Getting Started with Revel™ - 16-Nov-2011

Getting Started with Revel™ - 16-Nov-2011
Getting Started
with the MiniMed Paradigm®
REAL-Time Revel™ Insulin Pump
A
PUMP Foundations
B C
PUMP Foundations
C
PUMP Foundations
PUMP Foundations
A
B C
PUMP Foundations
PUMP Foundations
C
PUMP Foundations
PUMP Foundations
Table of Contents
A Step-By-Step Guide to the MiniMed
Paradigm® REAL-Time Revel™ Insulin Pump
Introduction
Welcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
A Step-By-Step Guide
Pump Mechanics and the Delivery of Insulin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Section 1: Pump Basics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Section 2: Inserting the Battery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Section 3: The HOME Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Section 4: The Pump Buttons. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Section 5: Modes of Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Section 6: The STATUS Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Section 7: Reading the Menus and Screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Section 8: Learning to Program Your Pump. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Section 9: Delivering Boluses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Section 10: Suspending Insulin Delivery on Your Pump. . . . . . . . . . . . . . . . . . . . . 37
Introduction to CareLink® Therapy
Management Software. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Frequently Asked Questions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Training Handouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Basal Quick Reference .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Bolus Quick Reference.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Changing Your Infusion Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Safety Rules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Appendix
Alerts and Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Possible Battery Problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Expanded Menu Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
1
2
Introduction
A Step-By-Step Guide to the MiniMed
Paradigm® REAL-Time Revel™ Insulin Pump
Welcome, and thank you for choosing Medtronic as a partner in managing
your diabetes. You have made a great choice and have just purchased the
latest advancement in insulin technology. We are pleased to be a part of
your healthcare team.
Whether this is the first time you are using an insulin pump or you have
“pumping” experience, you will want to learn how your new Paradigm®
Insulin Pump works. This guide provides step-by-step instructions on the
basic operations and programming of your pump.
Please use your pump to complete each practice exercise. Be sure you are
not attached to your pump while you practice. The exercises are presented
in a logical sequence. Completing them in order will help you build your
pump skills and knowledge. Practicing these exercises will prepare you to
use your pump with ease and confidence. Additional training will be
provided during your pump start training session.
Did You Know?
An interactive
version of this
training is available
on the instructional
CD-ROM that was
shipped with your
pump and can also
be found online.
Please make sure you also complete The Basics of Insulin Pump Therapy
workbook. Our objective is to provide you with a multi-faceted training
program that will empower you to use your pump with confidence and
success.
Here are some quick tips to keep in mind. It’s okay if you make a mistake.
Your pump automatically returns to the HOME screen (if you do not touch a
button for 30 seconds). The ESC key allows you to backup to the previous
screen if you push the wrong button. Have fun as you practice!
Did You Know?
A complete
explanation of the
technical and
operational aspects
of your pump can be
found in the Paradigm
Revel User Guide.
IMPORTANT Do not attach the insulin pump to your body
or attempt to use insulin in the pump while learning to
navigate the pump screens and understand the pump
functions during your self-study (i.e., as you go through this workbook
or the online courses). Using the pump, with either saline or insulin,
should only be done when you receive formal training with a Certified
Product Trainer.
3
Pump Mechanics
Pump Mechanics and the Delivery of Insulin
Infusion Set*
Before we begin, let’s make sure you know how insulin is delivered when
using an insulin pump. The parts that make up the pump’s delivery
system are the infusion set, the reservoir, and the pump.
Infusion Set
1 Tubing
2 Reservoir Connector
3 Insertion Site Section
4 Cannula
5 Adhesive
1
The infusion set consists of tubing (1) that transports insulin from the
pump to you. On one end of the tubing is the reservoir connector (2)
that attaches to the reservoir. On the other end is the insertion site
section (3) that attaches to you.
The insertion site section has a tiny tube
3
(cannula) (4) that goes into your skin.
Insulin is delivered through the cannula.
A small piece of adhesive (5) surrounds
the insertion site and holds the infusion set in place.
5
4
u
Reservoir
2
The reservoir is similar to a syringe and holds a 2- to 3-day
supply of insulin. The reservoir fits into the pump’s reservoir
compartment (6). You will change the infusion set and fill
a new reservoir with insulin every 2 to 3 days.
6 Reservoir
The pump contains a mini computer and motor that
controls the movement of a piston, located at the bottom
of the reservoir compartment. The piston acts like a plunger
rod on a syringe and precisely controls the delivery of basal
and bolus insulin.
Compartment
7 Piston
6
u
Pump
Reservoir
Each time the pump delivers insulin, the piston moves
forward and pushes up on the bottom of the reservoir
to deliver the exact amount of insulin that was
programmed. The piston must be re-wound each
time a newly-filled reservoir is placed into the
reservoir compartment.
4
Pump
7
*Quick-set® infusion set shown in illustration.
Pump Basics
Section 1:
Pump Basics
What’s on Your Insulin Pump
Before inserting the battery or pressing any buttons, let’s take a closer look at your pump and
become familiar with all of its features. Please use your pump and follow along.
The Front of Your Pump
Pump Screen
Displays all of the information
needed to operate and
program your pump.
Pump Buttons
Five buttons, each
with specific function(s),
operate the pump.
Pump Buttons
The Back of Your Pump
Diagram of (AAA) Battery
Shows direction of battery
insertion.
Pump Serial Number
You will need to provide
this number if you call the
HelpLine.
Medtronic Diabetes 24-Hour
HelpLine Telephone Number
Trained product experts are available to
assist you 24 hours a day, 7 days a week.
Note Revel pumps can vary slightly in appearance
5
6
Pump Basics
The Reservoir and Battery Compartments
Battery Compartment
The battery is inserted here.
Reservoir Compartment
A reservoir holding a
2- to 3-day supply of
insulin is inserted here.
The Reservoir Window and Piston
Reservoir Window
Provides a view of the insulin
remaining in your reservoir.
Piston
The piston is located inside
the reservoir compartment
Note The pump ships with a red cap in the reservoir
compartment (not shown on this page). Leave the red
cap in place for now.
Inserting the Battery
Section 2:
Inserting the Battery
Your insulin pump is powered by a AAA battery. To insert a battery, you will
need a thick coin (nickel or quarter).
Step 1. Place the edge of the coin in
the slot of the battery cap. Turn the
cap to the left (counter-clockwise)
until it comes off.
Step 3. Replace the cap. Use the coin
to turn the cap to the right (clockwise)
and tighten until the slot is horizontal.
Step 2. Place battery into the battery
compartment with negative (flat) end
of the battery in first and positive end
facing out.
Step 4. The pump should power-up.
It will cycle through several screens
and then display the HOME screen,
as shown above. If the HOME screen
displays, your battery is good, and it is
inserted correctly. If the HOME screen
does not display, follow the steps on
the “Possible Battery Problems” page
in the Appendix.
IMPORTANT
Be careful not
to overtighten
the battery cap!
Did You Know?
