Insulin infusion device complications - Revision history

Rossdonaldson1: Rossdonaldson1 moved page Insulin infusion device complication to Insulin infusion device complications

2021-03-11T17:23:50Z

Rossdonaldson1 moved page Insulin infusion device complication to Insulin infusion device complications

← Revisión anterior	Revisión del 17:23 11 mar 2021
(Sin diferencias)

Mholtz: Text replacement - "-->" to "→"

2017-02-08T22:32:39Z

Text replacement - "-->" to "→"

← Revisión anterior		Revisión del 22:32 8 feb 2017
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	***May look/feel like an abscess		***May look/feel like an abscess
	***Area has decreased sensation		***Area has decreased sensation
	***Infusing through such ~~sites-->~~ erratic insulin ~~absorption-->~~ labile blood glucose, hyperglycemia		***Infusing through such sites→ erratic insulin absorption→ labile blood glucose, hyperglycemia

	==Evaluation==		==Evaluation==

ClaireLewis at 17:32, 23 October 2016

2016-10-23T17:32:09Z

← Revisión anterior		Revisión del 17:32 23 oct 2016
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	==Background==		==Background==
	*External ~~pump visible on the abdomen with~~ subcutaneous catheter ~~placed under a dressing nearby~~		[[File:InsulinPumpALIEM.jpg\|thumb]]
	*~~Insulin pumps are easily removed~~ by ~~pulling the catheter out from under the dressing removing it from the~~ subcutaneous ~~insertion~~ site		*Commonly used by patients with type 1 [[diabetes]] in the US
			*External device connected by flexible tubing to a subcutaneous catheter
			*Delivers continuous basal [[insulin]] and (by manually activating) bolus insulin (prandial or correction doses)
			*Patient switches subcutaneous site every 3 days, refills insulin reservoir as needed every few days

	==~~Clinical Features==~~		==Complications==
			*[[Hyperglycemia]]/[[DKA]]
	~~==Differential Diagnosis~~==		**Due to failure to deliver insulin
	~~Complications:~~		**accidental (or iatrogenic) disconnection, kinked tubing, empty reservoir, uncharged batteries, poorly positioned needle, lipohypertrophy, patient not rotating sites
	*[[Hyperglycemia]]		**DKA can occur very rapidly if pump fails, since pumps only use rapid-acting insulin
	*[[Hypoglycemia]]		*[[Hypoglycemia]]
	*[[~~DKA~~]]		*Local complications
	*Local Infection<ref>Richardson T, Kerr D. Skin-Related Complications of Insulin Therapy: Epidemiology and Emerging Management Strategies. Am J Clin Dermatol, 2003; 4 (10): 661-667</ref>		**[[Cellulitis]]<ref>Richardson T, Kerr D. Skin-Related Complications of Insulin Therapy: Epidemiology and Emerging Management Strategies. Am J Clin Dermatol, 2003; 4 (10): 661-667</ref>, usually due to strep or staph
			**Local reactions to adhesives or insulin preparation
			**Lipohypertrophy
			***Subcutaneous granulation tissue due to local insulin action
			***May look/feel like an abscess
			***Area has decreased sensation
			***Infusing through such sites--> erratic insulin absorption--> labile blood glucose, hyperglycemia

	==Evaluation==		==Evaluation==
			*See [[Hyperglycemia]] and [[DKA]]
			*See [[Hypoglycemia]]
			*See [[Cellulitis]]
			*Patients most often know how to operate and perform basic diagnostics on their pump
			*Many devices have a log of bolus histories and changes to basal rates, alarms, etc.
			*All major pump manufacturers have a 24/7 technical support hotline

	==Management==		==Management==
			*Awake, alert patients without diabetes-related complaints should be allowed to operate their pump while in the ED
			*If pump needs to be disconnected for >1hr, give a dose of subcutaneous insulin
			*[[Hypoglycemia]]
			**Do NOT disconnect pump
			**Work up and treat as you would any other hypoglycemic patient
			*[[Hyperglycemia]]
			**Have patient administer an insulin bolus
			*[[DKA]]
			**Assume device failure
			**Turn off and disconnect pump by pulling the catheter out from under the dressing removing it from the subcutaneous insertion site
			**Continue usual DKA management

