Infusion Site

My daughter is 11 years old and she's been on pump for almost 8 months. A few days ago she came to me complining from site pain. I looked at it and noticed it's bleeding badly. As soon as I removed the canula the blood gushed out severely. I had to put couple of towel paper on it and all soaked. I called the hospital and doctor on call panickly and he advised me to take her to the closest hospital if I am not abnle to stop bleeding. It was a terrifying experience. I finally managed to stop it. The site was not due to be changed at that time, no activities. She was just sitting and doing homework while it happened. I know that sometimes it happens during site change but in my case it happened from no where.

We call that a "gusher" and, unfortunately they happen occasionally. It is pretty shocking the first time, and yep, paper towels, not tissues are called for If I see blood under the canula I get my paper towel ready, but it doesn't happen often. I think it happens from hitting a blood vessel which is why she had pain. I sometimes get a tad of pain right after putting in an infusion set but if it doesn't go away or happens a day or two later, I know I have a bad site. Such fun!

Ah, a gusher!! Don't worry, they happen sometimes when the canula hits a blood vessel. They look way worse than they are...I've soaked through several paper towels, but as a CDE once told me, unless you have some sort of bleeding disorder, you're not going to bleed to death or anything.

Like Zoe points out, if a site hurts more so than usual when it goes in, it may turn into a gusher. Another symptom I've had that corresponds with a gusher is lots of lows, as the insulin is getting dumped right into the blood stream.

This will happen from time to time and again, the trick is not to panic and just remove the site and start over. This is also a good lesson for why you should never leave the house without at least 2 extra infusion sets on hand. Never know when a site will go bad.

Tell your daughter that there are some folks who like to post really gross pictures online of their gushers. I think it was on the flickr feed last year (the diabetes 365 project) where there almost seemed to be a contest going of who had the grossest pictures of their gushers. Seriously, who says diabetes can't be fun?!??!

ditto to everything MyBustedPancreas just said, and don't worry, they don't happen very often.

Tina, I agree. I have only had one gusher in 10 years of pumping and it was from my CGM site, not the pump. Scared me to death,and I was in the bathroom at work...(Long story you do not need to be bored by!)

I am a little roly poly at the waist, so maybe that helps.

I agree it is scary, but after the scare went, I realized I probably lost less blood than the tubes they draw at the lab.

Sounds like it lacerated an artery...

They tried to do an arterial stick on me when I was in the ER... and that was the most excruciating pain I've ever felt. I asked them to stop after the third attempt..

Doesn't matter either way which it lacerated, just might explain the pain.. I hope it doesn't happen again to her!

Over the past several years I have been able to avoid hitting veins. I put my sets in manually and I can feel the pinch of a vein even before I hit one, I just move to another spot. There are more nerve endings just above a vein even though veins have not nerves themselves. If she feels any pain beyond the normal skin pinch , I would suggest taking it out and putting in a new one. I also think you can consider not using a spring loaded inserter because they are much more aggressive than you would be if you just do it manually. It takes getting used to, but I don't use them at all even for my CGM, I take it out and insert it manually.

The gusher she had is from hitting a vein and leaving it in, The vein can not heal with the canula in there and the normal inflamation after a few days makes it more severe. I have only ever had one in 7 years of pumping.

Arteries are very deep. I doubt you could reach one with an canula needle.

Yeah, arteries are typically deep to veins...

But there are smaller arteries and venules in your skin layer.. and it's possible to hit either one.. since arterioles/arteries have greater pressure than venules/veins, it would be harder to stop the bleeding... plus if you freak out and your blood pressure is higher anyway, it will be even harder to stop..