You made the decision to use an insulin pump. You overcame your anxiety about inserting that infusion set, and you found some basic techniques to wear or hide the pump. But still, some questions may remain. Maybe you're wondering about getting your set to stay in place. Maybe you're concerned about finding an appropriate site to begin with. Either way, the following tips and tricks should help you choose and maintain an infusion site that gives you as little trouble as possible.
Choosing and Preparing a Site
A good rule to follow when picking an infusion site is to place it anywhere you could inject with a short-needle syringe. Avoid places that will be constricted or irritated by clothing, such as belt or bikini panty lines. You should also avoid locations you might sit on or constantly bump. (see figure 1).
Once selected, the site needs to be carefully prepared. Careful attention to cleaning the site cannot be over-stressed. You want sites that can be reused later, with good insulin absorption, and no infections.
Consider your personal issues and planned activities for the number of days you plan to use the site.
The following challenges may influence your choice of site location:
- Fashion conscious? Try using a hip or leg site. The pump can be placed inside pantyhose, or panty girdle, or placed inside a baby sock and attached to a garter or pinned to clothing when wearing dresses. A bra pouch will work for some ladies. Use the upper hip or lower abdomen when wearing a two-piece bathing suit or bikini.
- If you're pregnant, it might become increasingly difficult to locate a site on your abdomen where you can "pinch an inch" of tissue to insert your set. Try the upper hip or leg sites.
- If you have surgery planned, any site not in the area being operated on is acceptable.
Once you've found an appropriate site, keep the following in mind to make the set stay in place as comfortably as possible:
- If hair is a problem, speak to your pump trainer or health care provider.
- Clean the site with antibacterial soap and water, like Dial or Hibiclens. Apply antibacterial soap in a concentric circular motion, cleaning from the intended insertion point and moving outward. After the area is cleaned and dried, don't let anything come in contact with it until you've inserted and secured the set.
- If your skin is sensitive or you have tape allergies, you need a skin barrier between your skin and the set adhesive. Available products are IV Prep, Mastisol cream, Cavilon cream, Tincture of Benzoin, Skin Shield, Liquid Bandaid and Skin-Tac H. Try a few of them to find one that works for you. Additional barrier products are clear adhesive dressings such as Tegadem HP and IV 3000. Hypafix tape is also a non-allergenic tape, but it is not a clear tape. Insert your set through these special tapes after you place them on the cleaned site.
- Once the set is in place, applying your hand over the set and tape for a few minutes will warm the adhesive and can help keep the dressing tape in place.
- Perspiration can loosen an infusion set adhesive when you are active. Many pump wearers use Tincture of Benzoin to maintain set adhesion for those situations where they might work up a sweat, and Cavilon and Mastisol provide the same protection. Be sure to follow manufacturer directions.
Maintaining Good Sites
Change your sites as recommended by your physician or educator/pump trainer. Each new site should be at least an inch away from the old site. Additionally, make sure to check for the following regularly-they're a sure sign your site needs changing:
- Look at your site several times daily to make sure the set is secure and the tape edges are not loose. A quick fix to loose edges is an application of IV prep to the edges of the tape and the skin. Don't be too casual about loose tape. Make sure the infusion catheter or needle is still under the skin. If doubtful, replace the set and change the location.
- The warning signs of infection are: redness, pain, heat, or swelling. If the site hurts, or itches, replace the set, change the site and ask your doctor about applying some antibiotic ointment to the old site. Does it feel warm to touch? Do you have an elevated temperature? Does the old site have a round hard lump under the skin? It could be an abscess that needs to be opened and drained. Notify your physician if you have any of these symptoms. Your doctor will likely order warm moist soaks to the area 3 to 4 times a day. If you are prone to red spots and bumps, application of triple antibiotic ointments can be helpful. Always check with your physician for preferred products.
We are all unique, and will have different issues appear from time to time. By following some simple procedures, however, you can make sure to minimize your risk of injury and infection. Here's wishing you years of successful pumping.