Energizer 515 Podręcznik Użytkownika Strona 1

User GuideINSULIN PUMP

Contents ixChapter 8 Utilities ...105Alarm review ...

Optimizing pump therapy 83 Your turn: Square Wave bolus practiceYour target pre-meal blood glucose range is ______ to _______.Check your pre-meal b

84 Chapter: 6 Example 2: Dual Wave bolus - Set a Dual Wave bolus for correcting elevated blood glucose before a mealMarsha uses the Square Wave bolus

Optimizing pump therapy 85 Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus If you are using the Bolus Wizard feature to calculate

86 Chapter: 64 For a Square Wave bolus do these steps:The SET SQUARE BOLUS screen will appear. Change the amount if desired. Press ACT to accept. For

Optimizing pump therapy 87 5 The SQUARE DURATION screen will appear. Enter the amount of time you want the Square Wave bolus to last and press ACT. NO

88 Chapter: 6NOTE - If you are using the remote control, the Easy Bolus must be set to on. Step value setupYou can set the step value from 0.1 to 2.0

Optimizing pump therapy 89 1 From the HOME screen, press . The SET EASY BOLUS screen will appear. The single “step” value will be flashing. 2 Press

90 Chapter: 6 Example 1: Easy bolusAlexander is a busy executive with an accounting firm. He wears his Paradigm pump on his belt and does not want t

Optimizing pump therapy 91 Basal patternsThe Basal Patterns feature is optional for pump users. You can set your pump to deliver a standard basal and

92 Chapter: 6Program a patternYour pump will keep your pattern settings even when the Patterns option is turned off. The patterns feature must be on t

xContentsMy bolus stopped ... 128My pump buttons are not acting right

Optimizing pump therapy 93 5 After you press ESC, the BASAL RATE screen appears. The screen will show: ➠ the current basal pattern and basal rate, ➠ t

94 Chapter: 6 Example 1: Basal patternsKen has had his insulin pump for about a month. He tests his blood glucose 4 - 6 times a day and records his

Optimizing pump therapy 95 Temp (temporary) basal ratesTemp basal should be used based on the guidance of your healthcare professional. The temp (temp

96 Chapter: 6Temp basal typesBased on your preference, you can select either Percent of Basal or Insulin Rate.Insulin rateInsulin rate is a fixed basa

Optimizing pump therapy 97 Percent of basalThe temp basal type is dependent on your current basal rates. Percent temp basal is a percentage increase o

98 Chapter: 6NOTE - The pump delivers basal amounts in 0.05 U/H increments. Because of this, your temp basal amount will be rounded down to the next 0

Optimizing pump therapy 99 Selecting temp basal typeYour pump will remember the temp basal type setting. Once the type is set, you do not have to set

100 Chapter: 63 In the SET TEMP BASAL screen, the temporary basal rate will flash. Enter your temp basal rate, then press ACT. 4 The BASAL MENU will a

Optimizing pump therapy 101 Canceling a temp basalUse the cancel temp basal function in the BASAL MENU to cancel a temporary basal. This function imme

102 Chapter: 6 Example 2: Temp Basal for an increased temporary basal rateGail has had a cold with a cough for a couple of days. Because she is not f

Contents xiChapter 11 Pump specifications ...139Alarms and error messages ...

Insulin pump therapy follow-up 103 Chapter: 7Insulin pump therapy follow-upWe hope that you are now comfortable using the pump and your blood glucose

104 Chapter: 7Laboratory tests➠ Test for HbA1c four or more times a year➠ Test for cholesterol, HDL, LDL, triglyceride yearly➠ Test for microalbuminur

Utilities 105 Chapter: 8UtilitiesAlarm reviewYou can review alarms in the ALARM HISTORY screen. This screen shows up to 36 past alarms and/or errors.

