Change an Accu Chek Spirit or Combo Insulin Pump Cartridge

This article tells you the most efficient way to change the cartridge in your Accu-Chek Spirit or Spirit Combo insulin pump, and how to deal with bubbles as you're doing so.

Steps

  1. Gather all the bits you will need. It's best to place them in a "clean-field", such as on a piece of kitchen roll, so that you can be sure you are being as hygienic as possible. You will need to make sure you have a vial of insulin, a new cartridge, and a new tubing set if you are going to change that as well.
  2. Take the new cartridge out of its packet. Pull the plunger up and down a few times without pulling it right out to lubricate the inside of the cartridge. This will help to ensure the O-rings don't leak.
  3. Place the cartridge filler needle into the insulin vial. The filler cap is specially designed to fit the top of insulin vials, so this should be nice and easy.
  4. Push the plunger down to push air into the vial. Keep pushing until the plunger reaches the bottom of the insulin cartridge.
  5. Rotate the cartridge so that the vial is at the top, upside down. Make sure you keep the plunger pressed to the bottom while you do this.
  6. Release the plunger. The pressure that is built up in the insulin vial will push it out naturally, and once it stops you can pull it until you have drawn as much insulin as you want into the cartridge.
  7. Remove the insulin vial and then the filler cap from the cartridge. They should both simply pull off: a little twist is required to remove the filler cap.
  8. Check that there is no air in the cartridge. Little "champagne" bubbles are nothing to worry about, but if there are any larger bubbles, tap the cartridge to move them to the top and then gently push the plunger to push them out. See the Tips below for more information on removing bubbles.
  9. Remove the plunger. This is done by twisting gently in an anti-clockwise direction. You might want to put the little protective cap on the cartridge at this point until you need it later.
  10. Stop and disconnect your pump from your body. To do this, press the menu key once until the Stop sign shows and then the tick key. Follow the instructions that come with your infusion set to disconnect from your body.
  11. Unscrew the cartridge from the insulin pump. To do this, twist in an anti-clockwise direction. You should then do the same again to remove the luer-lock connection between your cartridge and your tubing set, before pulling the cartridge out.
  12. Dispose of the old cartridge and tubing set according to local regulations.
  13. Select Cartridge Change from the menu. A warning screen will appear prompting you to remove the cartridge.
  14. Hold down the tick button for 3 seconds to start the rewind. Wait for the plunger to rewind all the way back.
  15. Place the screw piece on the new cartridge and rest it against the opening of the cartridge compartment to visually check the plunger matches up with the stopper in the cartridge. If it doesn't, press either of the arrow buttons to wind the plunger up a notch until it is level.
  16. Gently screw the cartridge in. If there is a gap between the plunger and the stopper at this point, you should unscrew it again and adjust using the arrow buttons until the gap no longer exists.
  17. Press the tick button. The self-checks will begin.
  18. Screw the new tubing set onto the end in a clockwise direction. Then press the tick button on the Infusion Set Priming screen.
  19. Check that the priming volume is suitable, then hold down the tick button for three seconds. If the priming volume is not suitable, you will need to change in the settings. Refer to the manual for this.
  20. Hold the tubing vertically and watch the insulin move up the tubing. When a drop appears at the end, you should press the tick button to stop the priming.
  21. Connect your infusion set and start your pump. Your pump is now ready to go until the next cartridge change!

Tips

  • When tapping to move bubbles to the top, it often works best if you tap the opposite side of the cartridge to where the bubble is stuck.
  • If you're worried about a large number of "champagne" bubbles, you can often pull the plunger back to create a much larger bubble, and "roll it around" so that it picks up the smaller bubbles, before pushing the air out again.

Warnings

  • Practice aseptic technique––wash your hands, or you could end up with a nasty infection.

Things You'll Need

  • New cartridge set
  • Insulin vial
  • New tubing set

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