Question: Silhouette site changes

Hello, Everyone! We recently changed Elisabeth from the Medtronic Quik-set to the Silhouette. She was having some trouble with the end of the cannula kinking, so the Medtronic lady recommended the Silhouette. It is true that we haven’t had trouble with kinking or the site coming out, but I also find it tricky to insert.
When I insert the needle and lay down the adhesive, I have trouble pulling the starter needle out without Elisabeth complaining of pain. I was told by the Medtronic lady that I needed to lay my finger on the site while I pulled out the starter needle so I wouldn’t pull the whole thing out.
Does anyone have some experience or tips on this? Is it just that I don’t have it all down yet and will get better with time, or is there some way I can make the process less painful for her? Or, is this something we just have to get used to? I do like that the site is more secure but I also find using the Silhouette on her stomach more difficult as well.
Thanks in advance!

Are you doing it manually or using the silserter? I found that if you put your finger on the clear window of the adhesive and squeeze and pull, it’s easy to get out. I do it manually, because that silserter is really scary looking to me. The other thing I did this morning when I changed the set was as soon as I got the introducer with the cannula in, I did the first side of adhesive, pushed it down and then pulled the introducer out. Make sure to squeeze the sides of the introducer and pull smoothly. Wiggling it will HURT!

As for less pain, ice works wonders. I didn’t believe it until I tried it!

Good luck!

Hi, Laura, Thanks for your response. No, we’re doing it manually…I also was nervous about the inserters. I guess the thing that is now hard for me is holding down the clear window while squeezing the introducer & pulling out. This is what seems to hurt Elisabeth. Yes, we use ice also and it does seem to really help as well as save monies on numbing cream.
Thanks for your input!

Just put a finger on the clear window. Very, very slight pressure. If you push too hard that will hurt. Have you tried the sure-T sets? They work really well…I just switched from them because of needing a flexible canula. My educator was afraid I’d scar the heck out of my sites with all of the getting stuck and bumping into things I do. I don’t think those would hurt her as much as there’s no introducer or anything.

I pinch the skin when I insert it and pinch it again when sliding the starter needle out. Pull straight out at the same angle it went in.


Thanks Laura for your recommendations. I will look at the Sure-T sets, although I now have boxes of the Silhouettes, so I have to make this work for awhile! :slight_smile: I also find it helpful to hear how things feel from adults who deal with it all the time, things that Elisabeth can’t always express yet.

Thanks, Terry. I’m going to try this tomorrow for her site change. I hadn’t been pinching the skin when I pull out.
Take care!

Call Minimed and get samples of all the different infusion sets and have them send you a pamphlet on infusion sites, they have a pretty good one that they do not send with their sets. If you have not tried the incursion tool it can help.

I’ve been using a pump for 15 years and have used several pumps and sets. IV Prep works best if it does not irritate her skin. One sticky trick is to use Mastisol on the skin, then a IV-3000m then the site or another layer of Mastisol then the site.

Those are a few of my tricks.

Un fortunately the adhesive in the Quick-set sets are the best at sticking to the skin in my experience. That is one of the reasons I switched to the QS.

let us know how it goes!

First, leave the tape on the larger portion of the set, but the smaller “slice” at the top, peel this tape off and bend back. Remove needle cap and slide the set in at 30 degree angle. You do not have to go in deep, just get the canula in there. With other hand, push the “slice” with the tape removed over the skin and adhere. Now, place your fingers over the adhered “slice”, securing set, and pull the needle back out, making sure not to move the set. Pull needle out on the SAME PLANE as you have inserted it. Keep your hold on the “slice” and over the now inserted set. Take the tape off the rest of the set, carefully, and adhere to skin. Put IV 3000 dressing (into which a hole has been cut for the set to stick through) over the whole thing. Use a firm touch, not too slow. Get the canula under the skin but don’t push in too deep. Use EMLA (leave it on for a solid hour beforehand) if this bothers you or your child. No need to suffer.

Hello, Everyone,
Thanks so much for your tips…they really help. Last night I pinched the skin as I pulled the needle out as Terry suggested and this seemed to help.
Jan, your explanation really helped me. When I put the smaller slice of adhesive down on the skin, I had been trying to hold down the cannula (or the clear window) while pulling the needle out. The Medtronic rep had said I needed to hold this part down while I removed the needle because the cannula might come out. However, maybe she meant to hold down the top slice of adhesive while I pull out the needle. I’m going to try this next time.
Also, I push the needle and cannula in pretty much as far as it will go…is this not necessary?

Thanks so much for taking the time to respond, everyone!