106 Chapter: 81 Go to the ALERT TYPE screen. Main > Utilities > Alarm > Alert Type 2 Select your alert type and press ACT. That alert type is

Utilities 107 NOTE - If you use “time” as the low resv warning type and you deliver large boluses, the actual time remaining could be less than the wa

108 Chapter: 8Review daily insulin totalsThe DAILY TOTALS screen provides a day-by day history of the total amount of insulin that delivered for the p

Utilities 109 Pump data managementThe pump data management feature allows you and your healthcare professional to view and manage your basal and bolus

110 Chapter: 8➠ total man (manual) bolus insulin delivered for the day and total percentage of manual boluses delivered for the dayTo view more data,

Utilities 111 Days to average The DAYS TO AVERAGE screen allows you to choose the number of days to average. This example shows the previous 12 days a

112 Chapter: 8➠ the total average percentage of bolus insulin delivered for the previous 12 days ➠ the average total correction bolus insulin delivere

xii ContentsBolus Wizard feature examples ... 148Default (factory) settings ...

Utilities 113 Main > Utilities > Alarm Clock 5 Repeat step 3 and step 4 to program additional alarm clock times. Exit the menus when you are don

114 Chapter: 8Turn on remote control option1 Go to the REMOTE OPTION screen. Select On and press ACT. Main > Utilities > Remote Options2 The REM

Utilities 115 3 Exit the menus when your are done. Block featureThe block allows you to prevent (block) people from changing pump setting that should

116 Chapter: 8 Example 1: BlockNicholas is a very active toddler who wears a Paradigm pump. His parents don't want to worry that he will play wi

Utilities 117 Lock keypad featureLock keypad prevents accidental pump keypad presses. The only button you can press is the to view the STATUS screen.

118 Chapter: 81 Go to the UTILITIES MENU. Select Selftest and press ACT. Main > Utilities > Selftest2 As part of the selftests, the pump will do

Utilities 119 User settingsThe user settings function allows you to save, restore, and clear all pump settings. You can also view a listing of the dat

120 Chapter: 83 If this is the first time you have saved pump settings, go to step 4. If you have previously saved pump settings, a message displays,

Utilities 121 4 The SETTINGS RESTORED message displays to confirm that your current pump settings have been replaced with the pump settings you had sa

122 Chapter: 84 You will see a RESET screen, and then the pump will go through various screens while it restarts. After the pump clears all of your se

xiii Practice lessons and examplesBolus examplesMeal bolusNormal meal bolus using the exchange system ...

Utilities 123 Language settingThe language shown on the pump screens can be changed. Some languages will not be available on all pumps. To change the

124 Chapter: 8

Troubleshooting 125 Chapter: 9TroubleshootingThis chapter is designed to help you understand the messages that your pump is giving you when you get an

126 Chapter: 97 Monitor your blood glucose closely.8 If you followed these steps and you are still receiving a No Delivery alarm, call the 24 Hour Hel

Troubleshooting 127 The usage of some features. The backlight, vibrate, remote control and/or meter options decrease battery life.What is a CHECK SETT

128 Chapter: 9The pump is asking me to rewindThis is normal after any of the following:1 any E-alarms, 2 the Clear Settings function, 3 or, a “No Deli

Troubleshooting 129 8 If your pump still does not receive your blood glucose reading from the Paradigm Link meter, use the up/down buttons to manually

130 Chapter: 9I cannot get to the User Settings menuIf you do not hold down the button while pressing ACT when you have User Settings highlighted, yo

Troubleshooting 131 Low reservoir alert You can program the pump to sound an alert when either a specified number of units remains or a specified amou

132 Chapter: 9What to doWhen an alarm is triggered, the pump goes into Attention mode and an alarm message shows on the screen. The pump then defaults

xivBolus Wizard feature examplesExample 1: BG on target (normal BG) and no active insulin ...75Example 2: BG above tar

Troubleshooting 133 Alarm conditionsAlarms put the pump in “Attention” mode.A (Alarm)This alarm shows an “A” followed by two numbers. A-alarms cause a

134 Chapter: 9Button errorOccurs if a button has been continually pressed for more than 3 minutes.Check settingsWhen this alarm is active, you should

Troubleshooting 135 Is priming complete?If you manually prime your pump with more than 30u insulin, this message appears. Press ESC, ACT to clear the

136 Chapter: 9Off no powerThe battery is dead. Replace battery immediately. Follow the directions on the screen. Check to make sure that the time is c

Pump maintenance 137 Chapter: 10Pump maintenanceIt is recommended that you read your warranty statement included with your pump for information about

138 Chapter: 10Cleaning your pump1 Use only a damp cloth and mild detergent mixed with water to clean the outside of your pump. 2 Rinse the pump with

Pump specifications 139 Chapter: 11Pump specificationsThis section provides detailed information on specifications related to your pump. The safety fe

140 Chapter: 11BG (blood glucose) targetBolus deliveryBolus historyMaximum records shown: 24 Bolus unitsIncrements: 0.1 unitsBolus Wizard feature(See

Pump specifications 141 Pump motorThe pump motor has a unique, patented design with an integrated safety check system. The system delivers in precise

142 Chapter: 11Meter valueThe blood glucose measurement received from Paradigm Link meter. Appears in the ENTER BG screen during bolus programming. Ap

xv Your personal informationYou may need the following information from your healthcare professional before going to your pump start appointment. If y

Pump specifications 143 Program safety checksMaximum infusion with single fault condition: 0.0 ml.Pump sizeThe dimensions of the pump are approximatel

144 Chapter: 11Status screen➠ Alarm Clock:* (appears if scheduled to alarm)Time set is displayed.➠ Auto-off: (appears if enabled) X HR➠ Basal pattern

Pump specifications 145 *If all Reminders and Alarm Clock are enabled, only the reminder nearest to alarming will appear in the STATUS screen. ➠Standa

146 Chapter: 11Bolus Wizard feature specificationsThere are three different formulas the Bolus Wizard feature uses to estimate a bolus, depending on y

Pump specifications 147 ➠ Active insulin only reduces the correction portion of the estimate, not the food portion.➠ For a current blood glucose that

148 Chapter: 11Bolus Wizard feature examplesSettings:➠ Carb ratio: 30 grams/unit ➠ Insulin Sensitivity: 40 mg/dL/unit➠ BG Target: 90-120 mg/dL ➠ Activ

Pump specifications 149 #3: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a blood glucose of 70. #4: No active ins

150 Chapter: 11Default (factory) settings#6: Previous bolus activity results in a calculation of 3.5 units unabsorbed (active) insulin. User inputs 60

Pump specifications 151 Utilities Menu: Lock Keypad:Off(Alarm) History:(no defaults)Alert type:audio, beep-medAuto-off:OffLow reservoir warning:(20) i

152 Chapter: 11Menu Item Default SettingLimits IncrementsBolus Wizard feature Settingscarb units: gramsor exchangesnone noneins to carb (or exch) rati

xviCarb ratios (meal bolus information)Your carb ratios are used to calculate your meal boluses.If you count grams: this ratio is the number of carb g

Pump specifications 153 Icon tableDo not reuseAttention: See Instructions for UseMethod of sterilization using ethylene oxideDate of manufacture (year

154 Chapter: 11

Glossary 155 GlossaryAAccept - Pressing the ACT button to approve the selection or setting.Active insulin - Insulin that has been delivered to your bo

156 GlossaryBG (blood glucose) target range - The range of your normal or desirable blood glucose levels. You can set up the pump so that you receive

Glossary 157 Dual Wave™ bolus - Combination of a normal bolus that is delivered immediately, then followed by a Square Wave bolus. The Square Wave por

158 GlossaryLLDL - (Low-density lipoprotein) A complex of lipids and proteins, with greater amounts of lipid than protein, that transports cholesterol

Glossary 159 Pattern, standard - Your normal basal that supports your usual day-to-day activity. When the Patterns feature is off, the pump uses your

160 Glossary

Index 161 IndexSymbolsμL 159Numerics24 Hour HelpLine 1Aaccept 155accessories,activity guard 5holster 5leather case 5meter 3pump clip 5remote control 3

162 Index definition 156selecting 66BG (blood glucose),definition 155block feature,definition 156turning on 115BLOCK OPTION screen 115blood glucose (B

Introduction 1 Chapter: 1IntroductionThank you for choosing Medtronic MiniMed as your partner in helping you gain better control of your diabetes. Whe

Index 163 cleaning your pump 138clearing factory settings 121correction bolus 24correction bolus factor 156correction bolus,amount of insulin needed 1