	==Disposition==		==Disposition==
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	==See Also==		==See Also==
	*[[Medical device complications]]		*[[Medical device complications]]
			*[[Insulin]]
			*[[DKA]], [[Hyperglycemia]]
			*[[Hypoglycemia]]

	==External Links==		==External Links==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T10:43:50Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 10:43 22 jul 2016
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	*Local Infection<ref>Richardson T, Kerr D. Skin-Related Complications of Insulin Therapy: Epidemiology and Emerging Management Strategies. Am J Clin Dermatol, 2003; 4 (10): 661-667</ref>		*Local Infection<ref>Richardson T, Kerr D. Skin-Related Complications of Insulin Therapy: Epidemiology and Emerging Management Strategies. Am J Clin Dermatol, 2003; 4 (10): 661-667</ref>

	==~~Diagnosis~~==		==Evaluation==

	==Management==		==Management==

Ostermayer: Text replacement - "Category:Surg" to "Category:Surgery"

2016-03-22T16:18:40Z

Text replacement - "Category:Surg" to "Category:Surgery"

← Revisión anterior		Revisión del 16:18 22 mar 2016
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	<references/>		<references/>

	[[Category:~~Surg~~]]		[[Category:Surgery]]
	[[Category:Endocrinology]]		[[Category:Endocrinology]]

Ostermayer: Text replacement - "Category:Endo" to "Category:Endocrinology"

2016-03-22T14:01:08Z

Text replacement - "Category:Endo" to "Category:Endocrinology"

← Revisión anterior		Revisión del 14:01 22 mar 2016
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	[[Category:Surg]]		[[Category:Surg]]
	[[Category:~~Endo~~]]		[[Category:Endocrinology]]

Rossdonaldson1: /* References */

2015-07-20T12:56:11Z

References

← Revisión anterior		Revisión del 12:56 20 jul 2015
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	==References==		==References==
	<references/>		<references/>

			[[Category:Surg]]
			[[Category:Endo]]

Rossdonaldson1: /* Differential Diagnosis */

2015-07-20T12:30:20Z

Differential Diagnosis

← Revisión anterior		Revisión del 12:30 20 jul 2015
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	==Differential Diagnosis==		==Differential Diagnosis==
	Complications:		Complications:
	~~#Hyper/~~Hypoglycemia		*[[Hyperglycemia]]
	# [[DKA]]		*[[Hypoglycemia]]
	#Local Infection<ref>Richardson T, Kerr D. Skin-Related Complications of Insulin Therapy: Epidemiology and Emerging Management Strategies. Am J Clin Dermatol, 2003; 4 (10): 661-667</ref>		*[[DKA]]
			*Local Infection<ref>Richardson T, Kerr D. Skin-Related Complications of Insulin Therapy: Epidemiology and Emerging Management Strategies. Am J Clin Dermatol, 2003; 4 (10): 661-667</ref>

	==Diagnosis==		==Diagnosis==

Rossdonaldson1 at 12:29, 20 July 2015

2015-07-20T12:29:49Z

← Revisión anterior		Revisión del 12:29 20 jul 2015
Línea 1:		Línea 1:
	==Background==		==Background==
			*External pump visible on the abdomen with subcutaneous catheter placed under a dressing nearby
			*Insulin pumps are easily removed by pulling the catheter out from under the dressing removing it from the subcutaneous insertion site

	==Clinical Features==		==Clinical Features==

	==Differential Diagnosis==		==Differential Diagnosis==
			Complications:
			#Hyper/Hypoglycemia
			# [[DKA]]
			#Local Infection<ref>Richardson T, Kerr D. Skin-Related Complications of Insulin Therapy: Epidemiology and Emerging Management Strategies. Am J Clin Dermatol, 2003; 4 (10): 661-667</ref>

	==Diagnosis==		==Diagnosis==

Rossdonaldson1: Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ==Diagnosis== ==Management== ==Disposition== ==See Also== *Medical device complications ==External L..."

2015-07-20T12:27:51Z

Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ==Diagnosis== ==Management== ==Disposition== ==See Also== *Medical device complications ==External L..."

Página nueva

==Background==

==Clinical Features==

==Differential Diagnosis==

==Diagnosis==

==Management==

==Disposition==

==See Also==
*[[Medical device complications]]

==External Links==

==References==
<references/>