Building Independence: Insulin Pumping

Building Independence in Diabetes Skills… What Does My Child Need to Know about:

We all know that eventually our T1D child needs to be able to complete diabetes self-care tasks for themselves. But how do we hand over that baton? The first step is identifying the concrete skills that we need to teach them.

Ask yourself if your child can – and will – independently do all of the following tasks related to using an insulin pump. If you answered “no” to a certain step, that could become a teaching target to move your child towards independence.

Steps for Using an Insulin Pump

  1. Inserts Infusion Sets:
    1. Gathers necessary supplies.
    2. Applies EMLA® cream or other topical anaesthetic (if desired).
      1. Applies appropriate amount of cream.
      2. Covers with Tegaderm®, IV3000®, or other barrier film.
      3. Waits the indicated time for product to “numb” area.
      4. After waiting period, removes the cover.
      5. Wipes away excess cream.
    3. Selects an infusion site (good absorption, not overused).
    4. Cleanses the intended site.
    5. Uses any skin preparatory products (SkinTac®, SkinPrep®, etc), as applicable.
    6. Inserts infusion set (according to manufacturer instructions).*
      (*These steps f, g and h may come in a different order, depending upon type of infusion set used – see manufacturer’s instructions.)
    7. Primes tubing just prior to connection.*
      (*These steps f, g and h may come in a different order, depending upon type of infusion set used – see manufacturer’s instructions.)
    8. Connects infusion set to the tubing/pump.*
      (*These steps f, g and h may come in a different order, depending upon type of infusion set used – see manufacturer’s instructions.)
    9. Fills cannula, if applicable. (i.e. For many FLEXIBLE cannula infusion sets, the cannula is filled after insertion – see manufacturer’s instructions.)
      (NOTE: FILL CANNULA STEP DOES NOT APPLY TO FIXED (metal) CANNULA INFUSION SETS.)
    10. Removes old infusion set.
    11. Safely disposes of old infusion set (in a sharps container), as well as other refuse.
    12. Effectively rotates sites.
    13. Recognizes the signs and symptoms of a possible site infection, and alerts caregiver.
  2. Replaces Pump Cartridges/Reservoirs and Batteries
    (Steps vary according to pump manufacturer and model – please consult manufacturer instructions.)
  3. Responds Appropriately to Insulin Pump Error Messages:
    1. Notices pump alarms and warnings sounds when they occur.
    2. Reads the alarm or warning from the pump screen.
    3. Takes appropriate steps to resolve the situation (restores prime, replaces battery, replaces low cartridge, etc).

The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.