in the tubing. Your pump stops priming after the pre-set amount of 25 units of insulin have been pushed through the tubing. You can stop the priming process at any time by pressing Icon. When you do this, your pump returns to STOP mode.

    Your infusion set is correctly primed when you see no air bubbles in the tubing and a bubble-free flow of insulin emerges from the tip of the cannula for steel cannulas or the connector if you are using soft cannulas. For soft cannulas, connect the transfer set to the newly inserted head set and fill the empty space of the cannula housing with a bolus as described in the infusion set User's Manual.

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  • Quiz

    If you were using a disconnectable infusion set, could you change the cartridge if the cannula was still inserted or still in your body?

  • Quiz

    Which of these cartridges has been put into the pump the correct way?

  • Quiz

    What does the 0.9 U on the pump screen mean?

  • Congratulations!

    You have completed the connecting cartridge adapter and infusion section.

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    Starting insulin delivery

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Lesson - 5

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