164 Index setting 66warning limits (mg/dL) 141warning limits (mmol/L) 141Llanguage setting 123LDL (Low-density lipoprotein) 158Link 158lock keypad fea

Index 165 PParadigm Link meter 3, 57ParadigmPAL,managing your pump settings 5pump setting reports 5types of data you can manage 5Pattern feature 158pa

166 Index removing the 46transfer guard 44tubing connector 11restores,history of 122restoring your pump settings 120Resume feature 159Rewind feature 1

6025066-016C 081406INSULIN PUMP

2Chapter: 1Emergency kitKeep an emergency kit with you at all times to make sure that you always have necessary supplies. Inform a family member, co-w

Paradigm®515 and 715 Insulin PumpsUser Guide

Introduction 3 DisposablesThe pumps use disposable reservoirs and infusion sets for insulin delivery. Installation instructions for Paradigm reservoir

4Chapter: 1Download pump and meter dataThe Medtronic CareLink™ Therapy Management System for Diabetes Web site is designed to help you take informatio

Introduction 5 ParadigmPALWith ParadigmPAL™ you can do the following with your pump settings:➠ See your pump settings on your PC screen.➠ Backup, or s

6Chapter: 1How to use this guideNOTE - This User Guide shows sample screens only. Your pump screens may be slightly different. For step-by-step instru

Introduction 7 User safetyIndicationsThe Paradigm 515/715 pump system is indicated for the continuous delivery of insulin, at set and variable rates,

8Chapter: 1PrecautionsAlthough the pump has multiple safety alarms, it cannot notify you if the set is leaking or the insulin has lost its potency. It

Introduction 9 Notice Insulin pump and RF accessoriesThe pump, Paradigm Link meter, and remote control comply with the United States Federal Communica

10 Chapter: 1

The basics 11 Chapter: 2The basicsYour pumpTake a look at your pump. The reservoir window allows you to view the insulin in the reservoir. The reservo

12 Chapter: 2Install batteryMedtronic MiniMed designed the pump to only accept a NEW battery. As a safety measure, if you install a battery that does

© 2006, Medtronic MiniMed. All rights reserved.This product is covered by U.S. Patent Nos. 6,551,276; 6,554,798; 6,872,200; 6,936,029; 6,979,326; 6,9

The basics 13 5 While the pump turns on, it will show various screens until the HOME screen appears.NOTE - If you are replacing a battery for a pump t

14 Chapter: 2Pump buttonsThe buttons on the pump are used to navigate through the menus and screens, and to program the features of the pump.From the

The basics 15 The pump screenThe screen shows five lines of text at one time. The first is the operating mode. The second is the current open menu or

16 Chapter: 2Time displayThe current time of day is displayed across the top of the pump screen in the format you select—12-hour or 24-hour. The AM or

The basics 17 Screen backlightWhen you press from the HOME screen, the light on the screen turns on or off. During programming, the backlight can be

18 Chapter: 2Special - indicates a special feature is active or an alert condition(s) exists. Special mode does not restrict any of the pump functions

The basics 19 MenusThe MAIN MENU is the highest level menu. There are submenus, functions, status and programming screens in the lower menu levels. Th

20 Chapter: 2STATUS screenThe STATUS screen shows information about what your pump is doing. The information that shows on the STATUS screen depends o

The basics 21 If you remove your pumpPump settingsYou may have an occasion when you need or want to remove your pump. If you have to remove and store

22 Chapter: 2

Important Safety InformationRegarding Your Paradigm Insulin Infusion Pump (includes all models)Avoid Immersing Your Pump In WaterAlthough it is unlike

Basic programming 23 Chapter: 3Basic programmingSetting the time and dateSetting the correct time and date in your pump is necessary for accurate basa

24 Chapter: 35 The TIME SET AT screen will show the settings that you programmed. Press ACT and exit the menus. Your time/date settings are complete.B

Basic programming 25 NOTE - If you have the BG Reminder feature turned On, a screen displays allowing you to accept or modify the length of time after

26 Chapter: 3 Bolus practice: Going through the menus, program a 2.0 unit Normal bolus now.Check here if you were able to program it.Using the expr

