Rude Awakening

[Jennywren]

Ive fallen out with my pump !!!! (only joking) i was rudely awoken at 3.30 this morning with alarms and vibratations (accu-Chek combo) with the message E$ Occlusion !!!!! Looked in manual and it just says Change the cartridge and infusion set , which i did . Does anybody know what occlusion is ive looked it up and the best definition i could find was

: In Medicine An obstruction or a closure of a passageway or vessel.

Dont tell me the dreaded bubbles again what do you think ?😱 Thanks Jenny

 

[bex123]

hiya , ive never had one but i was told its when the insulin gets stuck and cant either come out the pump or the tubing...aparently sometimes you get insulin crystals thats block bits up

 

[Ellie Jones]

Occulsion are normally to do with either the tubing or cannular being blocked..
Normally it's the cannular causing the problem, either it's become kinked stopping slowing the insuling going through.. Or as I've found on several occasions my waistband has been putting presure on the cannular..

It's rare for the blockage to be caused by crystaliation (sp) of the insulin, humalog, novorapide and Apidra don't cyrstalise like the older insulins..

 

[Adrienne]

It is normally a kinked tube.

If insulin is in the tube for days and days (more than recommended) there could be a problem with it, it apparently can stick to the tube and so not be delivered as well as it should be. Not sure you would get an occlusion message with that though.

 

[Freddie99]

Did the cannula look dodgy when you took it out? I've had some spectacular highs with bent cannulas which have been rather entertaining.

 

[Adrienne]

It could also be as simple as a kinked or bent tube on the outside, not just the inside, although that is most common, especially if using Quick Sets.

 

[Alzibiff]

Hope this isn't too far off topic but around 10 months ago, I spent some time with a very nice lady on the Medtronics technical help desk who asked me to carry out a number of checks on my pump. (I wasn't plumbed in at the time).

One of the checks was to use a little blue thing which came with the pump to create an occlusion manually. This little blue thing was used to squash the tubing so tight that no insulin could get through. Now here's the interesting - or should I say alarming thing - can't remember the exact number of units I had to deliver before my pump reported an occlusion but it was massive - beyond the teens - and that was NORMAL!

I think I would notice the non-delivery of 20+ units well before my pump realised there was a blockage!

Alan

 

[HelenM]

I've only ever had a 'no delivery' alarm during a bolus. My max basal rate is O.6 and for most of the day it's 0.4units. It could be occluded for several hours before it alarmed...all the more reason for frequent testing.

From the Medtronic 512 handbook:

"When occlusion is detected, the ?no delivery alarm? will occur. The occlusion alarm is triggered by an average of 2.35 units of ?missed? insulin. This table shows occlusion detection for 3 different situations when using U100 insulin."
bolus delivery (1.5 u/minute)
Minimum time before alarm: 26 seconds
Typical time before alarm 94 seconds
Maximum time 2.5 minutes

basal delivery (1.0 u/h)
Minimum time before alarm:40 minutes
Typical time before alarm :141 minutes
Maximum time: 4 hours

basal delivery (0.05 u/h)
Minimum time before alarm: 13hours
Typical time before alarm: 47 hours
Maximum time: 81 hours