||An infusion set should last 3 days, though in some children, rising blood sugars on day three can indicate the need to change more frequently if it occurs consistently. This may be due to the combination of a low infusion rate and rapid healing often seen in children.
||If your client is struggling with dislodgement or site problems, it is important to evaluate their technique in placing their infusion set including the use of an insertion device.
||A kink in the tip of the cannula may indicate an infusion set resting against a muscle. Use a shorter length cannula, or angled infusion set to a lesser degree upon insertion. Kinks at the top of the set close to the hub are due to “set migration” caused from added pulling on the tubing. Either secure the site using the “sandwich technique” or use another piece of tape to secure a loop of tubing close to the body.
||Skin irritation under the infusion set is not un-common. This can occur when the set is left in too long, gets wet and or there is a sensitivity to the adhesive, skin prep product or cannula itself. Rule out product sensitivities by using only soap and water. Sandwiching the set is the next step at isolating the cause of the sensitivity. If it truly is a cannula sensitivity and your client is using the Quick set or Sillouhette, suggest they try a sof set as the cannula is made of a different material.
||Site allergy is more serious and may require systemic medications to prevent an allergic reaction. Localized site allergy may be temporarily offset by the use of a topical antihistamine such as Benedryl stick or lotion. Talk to the physician about prescribing Atrovent for topical use. One dose on the skin prior to infusion set placement has been known to prophylactically prevent a skin reaction.
||Removing adhesives can appear as a local site irritation the same way a raised red area commonly occurs when removing a band aid. Use baby oil or lotion to remove an infusion set if this is the case. Use lip balm on the site to remove the grey “gunk” left from the adhesive. If removing an IV 3000 dressing remove by stretching the dressing progressively until it peels off easily.
||Long-term pump users may experience “site fatigue” from using the same areas over a long period of time. This scarring and decreasing or variable absorption is preventable to a point. There is no one type of infusion set that is better than another one at preventing site fatigue. A more important factor is good skin care. Explain to the client that leaving their infusion set in too long, surface skin infections after the set is removed or lack of rotation of infusion areas are causes of site fatigue. Each nursing visit should include an assessment of the infusion sites and review site rotation and good skin care techniques.