Energizer® Alkaline
AAA batteries are
recommended. Tests
show they are the most
reliable battery to use
in the pump. Batteries
should be stored at
room temperature,
not in the refrigerator
or other cold locations.
Note Please do not set the time and date yet. We will
explain how to do this later in the guide.
Energizer® is a registered trademark of Eveready Battery Company.
7
8
The HOME Screen
Section 3:
The HOME Screen
1
2
Reservoir Icon
Time
Everything Starts Here
3
Battery Icon
When a working battery is inserted, the insulin pump is ON
and the HOME screen will display. The HOME screen always
displays the reservoir icon, the time, and the battery icon.
All the other screens and menus are accessed from the
HOME screen. The pump “rests” on the HOME screen.
The pump returns to the HOME screen if no buttons are
pressed for 30 seconds.
HOME Screen with Time and Icons
The pump is ON and ready to be
programmed if the HOME screen is
displayed.
24-Hr
1
Reservoir Icon 75% to 100% left
Shows you
approximately how
Less than 25% left
much
insulin is left
in your reservoir.
The icon is divided
into four sections;
each section
represents about
25% of a full
reservoir.
2
Time
Time Display 12-Hr
Shows the time.
3
Battery Icon
75% to 100% left
Shows you
approximately
battery
howLow
much
battery
life is left.
The icon is divided
into four sections;
each section
represents about
25% of the
battery life.
Note If the pump screen is blank, your pump is not ON.
See the “Possible Battery Problems” page in the Appendix.
The Pump Buttons
Section 4:
The Pump Buttons
Each button on your pump has a special function. Some buttons have more than one function.
These additional functions depend on which screen or menu you are using.
act
ESC
UP arrow
• Used to scroll
up through
the items on
a menu
DOWN arrow
• Used to scroll
down through
the items on a
menu
• Used to increase • Used to
or change the value of flashing
items
decrease the
value of a
flashing number
• Turns the screen
backlight ON or
OFF if pressed
from the HOME
screen
ACT button
ESC button
act
ESC
• Opens menus
• Accepts,
confirms, or
activates menu
selections
• Allows you to
return to the
previous screen
or exit
• Opens the
STATUS screen
if pressed from
the HOME
screen
B button
• Also called the Express Bolus button
• Shortcut to the SET BOLUS
screen
• Shortcut to
Bolus Wizard®
feature
(when it is on)
• Used with other
keys to access
certain features
9
Practice Exercises
Practice Exercises
Use your pump to perform the following practice exercises.
In all practice exercises throughout this chapter, when you see the word:
• “Press”: Push and release the button
• “Hold”: Press and maintain pressure on the button
Practice Exercise 1: Learning to Use the Pump Buttons
From the HOME screen:
1.Press
act
2. Press the
3.Press
ESC
to open the MAIN MENU.
and
arrows to scroll through the menu.
to return to the HOME screen.
Practice Exercise 2: Turning the Backlight ON and OFF
From the HOME screen:
1. Press the
arrow. The backlight turns ON.
2. Press the
arrow again. The backlight turns OFF.
10
Note Do not use sharp objects like your fingernails, a pen, or a
pencil to press the buttons on your pump. This can damage your
keypad.
Practice Exercises
Practice Exercise 3: Delivering a Practice Bolus
From the HOME screen:
1.Press
. The SET BOLUS screen appears with 0.0 flashing.
2. Press the
arrow five times to set a 0.5 unit bolus.
3.Press act to confirm. The pump will beep one time as
it starts to deliver the bolus in 0.025 unit increments
or amounts.
The pump will beep again when it has finished delivering the bolus. Then it will return to
the HOME screen.
Congratulations! You have just delivered your first practice bolus. Keep in mind, you will normally
deliver a bolus using the Bolus Wizard feature.
Note Each time the
button is pressed, the bolus amount will
increase by 0.1 units (unless the pump settings have been changed
in the BOLUS MENU).
11
Modes of Operation
Section 5:
Modes of Operation
Your insulin pump runs or operates in one of three modes: Normal, Special, or Attention.
A circular icon is displayed on the screen if the pump is operating in any mode other than the normal
mode. An example of the alert icon that displays during each mode of operation is shown below.
12
1
Normal 2
Special
3
Attention
No Circle Icon
Open Circle Icon
Solid Black Circle Icon
The pump is operating and
delivering insulin as
programmed. When the
pump is operating in normal
mode, it means there are no
special features being used
and there are no active
alarms or alerts. The pump is operating and
delivering insulin using a
special feature or under a
special condition such as a
temporary basal setting, low
battery, or low reservoir
volume.
The pump is not delivering
insulin. This occurs if the
pump is placed in
suspend or another
condition has caused the
pump to stop.
The pump will sound a beep
or vibrate to remind you that
it is operating in the Special
mode (the frequency of the
alert will depend
on the condition).
The pump will beep or
vibrate periodically to
notify you that you are not
receiving insulin (the
frequency of the alert will
depend on the condition).
The STATUS Screen
Section 6:
The STATUS Screen
This screen allows you to quickly view information about your insulin pump’s operating status. It is
continuously updated and shows the most current information about:
• U100 – The type of insulin used in your pump
• Current basal rate
• Reservoir start date
• Units left in reservoir
• Battery status (normal or low)
• Date
• Serial number
• Version of software your pump is using
The STATUS screen can be accessed by pressing
ESC
from the HOME screen.
Practice Exercise: Viewing the STATUS Screen
From the HOME screen:
1.Press
ESC
. The STATUS screen appears.
2. Use the
and
arrows to scroll through and look
at your STATUS screen.
To return to the HOME screen,
ESC
Press
ESC
from HOME screen to see
STATUS screen
Note Your pump is not fully programmed yet. Therefore,
some of the information on your STATUS screen may be
default information or may be missing.
13
Reading the Menus and Screens
Section 7:
Reading the Menus and Screens
There are six primary menus. Each menu contains the features and options that pertain to that menu.
For example, if you are looking for a function related to bolus delivery, go to the BOLUS MENU; if you
are looking for a basal rate function, go to the BASAL MENU. Each menu is set up so that the features
that are used most often are closest to the top of the menu.
The Pump Screen
Your insulin pump screen can display up to five lines of information at one time.
• Line 1: Always displays the reservoir icon, time, and battery icon.
• Line 2: Always displays the name of the menu that you are currently viewing (MAIN, BOLUS,
SUSPEND, SENSOR, etc.).
• Lines 3, 4, and 5: Shows first three selections on the menu.
Line 1
Line 2
Lines 3, 4, 5
Scroll Bar
The Scroll Bar
When a screen or menu has more than five lines of information, a scroll bar appears on the right side
of the screen to let you know there is more information available. When you see the scroll bar on
your screen, use the
arrow to scroll down and view the remaining information.
14
More About The MAIN MENU
The MAIN MENU allows you to choose one of these six menus:
• Bolus: Contains the options and features related to boluses.
• Suspend: Allows you to interrupt insulin delivery. This is commonly used when disconnecting to
take a shower, change clothes, or swim.
• Sensor: Contains selections that refer to our continuous glucose monitoring product (this
information is not covered in this workbook).
