Thursday, September 30, 2010

Think I've figured part of it out..

Well, I think I figured out part of the problem with all the 300s on Wednesday (See previous post).

When I got ready to fill the cannula for the new site, I decided to look over some things. I unlocked his pump, and noticed that there was only 26 units in it. Hm. Wonder why. When you do a site change for Lenny, you should fill the cartridge up enough to last him for 2 days. His TDD (Total Daily Dose) for the most part hovers around 15-16 units per day. Therefore, she should have filled it at the minimum of 40 units. I typically fill it to about 80 units, just in case I am not able to do a site change every 2 days, or if he gets sick or whatever, there is more than enough insulin in there to remove that worry from my mind. Anyway, I decided to go through the history, checked how much insulin was given at each meal/snack throughout the day. Hm, he was given 2.20 units at morning snack and 3.65 units at lunch... why hasnt he come down with all that insulin plus a site change? I also decided to look at the TTD for today. At 4:30 he had already been given 10 units, this is bolus and basal total.

I decided to sit down and do some calculations about an hour ago. 10u TDD just did not seem right to me. Seemed too high knowing the site change was done at 10am that morning. His TDD from 12am to 4:30ish pm, by my calculations, should have been 10.6625. His TDD from 10am (which is when she said she was doing the site change) to 4:30ish pm, according to my calculations, should have been 8.2875.

So, if she did the site change correctly, how was there 10u TDD between 10am to 4:30pm? How were there such HUGE air bubbles in the tubing? How is it that when I look at the prime/rewind setting, all boxes are completed, yet the TDD shown in the pump doesnt match up with the calculations I came up with that it should have been for 10am through 4:30pm? And, more importantly, why did his numbers not come down much after her site change?

My conclusion...

It wasn't done correctly.

No comments: