Infusion Site Management » Special Situations

Infusion Site Management Guide

Special Situations

Situation	Solutions & Suggestions for the Pump User
Rash/itching	1. Could be due to loss of protective skin oils with use of alcohol or soap; cleanse the skin and create a barrier using antiseptic and adhesive wipes.
Pump bumps – white or red dots at the point of insertion	1. Cover the area with a topical antibacterial ointment; observe and monitor the area for infection; to prevent in the future, make sure not to wear the set longer than recommended.
Lumps under the skin	1. Do not use the site longer than recommended. 2. Change the site placement; change the type of infusion set; or change the type of insulin.
Burning during a bolus	1. If the bolus is large, use an extended bolus or deliver the bolus in 2 equal parts before and after the meal. 2. Try a different type of infusion set or a shorter length needle or cannula.
Dressing does not stick well	1. Make sure site is clean and dry prior to insertion. 2. Apply an extra-strength adhesive. 3. Use the sandwich technique – cleanse the skin using an adhesive wipe, allow to dry, apply a sterile dressing, insert the set into the dressing, cover the set with another sterile dressing to"sandwich"; the infusion set.
Dressing sticks too well	1. Carefully remove dressing after loosening with a solvent or baby oil to prevent skin tears. 2. Run warm water over dressing in the shower to help loosen, while disconnected from pump.
Bleeding or bruising at the site	1. Bruising at the site: replace the set and tubing in a new area; do not rub the area; do not utilize the area for future site placement until the bruising has completely disappeared. 2. Blood in cannula or tubing: replace the set using a new area and tubing if necessary. 3. Bleeding from insertion site upon removal: apply firm pressure to the area with a sterile cloth; do not rub the area.
High blood sugar response after site change	1. Place new infusion set in different area, attach the tubing to new site, prime for the airspace, leave the old infusion set in the skin for 1-2 hours after the new site has been placed to allow for complete absorption of remaining insulin.
Insulin leaks out of site once set is removed	1. Due to lipohypertrophy or the set not being placed deep enough; change the infusion site placement and/or try a longer depth needle or cannula.

Printable Infusion Site Management Guide (Acrobat Reader Required)