• Basal: Contains all of the selections related to basal rate delivery.
• Reservoir + Set: Contains selections needed for changing the
infusion set, reservoir, and insulin.
• Utilities: Contains a variety of other options.
Each menu (Bolus, Sensor, Basal, Reservoir + Set, and Utilities) has a sub-menu that contains additional
options and features related to that menu.
Press
to Scroll down to see all
options on MAIN MENU
Now let’s take a look at a map of the basic menu and then perform some practice exercises.
15
Reading the Menus and Screens
Practice Exercise 1: Viewing the Main Menu
From the HOME screen:
1.Press
act . The
2. Use the
3.Press
ESC
MAIN MENU appears. Notice the scroll bar on the right side of the screen.
arrow to view all of the options on the MAIN MENU.
to return to the HOME screen.
Practice Exercise 2: Accessing the Bolus Menu
From the HOME screen:
1.Press
act . The
MAIN MENU appears, and Bolus is highlighted.
2.Press act . The BOLUS MENU appears, and Set Bolus is highlighted. Notice that there is no scroll bar, as
there are only three options in this menu.
3.Press
16
ESC
twice to return to the HOME screen.
act
Practice Exercise 3: Accessing the BASAL MENU
From the HOME screen:
1.Press
act ,
2.Use
and the MAIN MENU appears.
to highlight Basal.
3.Press act , and the BASAL MENU appears. Notice that there is no scroll bar, as there are only three
options in this menu.
4.Press
ESC
twice to return to the HOME screen.
act
Here’s a tip! When you are viewing any screen other than the HOME screen, the
arrow functions
only as a down button and does not turn on the backlight. To turn the backlight on when you are in
another screen or menu, you will need to use a new technique called the “dual press.”
Practice Exercise 4:
Turning the backlight ON when NOT on the HOME screen
From the HOME screen:
1.Press
act . The
MAIN MENU appears.
2.To turn the backlight on, hold the
backlight should turn on.
button and press the
3.Hold the
arrow to turn the backlight off.
button and press the
Hold the
arrow at the same time. The
…then press
17
Reading the Menus and Screens
Basic Menu Map
Navigation
Press
act
from the HOME screen to open the MAIN MENU.
Press
act
on item from the MAIN MENU to open the sub-menus.
Press ESC to go back to each of the previous menus until
you return to the HOME screen.
The scroll bar appears on menus to indicate when
additional text is available.
Press
to scroll down to view additional screen text.
Press
to scroll back up.
18
Bolus MENU
Set Bolus1
Bolus History
Bolus Setup
SUSPEND MENU
Press act to Stop
Main Menu
Bolus
Suspend
Sensor
Basal
Reservoir + Set
Utilities
SENSOR MENU
Edit Settings
NOTE: This diagram shows the basic options that are available on each
menu when the pump is shipped from the factory.
An expanded menu that shows all features and options can be found in the
Appendix.
1
Displays only when the Bolus Wizard® feature is off.
Status Screen
Press ESC from the HOME screen to access
the STATUS MENU.
basal menu
Set/Edit Temp Basal
Basal Review
Basal Setup
2
Displays only when you hold
STATUS U100
Basal 1: .000U/H
Reservoir Started:
12JAN, 12:00A
Units left: 176.2U
Time left: --:-Battery: Normal
Mon 01 JAN 2007
S/N# 123456
Paradigm 523
VER 2.2A 1.1 OB OB
reservoir + set menu
Reservoir Setup
Fill Cannula
History
and press
act
.
utilities menu
Lock Keypad
Alarm
Daily Totals
Time / Date
Alarm Clock
Connect Devices
Block
Selftest
User Settings2
Capture Option
Language
19
Learning to Program Your Pump
Section 8:
Learning to Program Your Pump
Now you are ready to program some basic features on your insulin pump. This will help you learn
more about how your pump works and let you practice using the buttons.
The UTILITIES MENU
to find the UTILITIES MENU. It is the last option on the MAIN MENU. We will start here.
Scroll
The UTILITIES MENU has many options that allow you to customize your pump. You will learn which
features are best for you to use immediately and which features you may want to use later
First, we will scroll through and view the options that are available on the UTILITIES MENU. Then we
will select and program some of the features.
Practice Exercise: Viewing the UTILITIES MENU
From the HOME screen:
1.Press
act ,
2.Press
3.Press
and scroll to Utilities.
act ,
4.Use
5.Press
and the MAIN MENU appears.
and the UTILITIES MENU appears.
and
ESC
Scroll to view all options on the
UTILITIES MENU
to scroll through the UTILITIES MENU.
twice to return to the HOME screen.
At the beginning of each exercise you will see the following “shorthand”
used. This is a quick way to list the steps you need to follow to reach
each menu.
HOME Screen > MAIN MENU > Utilities
20
Additional menu options
available when you scroll
down with
Selecting and Setting Alerts
Selecting and Setting Alerts
IMPORTANT
Most alerts and
alarms on your pump
can be silenced and
cleared by pressing
ESC and then act .
Your insulin pump is easy to use and very safe. The pump constantly performs
a series of safety checks to ensure that it is working properly.
If it detects any condition that requires your attention, it will beep or vibrate to
alert you of the situation.
Examples of common alerts you will receive include:
• Low Battery Alert: Alerts when only 10% of battery life remains
• Low Reservoir Alert: Alerts when the insulin reservoir is low
• Suspend: Alerts every 15 minutes when the pump is in suspend
Note Your pump is shipped with the audible beep
alert activated, but you can choose to set it to vibrate if
you prefer.
Practice Exercise: Setting the Alert Type
HOME Screen > MAIN MENU > Utilities
From the UTILITIES menu:
1.Scroll
to Alarm and press
Alarm menu appears.
act .
2.Scroll
to Alert Type and press
Alert Type appears.
3.Scroll
or
act .
Select Alert Type on ALARM MENU
to listen to the alerts.
4. Select the alert you prefer: Beep (long,
medium, short) or Vibrate.
5.Press act to confirm your choice. Your
alert type is now set!
6.Press ESC three times to return to the
HOME screen.
Vibrate option available when
you scroll down with
21
Setting the Time and Date
Setting the Time and Date
IMPORTANT
Setting the right time
and date ensures that
basal insulin will be
delivered at the correct
time and that the data
entered into your pump
will be recorded
accurately.
Setting the correct time and date on your insulin pump is important.
Let’s set the time and date on your pump now.
Practice Exercise: Setting the Time and Date
The pump will go through a series of screens as you set the time and the
date. Use the
and
arrows to set the flashing values and then press
to confirm each selection.
HOME Screen > MAIN MENU > Utilities
From the UTILITIES menu:
1.Scroll
to Time/Date and press
act .
2. Select 12-hour (AM/PM) or 24-hour (military time) and
press act .
22
act
Always check to make
sure the date and time
• include AM or PM
• are set correctly
Setting the Time and Date
3.Press
act
to change the Time/Date.
and
to set the hour. Make sure you scroll through
4.Use
the hours until AM or PM time is set correctly.
5.Press
act
to set.
6. Repeat steps 4 and 5 to set the minutes, year, month, and day.
The first time you set the time and date, the following prompt
will appear: “If time and date are correct, highlight Yes and
press ACT.”
A CHECK SETTINGS alarm will also sound; clear the alarm by pressing
ESC and then act .
23
The Basal Menu
The Basal Menu
Did You Know?
The amount of each
hourly basal rate is
divided into 0.025
unit increments and
delivered evenly over
the hour. For example,
if your basal rate is set
for 0.300 units per hour,
the pump will deliver
0.025 units of insulin
every 5 minutes to total
0.300 units each hour.
24
In the Basal menu, you can program basal rates, change and review basal
rates, set a temporary basal rate, and set the maximum basal amount.
When you program a basal rate into your pump, that exact amount will
automatically deliver each hour.
When you first start on your insulin pump, you will most likely start with just
one basal rate. The pump will deliver that exact basal amount evenly, over
each hour, 24 hours a day. For example, if your starting basal rate is 0.500
units (½ unit) an hour, your pump will deliver a ½ unit each hour, 24 hours a
day. This means you would receive a total of 12 units of basal insulin each
day.
Your healthcare provider will determine your starting basal rate. When you
check your BG as instructed, your BG readings will help you and your
healthcare provider determine if the basal rate amount is correct, if it needs
to be adjusted, or if you need more than one basal rate.
If your BG readings indicate that you need more than one basal rate,
additional rates can easily be added.
The first example on the next page shows how a single basal rate might be
written and how it would deliver each hour.
The second example shows how multiple basal rates might be written and
how they would be delivered each hour.
For basal insulin...
Jill always had to remember to take her shot at bedtime prior to
having her insulin pump. Taking a shot at the same time every
night as instructed by her doctor was difficult to do. Jill is in
college and some nights she would go to bed early, other nights
she would be studying at the library until late. Now with her
pump, she doesn’t have to worry about when she takes her shot.
She receives her basal insulin automatically, 24 hours a day.
U/hr
1.000
0.75 U/hr
0.500
12:00 A
1.000
U/hr
12:00 A – 12:00 A
6:00 A
12:00 A – 8:00 A
0.900 U/hr
0.500
12:00 A
6:00 A
12P
24 Hours
8:00 A – 6:00 P
0.650 U/hr
12:00 P
24 Hours
12:00 A
6P
6:00 P – 12:00 A
0.900 U/hr
6:00 P
12:00 A
25
Setting a Single Basal Rate
Setting a Single Basal Rate
The Start Time for the first basal rate is pre-set at midnight and cannot be changed. As soon as Basal
Rate 1 is programmed into the pump, it begins to deliver each hour from midnight to midnight.
Practice Exercise: Setting a Single Basal Rate
HOME Screen > MAIN MENU > Basal
From the Basal menu:
1. Scroll to Basal Setup. Press
act .
2. Set/Edit Basal is highlighted. Press
act .
3.Set Basal Rate 1 appears with the time preset at
12:00 A and the rate 0.000 flashing.
4.Press and hold
to set the first basal rate amount to
0.500 u/h. If you go past 0.500 units, use the
arrow take
you back to 0.500 units. The basal rate will increase by 0.025
units with each press.
26
5.Press
act
to confirm your Basal Rate at 0.500 u/h.
6. Set Start Time 2 screen displays. (In this exercise you are only setting one basal rate, so you do not
need to set a start time for the second basal rate.)
7.Press
act ,
and the Basal Rate screen appears, showing:
• Current Rate .500 U/H
• Started #1 – 12:00A
• 24 Hr. Total 12.00 U
In this example, the 24-hour total is 12.00 u. This is the total amount of basal insulin that
your pump will deliver over 24 hours when the basal rate is set at 0.500 units per hour.
27
Setting Multiple Basal Rates
Setting Multiple Basal Rates
Now that you have learned to set one basal rate, let’s learn how to program multiple basal rates.
Practice Exercise: Setting Multiple Basal Rates
HOME Screen > MAIN MENU > Basal
From the Basal menu:
1. Scroll to Basal Setup and press
act .
2. Set/Edit Basal is highlighted. Press
act .
3. Set Basal Rate 1 appears.
4.Press act to confirm that the 0.500 rate is correct and that you do
not want to change the amount of that rate.
5.Set Start Time 2 appears with dashes flashing in the upper left
corner. The flashing dashes indicate that the start-time for the
2nd basal rate needs to be programmed here.
6.Set the following start times and basal rates using the
Press act , to confirm each time and rate:
28
a. Start Time 2: 3:00 AM Rate: 0.800 u/h
and
arrows.
b. Start Time 3: 7:00 AM Rate: 0.650 u/h
7. When the dashes for Start Time 4 appear, press
act .
8.The Basal Rate screen appears, showing the current rate, the time the current rate started
delivering, and the 24 Hr. Total, which in this example is 15.750U.
Needing more than one basal rate...
When Matt was on insulin shots, he would wake up in
the morning with low BGs. However, if he decreased his
insulin to prevent these overnight/early morning lows,
he would have higher BGs later in the day. Now that Matt
has his insulin pump, it is programmed to deliver less
insulin when he is sleeping and more insulin during the
day so that his BGs aren’t low when he wakes up and his
BGs aren’t high during the day when he needs it.
Helpful hint: Most people need more than one basal
rate to get the best control with their pump. Work with
your healthcare provider to get your basal rates adjusted
correctly when you start on pump therapy.
29
Basal Review and Erasing Basal Rates
Looking at the Basal Review Screen
Your insulin pump has another great feature that allows you to review
the basal rates you have set in your pump. Basal Review is found on the Basal menu.
Let’s review the basal rates you just entered.
Practice Exercise: Looking at the Basal Review Screen
HOME Screen > MAIN MENU > Basal
From the Basal menu:
1. Scroll to Basal Review and press
act .
2.STANDARD (basal review) appears, showing the 24-hour total and each basal rate:
3.Press
ESC
three times to return the HOME screen.
You can also look at your STATUS screen to see which basal rate is currently being delivered. To do this:
1.Press
2.Scroll
hour.
30
ESC
from the HOME screen to view the STATUS screen.
to see which basal rate is currently running and the amount that is being delivered each
Erasing Basal Rates
If you would like additional practice setting basal rates, you can erase the basal rate you just set. Once
erased, you can repeat the practice exercises or make up other basal rates to review programming your
pump.
Practice Exercise: Erasing Basal Rates
HOME Screen > MAIN MENU > Basal
From the BASAL MENU:
1. Scroll to Basal Setup and press
act .
2. Set/Edit Basal is highlighted.
3.Press
4.Press
5.Press
and Set Basal Rate 1 appears.
act
until the rate is set to 0.000 u/h.
act .
6.When Set Start Time 2 appears, press
to set the time to (--:--) and press
act .
7. Basal Rate: Current Rate screen appears.
The 24-hour total should now read: 24 Hr. Total 0.000U. Your basal rates have been erased.