Basic programming 27 1. Insulin sensitivity should equal the amount (in mg/dL or mmol/L) that blood glucose will be lowered to after taking 1 unit of

28 Chapter: 3 Practice: Meal bolusYou have determined your meal bolus as: _______ units.Your target blood glucose range is: _______ to _______ (avera

Basic programming 29 Review your bolus deliveriesYou can view a list of your bolus deliveries in the BOLUS HISTORY screen. This screen shows a list of

30 Chapter: 3Bolus detailsYou can view the details for any of the deliveries in the BOLUS HISTORY screen. The details include:➠ bolus types: normal, s

Basic programming 31 Maximum bolus limitThe maximum bolus (max bolus) is a safety feature that you can use to set a limit on the amount of insulin tha

32 Chapter: 3BG reminderWhen you deliver a bolus you may want to check your blood glucose afterwards. The BG reminder is an optional feature that you

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Basic programming 33 BasalBasal insulin is required to maintain your target glucose values when you are not eating. Your healthcare professional will

34 Chapter: 3Your basal settingsYou must program your basal settings before you can deliver basal insulin. Keep a written record of your basal setting

Basic programming 35 If you need to program more than one basal rate for the day, do these steps: a. In the SET START TIME 2 screen, enter the start t

36 Chapter: 3Basal reviewTemporary basal information is only available in the STATUS screen.Current basal deliveryThe STATUS screen shows your current

Basic programming 37 3 Exit the menus when you are done.2 If you do not use patterns: The delivery details for your standard basal will appear. If you

38 Chapter: 3Max basal rateMaximum basal rate is a safety limit for the amount of basal insulin that is able to be delivered per hour. This maximum ra

Basic programming 39 Stopping your pumpYou can stop your pump with the suspend function. Suspend stops all insulin delivery including the current basa

40 Chapter: 3Resume pump deliveryWhen the pump is suspended, it defaults to the HOME screen with a solid circle. Do these steps to resume your pump an

Basic programming 41 Practice: Suspend function1 Make sure you are NOT connected to your pump while practicing.Program your pump to deliver a Normal

42 Chapter: 3

Contents vContentsYour personal information ... xvBasal rate ...

Starting on insulin 43 Chapter: 4Starting on insulinPrepare your pump for useBefore continuing with the steps in this chapter, we recommend that you w

44 Chapter: 4Filling the reservoir WARNING: When filling the reservoir, take care to remove air bubbles.CAUTION: Insulin comes in different vial types

Starting on insulin 45 5 While still holding the plunger rod, flip the vial over so the vial is up, slowly pull down on the plunger to fill the reserv

46 Chapter: 4Changing your infusion setRemoving the reservoirEach time you remove and replace a reservoir in your pump, you have to rewind and prime y

Starting on insulin 47 Rewinding your pumpBefore you continue, make sure the pump is NOT connected to your body. 1 If you removed your reservoir and a

48 Chapter: 4Inserting the reservoir in your pumpIf your reservoir is already inserted in your pump, continue to “Manual prime” on page 49. You must d

Starting on insulin 49 Manual primeManual prime fills the infusion set tubing with insulin before you attach it to the infusion site. Manual prime is

50 Chapter: 45 Press ESC. Your manual prime is complete. 6 You can now insert the infusion set into your body as described in the next section.Insert

Starting on insulin 51 Quick-set infusion set (with Quick-serter®)Always refer to the instructions that shipped with your infusion set. 1 Wash

52 Chapter: 4Disconnecting Quick-setThe Quick-set allows you the freedom to temporarily disconnect from your pump without removing the infusion set fr

vi ContentsScreen icons ...15Battery ...

