Advice for Bubbles in Terumo Syringes?

Status
Not open for further replies.
Tigger's Friend

Tigger's Friend

Member Since 2013
Hi LL People!

I was so excited to use our new Terumo syringes tonight, but I couldn't make the syringe air gap even out at the top to get rid of the bubble. I blew 2 doses trying to make it work & failing. I finally had to shoot so I went back to the SureComforts. ohmygod_smile

Here's what I did:

Once I pulled the insulin, I tapped the syringe & got the small bubble to the top, then pulled in more air, & made sure the air was level before slowly expelling. Everything was great till I got to that last bit at the top - I still ended up with an air gap / bubble.

The SureComforts are a little concave at the top - not huge like the monojects - but enough for that air gap to tuck into, I assume. It appears the Terumos are completely level at the top.

Other than I'm totally spastic, what am I doing wrong? :cry: Any advice???

Thanks, everyone, I appreciate your help!
 
Oh Suzanne...I have had a time with those syringes too.

I was told to try this and it has been workingn pretty well. Once I have they syringe out of the package and the plunger moved around so it moves freely.

Push the syringe closed to squish out all the air. Put it into the vial and the slowly draw the insulin in.

Since I Have been doing that method I ususally only have one bubble that I can flick out petty easily.

When I was pushing air into the vial and the drawing out the insulin I would end of with bubble I could not for the life of me get rid of. I toss a few doses because of that.

Went searching for my prior condo with this question..here were all the advise I received :) air in syringe
 
Suzanne

I start like Janet....push the plunger in tight, insert it in the pen, s-l-o-w-l-y draw the insulin so the bubble sticks to the plunger. Flick the bubble to the top so it is right below the needle. Slowly pull in a little air and then expel. :-D

Takes time and practice.
 
Thanks, Janet & Marje,

I have exactly the problem Janet is talking about, even after I flick, draw in air & expel - it doesn't expel evenly. I'm already drawing about 1 unit extra to make sure I can balance, but..... :cry:

But - thanks for reiterating, Marje, I'll make sure I have the plunger pushed in firmly & am drawing S-l-o-w-l-y enough! :lol: :lol: :lol:
keeping paws crossed!
 
I think I've now used about every brand of syringe out there... :roll: I found the Terumo's to be the worst for getting rid of that pesky little bubble. I liked the syringes, just hated the bubbles. Went thru a whole box of 100 and still had that little bubble at the end, never DID figure out how to get rid of it completely.

HUGS!
 
Drat! Same problem. And thanks, KT - I'm not the ONLY one!

I spent 30 minutes trying to get the darn bubble out. This time, 2 teeny bubbles on the plunger. They flick up to the top, no problem, .

But - when I draw in the air, let it level, then s-l-o-w-l-y expel the air, one large bubble / air gap sticks to one upper side of the syringe. My guess is the plungers themselves are not entirely level? Holding the syringe at an angle to dispel the last bit of air helps, but there's still an air gap. Don't need 2 reductions!

@ 15 min. past shoot time, I ended up measuring from the bottom of the 0 unit line after the air gap had leveled out. :cry:

Next time I'll try flicking those tiny bubbles & expelling them w/o drawing in more air - that seems to be where I have trouble.

Sorry to be such a pest!
 
Hi!
I follow this method, which has only one variation from the advice given above, but it really works:

1. Work the plunger back and forth a few times, then push it all the way in and hold it in while you insert the needle into the vial.

2. Very slowly (as in Marje's instruction) draw out a little more insulin than you need.

3. Flick the syringe a few times to get the bubble up to the top. Try to center the bubble under the needle.

4. Now, here is the important part (as Marje told it to me last fall; this technique was developed by her DH, Mike): Very quickly and deftly, pull and push the plunger just slightly. Presto, the bubble is expelled. Now go on to measure your correct dose.

Hope this helps. It works for me every time, but you have to practice a bit. QUICK and DEFT.

Ella & Rusty
 
OOOOH! Thanks, Ella (& Marje's DH)!

So quickly draw a bit of air in & expel immediately - whoosh! I'm already visualizing...... :-D

I'll give that a try tonight! I guess in a worst case I can measure off the black 0 line again, then expel extra air till I get the technique right ;-)
 
I am so glad you posted this question!

I love the terumo's...but find I have the same problem! I will try what you have all suggested...

I thought you HAD to inject the same amount of air/or a little less into the vial as what you are going to extract??

I don't know why or where I read that.......but now I know

thanks for the info

~kelly
 
We have all had bubble baffling blocks and I do believe it has pushed some of us over the edge. :lol: Now after reading the steps Ella suggested with Marje's DH's quick and deft maneuver, we gotta try that one. Bubbles be gone! :cool:

We've used almost as many types of syringes as are available, and finally settled on the monojets, then we started getting boxes of those that got all bubblicious and we switched to the Terumos. We just couldn't get used to them and went back to the monojets. But regardless of what type of syringe, it seems we all have bubble problems. Using the calipers as Marje suggested, helped us get more confident in our proper dose and we relaxed some about the bubbles.

Paws crossed you are able to conquer the baffling bubble barrier to a good dose!
 