31
Delivering Boluses
Section 9:
Delivering Boluses
A bolus is given for two reasons: to cover food that contains carbohydrate or
to correct glucose levels that are above your target range.
The insulin pump allows you to access the bolus feature in a number of
different ways. This section covers how to deliver a bolus using the Set Bolus
feature found in the Bolus Menu and the Express Bolus button.
Practice Exercise 1: Delivering a 0.5 u Bolus
HOME Screen > MAIN MENU > Bolus
From the BOLUS MENU:
1. Set Bolus is highlighted. Press
act .
2. SET BOLUS screen appears with 0.0 u flashing.
3.Press
4.Press
5 times to set a bolus amount of 0.5 u (½ of a unit).
act
to confirm the amount and deliver the bolus.
Please note: Your pump delivers insulin in 0.025 unit increments. Watch as
the screen counts up in 0.025 increments (i.e., 0.025; 0.050; 0.075; 0.100,
etc.) until the half-unit bolus of insulin is delivered.
Did You Know?
As you deliver
boluses, the
amount of active
insulin that is
being tracked by
your pump is
displayed on the
lower left corner
of the screen.
32
Your pump will beep once when it has finished delivering a bolus.
It will then return to the HOME screen.
act
Set Bolus is highlighted,
press act
SET BOLUS screen appears,
0.0u flashing
Note The pump beeps once when it begins to deliver a
bolus and beeps again when it has finished. It then returns
to the HOME screen.
Delivering Boluses: Express Bolus
Express Bolus Button
The Express Bolus or
button, is the method you will probably use
most frequently when giving a bolus. It is easy and convenient to use
because the button is located on the front of your insulin pump.
When the Express Bolus button is pressed from the HOME screen, the
SET BOLUS screen immediately opens with 0.0 u flashing, ready for you
to enter the bolus amount. Once the Bolus Wizard® feature is turned on you
will use the
button to access the Bolus Wizard calculator.
Did You Know?
Once the Bolus Wizard®
feature is programmed
and turned on, you will
not need to enter the
amount of insulin to be
delivered. You will simply
enter your BG and the
number of grams of
carbohydrate you plan
to eat. The Bolus Wizard®
feature will calculate the
amount of insulin to be
delivered for you.
Express Bolus Button
Practice Exercise 1:
Button to Deliver a Bolus
Using the
From the HOME screen:
1.Press
. The SET BOLUS screen appears with 0.0 u flashing.
2. Use the
3.Press
act
arrow to set a 1.0 unit bolus (1 unit).
to confirm and deliver the one-unit bolus.
4.Watch as your pump delivers the bolus. It will beep once and return to
the HOME screen when it has finished.
33
The Bolus Wizard®
The Bolus Wizard
The Bolus Wizard is a feature that calculates the amount of bolus insulin you need when you enter
your current BG reading and the number of carbs you are about to eat. The Bolus Wizard uses your
individualized settings provided by your healthcare provider to estimate your bolus insulin amount.
These settings include your Carb Ratio, Insulin Sensitivity Factor, BG Target Range, and Active Insulin
Time.
By counting carbs and using the Bolus Wizard, you are able to give the right amount of insulin for your
food and correction bolus. This can help keep your glucose levels better controlled.
Using the Bolus Wizard:
Test and enter BG.
Enter grams of carbohydrates
to be eaten.
Displays estimated amount
of insulin to be delivered.
You will learn more about using the Bolus Wizard when you meet with your trainer.
34
Using the Bolus Wizard...
Larry is so excited that his insulin pump has made his
glucose management easier. Before his pump he had to try
to calculate on his own how much insulin he needed. Now,
his meter sends his BG to his pump, he enters his carbs, and
the pump delivers the bolus.
Helpful hint: After you begin pump therapy, testing your
BG two hours after meals will help you determine if your
Bolus Wizard settings are correct. If your BG is too high or too
low, your healthcare provider can help you adjust your settings to help you achieve better glucose control.
Delivering Boluses: Bolus History
BOLUS HISTORY Screen
The Bolus History screen is a great record keeping feature. It records
the date, time, amount, and type of every bolus delivered. The last 24
boluses can be viewed in the Bolus History screen. The most recent
bolus is displayed first.
Let’s look at the Bolus History screen and review the boluses that
you have given.
Practice Exercise 1: Viewing the Bolus History
HOME Screen > MAIN MENU > Bolus
From the Bolus menu:
1.Press
to highlight Bolus History and press
act .
Did You Know?
Your pump also keeps
the most recent bolus
that was given on the
STATUS screen. This
makes it easy for you
to quickly check the
time and amount of
your last bolus.
To view the last bolus
that was given on your
pump, press ESC from
the HOME screen to go
to the STATUS screen.
2.The Bolus History screen appears.
Shows the last 24 boluses delivered
and
to scroll through and review the boluses
3.Use
that you have given.
35
Delivering Boluses: Bolus History
You can see the details of the last 24 boluses by viewing the BOLUS DETAIL screen.
Did You Know?
Practice Exercise 2: Viewing Bolus History Details
The last 250 boluses
given on your insulin
1.Follow the steps on the preceding page to access the BOLUS HISTORY screen.
pump can be seen by
uploading your
2. Highlight the bolus you want to review and press act .
pump’s information
into a computer.
Special online software
called CareLink™
Personal Therapy
Management Software
for Diabetes organizes
all of the pump’s
3. The details of that bolus will be displayed.
information into
reports that can be
reviewed by you and
your healthcare
provider.
36
4.Press ESC to return to the BOLUS HISTORY screen. To see the details
on other boluses, simply highlight the bolus and press act .
5.Press
ESC
(4 times) to return to the HOME screen.
Suspending Insulin Delivery
Section 10:
Suspending Insulin Delivery on Your Pump
The Suspend Feature
Although you should never interrupt or stop the insulin delivery on your pump for more than an hour
or so, there will be times when you will want to set your pump in SUSPEND and disconnect it from
your infusion site. There are several reasons you might suspend and disconnect from your pump
which include the following:
• Bathing or Swimming
Suspending the basal rate and removing your pump is commonly done for bathing and water
activities. Infusion sets are designed so you can easily disconnect from your pump and tubing and
leave it in a safe, dry place.
Suspending the pump...
Danielle disconnects her pump when she goes swimming.
She always suspends her pump so that insulin isn’t delivered
while the pump is not attached to her.
Helpful hint: While the pump is suspended, it will beep or
vibrate every 15 minutes.
WARNING: Do not use your pump in water, such as when bathing, or wear it during
water activities and showering. The pump is not water-tight and it may become
damaged if it is used in water.
37
Suspending Insulin Delivery
• Interrupting or Stopping a Bolus
There may be times when you want to stop or interrupt a bolus. The pump is designed to allow you to
easily interrupt the delivery of a bolus by setting the pump in SUSPEND.
Interrupting or Stopping a Bolus
Sam programs a bolus for lunch, but before she can begin
eating the phone rings. It’s her cousin calling long distance so
Sam knows this phone call will take a while. So she programs
the pump to SUSPEND and cancels the delivery of the bolus
so that she does not experience a low blood sugar.