Starting on insulin 53 Reconnecting Quick-setA fixed prime is used before reconnecting the Quick-set to ensure that insulin has filled the infusion se

54 Chapter: 4Fixed primeA fixed prime fills the soft cannula with insulin and is required after the infusion set is inserted into your body and the in

Starting on insulin 55 Record keeping for diabetes managementNow that you are using the pump with insulin, we will be asking you to test your blood gl

56 Chapter: 4Using your daily journalTo use the daily journal that came with your pump, follow these easy steps:1 Write the day and date in the spaces

Using the Bolus Wizard feature 57 Chapter: 5Using the Bolus Wizard featureWhat is it?A feature that calculates an estimated bolus: Information you nee

58 Chapter: 5Get this information from your healthcare professional, and, for best results, talk to your healthcare professional before making any cha

Using the Bolus Wizard feature 59 BG target range:If your current BG is above the BG Target Range, the Bolus Wizard feature will calculate a correctio

60 Chapter: 5How the Bolus Wizard feature worksIf you are going to eat and you want the Bolus Wizard feature to estimate your food bolus:1 Enter your

Using the Bolus Wizard feature 61 More about the Bolus Wizard featureAbout high or low blood glucose levelsIf your blood glucose is less than 60 mg/dL

62 Chapter: 5About active insulinActive insulin is the bolus insulin that has already been delivered to your body, but has not yet been used. The Bolu

Contents viiChapter 4 Starting on insulin ... 43Prepare your pump for use ...

Using the Bolus Wizard feature 63 Bolus Wizard feature on/off1 Go to the EDIT SETTINGS screen. Bolus > Bolus Wizard Setup > Edit Settings 2Selec

64 Chapter: 5Carb unitsThe carb unit setting lets the pump know which way to count your carbohydrates (grams or exchanges). See the “Bolus Wizard feat

Using the Bolus Wizard feature 65 6 The screen will return to the EDIT SETTINGS screen. Set your BG Units as described in the “BG (blood glucose) uni

66 Chapter: 5BG (blood glucose) unitsYou can select mg/dL or mmol/L as your BG units (unit of measurement type). NOTE - If you make changes to your BG

Using the Bolus Wizard feature 67 3 The SET START TIME 2 screen will appear. 5 The screen will return to the EDIT SETTINGS screen. You can now progra

68 Chapter: 5NOTE - Pumps are sent from the factory with a BG target range of 90-140 mg/dL (5.0-7.8 mmol/L). If you adjust your BG targets outside of

Using the Bolus Wizard feature 69 Active insulin timeThe active insulin time setting lets the pump know which active insulin time to use in calculatin

70 Chapter: 5Review your Bolus Wizard feature settingsCheck your Bolus Wizard feature settings in the REVIEW SETTINGS screen. If necessary, compare th

Using the Bolus Wizard feature 71 Meter rulesIf you want your pump to communicate with the Paradigm Link meter, the following conditions must apply:1

72 Chapter: 52 Add, delete or review your meter ID(s) as desired. 3 Exit the menus when your are done. Add Delete Reviewa. Select Add ID and press ACT

viii ContentsReview your Bolus Wizard feature settings ... 70Meter option ...

Using the Bolus Wizard feature 73 Normal bolus using Bolus Wizard featureAfter the Bolus Wizard feature is turned on and programmed, this feature can

74 Chapter: 55 Review the information in the ESTIMATE DETAILS screen. Press ACT to continue to step 6. If you need to make any changes, press ESC to r

Using the Bolus Wizard feature 75 Bolus Wizard feature examplesFor the scenarios that follow, Michael has his Bolus Wizard feature turned on with the

76 Chapter: 5 Example 2: Blood glucose above target range and no active insulinThe next day, Michael wakes up before school. Before eating the same b

Using the Bolus Wizard feature 77 Example 4: Blood glucose above target range with active insulinMichael is at school and wants to eat a snack in the

78 Chapter: 5 Example 5: Blood glucose below target range with active insulinAnother day at school, Michael is getting ready to eat lunch. He tests hi

Optimizing pump therapy 79 Chapter: 6Optimizing pump therapySquare Wave and Dual Wave bolusesSquare Wave bolus delivers a bolus evenly over a period o

80 Chapter: 6Dual/Square Wave bolus on-offNOTE - It is important that you consult with your healthcare professional before using a Square Wave or Dual

Optimizing pump therapy 81 5 The SQUARE DURATION screen will appear. Enter the amount of time you want the Square Wave bolus to last and press ACT. NO

82 Chapter: 6 Example 1: Square Wave bolus - Use of a Square Wave bolus while eating a meal high in fatConner loves pizza. When he was using insulin s