The digital calipers are strongly recommended for making sure your dose is correct.
http://www.harborfreight.com/4-inch-digital-caliper-47256.html

The Terumo syringes almost always have discrepancies in the lines. With the calipers you can measure from the plastic disc, which should coincide with the zero line, but rarely does. Find a "perfect" Terumo (the disc and the zero line are the same), measure your dose with that syringe, and set the calipers. Once set, you don't have to set the calipers again until you change the dose. (Save your "perfect" syringe for future comparisons when you need to change the dose.)
Now, ready to draw up a dose: first look at the syringe you will be using. If the lines are "off" (zero line does not coincide with plastic disc), adjust for the difference visually. Draw your dose as usual, trying to take into account the inconsistency in the lines. Hold your "set" calipers next to the syringe with the top jaw of the caliper on the plastic disc and see how close the dose is to "perfect". Adjust the dose by twisting out excess insulin or by drawing a little more. Then check again with the calipers. As you practice this will be really easy. It enables you to forget about the lines and instead concentrate on the "real" amount of insulin.

Marje has a great condo on dosing with calipers: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=79851&hilit=calipers

Good luck!!

Ella & Rusty
 
I almost gave up using the Terumo's until I discovered the trick. You can't flick the syringe like you would normally to get the air bubble to go to the center. For some reason, with the Terumo's it makes the bubble stick to the side up at the top. Flicking the syringe just makes it go from one side to the other!! So frustrating. So, what I've found that works is to tap the side of the barrel where the bubble is resting, but tap very gently to "ease" the bubble to the center. Sometimes it works immediately, sometimes it takes a bit of tap tap tapping to get it to go where you want it to go. I usually draw up .25 to .5 more insulin than Champ's current dose so the dose is correct after expelling the air. Nothing more frustrating than to finally get that dang air bubble out and then have to redraw a bit of insulin to get a complete dose!!

Also, just as a side note, I notice you mention you use the SureComfort syringes. I ordered a box of those months ago when I started having problems with the Monoject lines being so messed up. I think the SureComfort syringes are dangerous. I actually took a picture of a SureComfort syringe sitting next to either a Relion or Monoject (can't remember which one, picture attached, SureComfort on the right). Notice how the lines on the Surecomfort just aren't right. There's a huge gap from the zero line to the .5 line, then equal spacing from the .5 line through the 4.5 line, and then a huge gap between the 4.5 line to the 5 unit ling. It looks like the amount of insulin from the zero line to half a unit is actually one unit (the same from the 4.5 unit line to the 5 unit line). I actually did an experiment with water and found twice as many water drops from the zero line to 0.5 than there was from 0.5 to 1 unit. With humans it might not that big a deal, but with kitties it can be dangerous.
 

Attachments

  • 2012-06-16-1_19.29.JPG
    2012-06-16-1_19.29.JPG
    31.8 KB · Views: 337
Thanks, Ella, for remembering to insert the "quick and deft" part. We've gotten so accustomed to drawing, flicking, expelling, that I forgot that I do "quick and deft" :lol: :lol: :lol:

I promise, once you get used to it and get your technique down, dosing is quick and deft ;-) ;-) ;-) Even with the calipers and having to put the calipers and magnifying glass down, pick up syringe, flick out bubbles, squeeze out insulin, pick up calipers/glass, etc., I can still draw a dose really fast. You'll get there.
 
Thanks, Patty for the tap-tap-tap concept - I'll give that a shot, too! (ooh- excuse the pun :lol: :lol: :lol: :lol: )

Patty & Champ said:
Also, just as a side note, I notice you mention you use the SureComfort syringes. I ordered a box of those months ago when I started having problems with the Monoject lines being so messed up. I think the SureComfort syringes are dangerous. I actually took a picture of a SureComfort syringe sitting next to either a Relion or Monoject (can't remember which one, picture attached, SureComfort on the right). Notice how the lines on the Surecomfort just aren't right. There's a huge gap from the zero line to the .5 line, then equal spacing from the .5 line through the 4.5 line, and then a huge gap between the 4.5 line to the 5 unit ling. It looks like the amount of insulin from the zero line to half a unit is actually one unit (the same from the 4.5 unit line to the 5 unit line). I actually did an experiment with water and found twice as many water drops from the zero line to 0.5 than there was from 0.5 to 1 unit. With humans it might not that big a deal, but with kitties it can be dangerous.
Click to expand...

Thanks, Patty about the SureComfort discrepancy. I didn't notice that until I started dosing with the calipers - & was shocked when I looked at it. You're right - the 1 unit mark appears to be about 2 units -it's odd! Luckily, the calipers take care of all that discrepancy & worry - thank you again, Marje!!!

I woke up late this AM, & with Tigger's AMPS @ 79, I went with what I know - Surecomfort. Also the last of our new pen.

So - tonight will give myself ample time to s-l-o-w-l-y draw & tap-tap-tap-tap & !draw-in/expel!

And - if that doesn't work, I'll just draw in enough air & let it level - & measure with the calipers from there to get my orrect dise, then expel the air till I get insulin.

@ Anne - I think adding a magic wand or an incantation against bubbliciousness is a perfect idea!!! :lol: :lol: :lol: :lol:

@ Kelly - the air is in reference to drawing in air to the syringe after the insulin has been drawn to level out the bubble once it's been flicked to the top - it usu. (hopefully) makes it easier to expel. Many are using the Lantus pens - no air goes into them before drawing insulin as they are already pressurized - that only occurs with the lantus insulin vials.

Thanks everyone - this has turned into a meaningful conversation!
 
It worked!!! Two out of two times, the 'tap-tap-tap' to the center & 'quick in-draw & out' expelled the feisty bubbles! Shot out a bit more insulin than expected - due to the trigger-happy plunger, but that can be fixed with practice.

Thanks, everyone! Hopefully this can help others with the same problems!
 
Status
Not open for further replies.
Back
Top