More About SUSPEND
When the pump is in Suspend, all insulin delivery stops.
Basal Insulin
When you take the pump out of SUSPEND and have it RESUME, basal insulin will begin to deliver again.
Any basal insulin that was missed while the pump was in SUSPEND will not be delivered.
Bolus Insulin
When you interrupt a bolus, the bolus insulin that has already been delivered prior to setting the pump
in SUSPEND is the only insulin that will be delivered for that bolus. When you RESUME insulin delivery,
the amount of bolus insulin that was not delivered before the pump was placed into SUSPEND will
not be delivered.
38
Practice Exercise 1: Setting the Pump in Suspend
From the HOME screen:
1.Press
to access the MAIN MENU.
act
2.Press
to highlight Suspend.
3.Press
act ;
4.Press
act
the screen flashes SUSPEND.
to confirm you want to place the pump in Suspend.
5.SUSPEND appears on the pump screen. The time your pump was stopped is shown directly above
SUSPEND, and the alarm icon (solid black circle) is displayed between the reservoir icon and the
time. After 30 seconds (to conserve battery power), the pump returns to the HOME screen.
Pump in Suspend; notice the alarm icon
6. Press ESC to look at your Status screen. Notice that the first information on your Status screen tells
you that the pump is in suspend and shows the time the pump was placed in suspend.
7. Press
ESC
to return to your HOME screen.
Status screen shows when pump
was suspended
39
Suspending Insulin Delivery
Practice Exercise 2: Resuming Basal Insulin Delivery
1.Press
act
from the HOME screen.
2. RESUME flashes on the screen.
Press
3.Press
act
act
when pump is in suspend
to confirm that you want to resume basal delivery.
4.Your pump will return to the HOME screen, and the pump will begin to deliver basal insulin as
programmed.
Pump will return to home screen
Congratulations! You have successfully used the Suspend and Resume functions. Notice the alarm icon
(solid black circle) is no longer displayed on your pump screen.
40
Note Any time the pump is in SUSPEND, the alarm icon will remain on the front of the screen as a visual reminder. The pump will also beep or vibrate every 15 minutes as an audible reminder that your pump is in SUSPEND and that you are not
receiving insulin.
Practice Exercise 3: Suspending Your Pump While a Bolus Is Delivering
From the HOME screen:
1. Press the
2.Press
3.Press
to display the Set Bolus screen.
to set a bolus of 5.0 u (5 units).
act .
4. Allow the bolus to begin to deliver, then press
act
again.
5. Suspend is highlighted on the MAIN MENU.
6.Press
act .
7.Press
act
Suspend flashes on the screen.
again.
8.The pump is in SUSPEND, and the bolus delivery has been cancelled.
To see the exact amount of insulin that was delivered before the bolus was suspended, RESUME
delivery and then look at the STATUS screen or go to Bolus History in the BOLUS MENU.
Congratulations! You have successfully completed your introductory training
on your new Paradigm® REAL-Time Revel ™ insulin pump.
For additional practice and training, please review the Instructional CD-ROM or visit
myLearning at www.medtronicdiabetes.com
41
42
Notes
Introduction to CareLink® Personal
Introduction to CareLink Therapy
Management Software
CareLink Personal Therapy Management Software is a web-based program that is provided free of
charge by Medtronic. This software allows you to upload the data from your pump and glucose
meter to a secure website and organizes it into easy-to-read reports and charts. These reports
provide an overview of how insulin, food intake and exercise affect you glucose control.
When you use the Bolus Wizard® feature on your pump, the pump tracks and records:
• Your BG meter readings
• Your carbohydrate intake
• The amount of insulin that was given for each bolus
• The time each bolus was given
Reviewing the data on these reports, allows you and your healthcare provider to identify glucose
patterns and trends so you can determine if any pump settings need to be adjusted.
Set up your CareLink Personal account so you can upload your pump and meter every 2 to 3 days
after you start using your pump. You and your healthcare provider will be able to review your
information and adjust and fine-tune your pump settings as needed.
To set up your CareLink Personal account go to:
www.medtronicdiabetes.com/carelinksetup
To learn more about using CareLink Personal software you can take the myLearning course, Exploring
CareLink Software and Reports. You can access this course at www.medtronicdiabetes.com and
clicking on myLearning. You will need to sign in to your account (or register for an account if you do
not have one) and then click on the Exploring CareLink Software and Reports course.
43
44
Notes
Frequently Asked Questions
Frequently Asked Questions
As with learning anything new, you typically have questions. Here is a list of commonly asked
questions. You may wish to make a note of any additional questions you may have to ask your
Certified Product Trainer.
Where should I wear my pump?
Where and how to wear the pump is a commonly asked question among new pump users. Most
individuals find that wearing an insulin pump presents no problem and that it can be worn in a
variety of ways. It typically takes only a day or two to find the ways that work best for you. Below are
just a few ideas to help get you started.
• Use the clip that comes with your pump and clip it to a waist band or belt
• Place the pump (with or without the clip) into the pocket of your pants
• Keep it in your shirt pocket
• Slip it into your bra
• Use the longer tubing lengths and place the pump in your sock
Where can I put the pump when I sleep?
• Clip it to the waist of your pajama pants
• Clip it onto your pajama top or in a pocket
• Place it next to you in the bed, under your pillow, or on the
bedside table
Medtronic Diabetes offers accessories that can add to the convenience of wearing, protecting and
concealing your pump. Refer to the accessories catalog or to the accessories information found on
our web site at www.medtronicdiabetes.com.
What about intimacy?
What to do with the pump during intimate moments is another question that is frequently asked. An
open discussion with your partner usually resolves any concerns you may have. Some individuals
simply choose to leave the pump in place. Others choose to use the longer tubing which allows them
to place the pump well out of reach. Another idea is to temporarily disconnect from the pump and
tubing. Just remember that disconnecting from the pump for long periods of time can result in high
glucose levels that could lead to DKA. So, always be sure you reconnect the pump afterwards.
45
46
Frequently Asked Questions
Should the pump be removed for X-Rays, CT Scans,
and MRIs?
Any time you have an X-ray, CT scan, MRI or any procedure
involving exposure to radiation or magnetic fields, remove your
pump prior to entering the radiation area or magnetic field.
Cannula infusion sets such as the Quick-Set,® Silhouette® and
mio™ can be left in place during the procedure. However,
infusion sets that use a needle instead of a cannula to infuse
insulin (such as the Sure-T® and the Polyfin®) must be removed
prior to the procedure.
X
If your insulin pump is inadvertently exposed to a strong
magnetic field like an MRI, discontinue use and contact our
24-Hour HelpLine at 800.646.4633.
Can the pump be worn when going through
airport security?
You can wear your insulin pump while going through
common security systems such as an airport metal detector.
Do not send your devices through the x-ray machine.
Medtronic has conducted official testing on the effects of the
full body scanners at airports with Medtronic medical devices
and have found that some scanners may include x-ray. To
avoid removing your devices, you may request an alternative
screening process. If you choose to go through an airport
body scanner, you must remove your insulin pump and CGM
(sensor and transmitter).
Print and complete the information on an airport emergency
card to carry with you.
Notify security screeners that you have diabetes, that you are
wearing an insulin pump and are carrying supplies with you.
Because travel rules are subject to change, it is advisable to
check with the Transportation Safety Administration (TSA)
before traveling. International passengers should consult their
individual air carriers for international regulations. Some
helpful tips regarding travel within the United States are listed
on the next page.
X
Tips about traveling with Insulin Pumps and Supplies
• Notify security that you have diabetes and are wearing an insulin
pump. Let them know you are carrying insulin and other supplies
with you.
• There is no need to remove your pump. The pump will not trigger
metal detectors and the detectors will not harm your pump.
• Do not send your pump through any x-ray equipment.
• If there is any question, ask that they visually inspect the pump
ratherthan removing it from your body. (Remember, you may ask
for a private screening, if removal or lifting of clothing is required
to display your pump.)
• A doctor’s letter is no longer sufficient proof of medical necessity
when carrying syringes. To board with syringes and other insulin
delivery devices, you must produce an insulin vial with a
professional, pharmaceutical, pre-printed label that clearly
identifies the medication.
• Never store insulin in checked luggage, as it may be exposed to
extreme temperatures. Extreme heat or cold can cause insulin to
lose its effectiveness.
• Boarding with lancets is allowed if the lancets are capped and
carried along with a glucose meter that has the manufacturer’s
name embossed on it.
If you encounter difficulty, ask to speak with the TSA ground security
commissioner or their international equivalent. The American Diabetes
Association (ADA) asks that you contact them at 1.703.549.1500 ext.
1768 should you encounter any problems.
47
48
Frequently Asked Questions
General Travel Tips
• Pack extra supplies including reservoirs, infusion
sets, batteries and ketone strips. Keep your
supplies, insulin and a prescription with you, just
in case your luggage is lost or your insulin
becomes denatured.
• Pack glucose tablets or carbohydrate for treatment
of low glucose. In case flights are delayed or
canceled, pack extra food that is easy to carry, such
as nutrition bars.
• If you travel outside the United States, you may
want to take advantage of Medtronic’s travel
loaner plan. This program allows you to take a
“back-up” insulin pump with you when you travel.
For more information or to request your travel
loaner today go to
www.medtronicdiabetes.com/travelloaner.
When Should I Call the 24-Hour HelpLine?
Medtronic Diabetes provides a 24-Hour HelpLine that is staffed
with highly trained and skilled service technicians. These
technicians are available to assist you with any technical issues
or questions that you may have regarding the operation of your
pump.
Examples of when you may need to call the HelpLine are:
• You are concerned that the pump is not functioning
properly.
• You are reading about a pump function in the User Guide
that you do not understand and need assistance.
• Your pump has alarmed and you have followed the
instructions to clear the alarm and it alarms again.
The number for the HelpLine is located on the
back of your pump.
49
50
Frequently Asked Questions
When Should I Call My Healthcare Provider?
Consult your healthcare provider about when, how often, and
under what circumstances you should contact them. Typically,
providers review your glucose information more frequently
when you first start on pump therapy. This allows them to adjust
and fine-tune your pump settings. Once adjusted, most
healthcare providers ask that you maintain a routine follow-up
schedule. Examples of other situations that you should notify
your healthcare provider about are:
Hypoglycemia (BG less than 70mg/dL)
• Any severe hypoglycemic event that requires another
person’s assistance to treat the low; or any event that
results in loss of consciousness.
• Frequent hypoglycemia
• Hypoglycemia that occurs around the same time each day
or that routinely occurs after certain activities (such as
vacuuming or washing the car)
• Hypoglycemia that occurs after or during exercise
Hyperglycemia (BGs above your maximum target
range or above 250 mg/dL)
• Hyperglycemia that is frequent or persistent
• Hyperglycemia that is accompanied by nausea or vomiting
• Hyperglycemia and positive ketones
• Hyperglycemia that occurs around the same time each day
or routinely after a certain event (such as eating).
As always, when low or high blood sugars occur, follow the
guidelines provided in the “Safety Guidelines” chapter of “The
Basics of Insulin Pump Therapy” workbook.
Training Handouts
Training Handouts
This section contains information that will be covered in your pump start
training. This content is intended for post-training review only.
IMPORTANT Please DO NOT perform the steps provided
in this section until after you have met with your healthcare
provider or certified pump trainer.
51
52
Notes
Basal Quick-Reference Guide for the Paradigm®
Revel™
Insulin Pump
®
™
Basal Quick-Reference Guide for the Paradigm Revel Insulin Pump
To Set a Single Basal Rate :
To Add a Basal Rate:
1. From MAIN MENU, scroll to Basal. Press
2. Select Basal Setup. Press
ACT
ACT
.
.
3. Set/Edit Basal is highlighted. Press
ACT
.
4. Press ACT to confirm
BASAL RATE 1.
1. From MAIN MENU, scroll to Basal. Press
ACT
.
2. Select Basal Setup.
Press ACT .
3. Set/Edit Basal is
highlighted. Press
ACT
5. Use arrows to
SET START TIME 2.
Press ACT .
6. Use arrows to
SET BASAL RATE 2.
Press ACT .
.
4. Use
to set the basal
rate amount. Press ACT .
5. Press
ACT
7. Repeat steps 5 and 6 as needed. Press
final START TIME.
6. BASAL RATE screen
appears showing the
current rate (u/h); start
time of rate and 24 hr.
basal total.
To Change a Basal Rate :
To Review Basal Rate(s):
1. From MAIN MENU, scroll to Basal. Press
ACT
ACT
.
3. Set/Edit Basal is highlighted. Press
ACT
.
4. Use arrows to change
the basal rate amount.
Press ACT .
5. Press
ACT
again to skip SET START TIME 2.
6. BASAL RATE screen
appears showing the
new current rate (u/h);
start time of rate and
24 hr. basal total.
to skip
8. BASAL RATE screen
appears showing the
current rate (u/h);
start time and 24 hr.
basal total.
again to skip SET START TIME 2.
2. Select Basal Setup. Press
ACT
.
1. From MAIN MENU, scroll to Basal. Press
ACT
.
2. Highlight Basal Review.
Press ACT .
3. STANDARD and the
24 hour total appear
on the top line. Below
are the programmed
basal rates, showing the
start time and units per
hour for each.
Note: The settings shown are for illustration purposes only — your settings will be different.
53
53
Basal Quick-Reference Guide for the Paradigm®
Revel™
Insulin Pump
®
™
Basal Quick-Reference Guide for the Paradigm Revel Insulin Pump
Temporary Basal Rate
Patterns
This feature allows you to immediately increase
or decrease your basal rate, for the temporary
period of time you set. It is used primarily for
exercise and sick days.
This feature allows you to pre-program up to
three different sets of basal rates so you can easily
accommodate routine schedule changes (example:
weekday vs. weekend; day vs. night shift, etc.).
To Set the Temporary Basal Type:
To Turn Patterns On:
1. From MAIN MENU, scroll to Basal. Press
2. Select Basal Setup. Press
ACT
ACT
.
1. From MAIN MENU, scroll to Basal. Press
2. Select Basal Setup. Press
.
3. Scroll down to Temp
Basal Type. Press ACT .
3. Select Patterns.
Press ACT .
4. Select Insulin Rate
(U/H) or Percent of
Basal. Press ACT .
4. Select On. Press
To Set a Temporary Basal Rate:
1. From MAIN MENU, scroll to Basal. Press
ACT
ACT
ACT
.
ACT
.
.
.
To Program Basal Patterns:
ACT
.
2. Set/Edit Temp Basal is
highlighted. Press ACT .
1. From MAIN MENU, scroll to Basal. Press
2. Scroll down to Basal Setup. Press
ACT
3. Set/Edit Basal is highlighted. Press
.
ACT
.
4. Highlight Pattern A.
Press ACT .
3. Use
to set duration
of time. Press ACT .
5. Use
7. BASAL RATE A screen
appears. The open circle
at top of screen indicates
Pattern A is now
running. Press .
8. To set Pattern B, repeat steps 3–7.
To Choose Basal Pattern:
To Cancel a Temporary Basal Rate:
ACT
.
1. From MAIN MENU, scroll to Basal. Press
2. Scroll to Select Patterns. Press
3. Highlight the pattern
you want to start.
Press ACT .
3. The open circle will disappear when temp basal
has been cancelled.
Note: The settings shown are for illustration
purposes only — your settings will be different.
54
54
.
ESC
5. An open circle at top of screen and an hourly alert
indicate temp basal is running.
2. Select Cancel Temp
Basal. Press ACT .
ACT
6. Set other times and rates as needed OR press
4. Use arrows to SET
TEMP BASAL U/H or
SET TEMP BASAL %.
Press ACT to start temp
basal rate.
1. From MAIN MENU, scroll to Basal. Press
to SET BASAL RATE 1. Press
ACT
.
ACT
.
ACT
.
Bolus Wizard® Quick-Reference Guide for the Paradigm® Revel™ Insulin Pump
To Turn the Bolus Wizard On:
4.Select Edit Settings.
Press act .
1.From the MAIN MENU, select Bolus. Press
act
.
5.EDIT SETTINGS screen
appears. Press act .
2.Select Bolus Setup.
Press act .
6.Select On. Press
act
.
3.Select Bolus Wizard
Setup. Press act .
Continue to next section to program settings.
To Program Settings:
4.Highlight Sensitivity.
Press act .
1.Highlight Carb Units.
Press act .
Select Grams. Press
act
.
Use arrows to set
Sensitivity. Press act .
Press act again to
skip SET START TIME 2.
2.Highlight Carb Ratios.
Press act .
5.Highlight BG Target.
Press act .
Use arrows to set Ratio.
Press act . Press act again
to skip SET START TIME 2.
Use arrows to set Low and
High Target. Press act after
each one. Press act again
to skip SET START TIME 2.
3.Highlight BG Units.
Press act .
6.Highlight Active Ins
Time. Press act .
Select mg/dL. Press
act
.
Use arrows to set Time.
Press act . Press ESC .
Bolus Wizard Setup is complete.
Note: The settings shown are for illustration purposes only — your settings will be different.
55
55
Using the Bolus Wizard® Feature
To Deliver a Food and Correction Bolus:
To Review Bolus History:
1.Press . Test BG. If
using linked meter
press act . Or, use arrows
to enter BG. Press act .
1.Press act .
Select Bolus. Press
to enter grams
2.Use
of carb. Press act .
2.Select Bolus History.
Press act .
3.Review details. Press
act
To Deliver a Correction Bolus (no food):
1.Press . Test BG. If
using linked meter
press act . Or, use arrows
to enter BG. Press act .
. Select Bolus. Press
act
act
.
.
3.Highlight Bolus Wizard Setup. Press
6.Change value. Press
act
act
.
.
To Review Bolus Wizard Settings:
1.Press
act
. Select Bolus. Press
2.Scroll to Bolus Setup. Press
act
act
.
.
3.Highlight Bolus Wizard Setup. Press
4.Highlight Review
Settings. Press act .
2.Use
to enter grams
of carb. Press act .
4.Confirm bolus amount
(change if necessary).
Press act to deliver.
.
5.Select the setting to be
changed. Press act .
.
1.Press . Leave the
Enter BG screen as
dashes. Press act .
act
act
4.Highlight Edit Settings.
Press act .
To Deliver a Food Bolus (no BG):
56
56
act
2.Scroll to Bolus Setup. Press
4. Confirm bolus amount
(change if necessary).
Press act to deliver.
3. Review details. Press
To Edit Bolus Wizard Settings:
1.Press
2.Leave grams of
carbohydrates at zero.
Press act .
act
.
3.Use arrows to review
boluses given.
.
4. Confirm bolus amount
(change if necessary).
Press act to deliver.
3.Review details. Press
act
.
5.Scroll down to review.
Note: The settings shown are for illustration
purposes only — your settings will be different.
Changing the Quick-set® Infusion Set Using a Revel™ Insulin Pump
To Rewind the Piston in Pump:
1. Wash your hands. Remove old infusion set from your body and the reservoir from pump.
2. Go to Reservoir + Set in MAIN MENU, then select Reservoir Setup to open REWIND screen. Press act to rewind.
To Fill the Reservoir:
1. Remove reservoir from package.
plunger
rod
reservoir
transfer
guard
2. Pull plunger rod down to fill reservoir with air
3. After wiping top of insulin vial with alcohol, hold blue transfer guard and press it down onto insulin vial.
4. Use thumb to push air from reservoir into vial. Continue to hold plunger rod down.
5. Continue to hold plunger rod down as you turn vial over (vial should now be on top and reservoir on bottom). Release plunger. Then slowly pull plunger rod down
to fill reservoir with
insulin.
6. Check reservoir for air bubbles. Tap side of reservoir to force bubbles to rise to top of reservoir. Push plunger rod up to move
air bubbles into
insulin vial.
7. After air bubbles are
removed, pull plunger rod back down to fill reservoir with enough insulin to last 2-3 days.
8. Flip vial over so it is now on bottom. Hold blue transfer guard with one hand. With other hand turn reservoir counter-
clockwise and pull it straight up until disconnected from
blue transfer guard. Disconnect blue transfer
guard and dispose into a
sharps container.
57
57
Changing the Quick-set® Infusion Set Using a Revel™ Insulin Pump
To Connect the Tubing:
Quick-serter®
To Fill the Tubing:
Reservoir connector
Blue
Button
White
Button
Quick-set®
White
Button
Tubing slot
Blue hub
1. Remove Quick-set from package. Hold reservoir in one hand. With other hand gently push connector onto top of reservoir and turn clockwise
until it slides and locks
into place.
2. Tap side of reservoir to force any remaining air bubbles to rise to top. Push up on plunger rod until bubbles are out
and some insulin is in tubing.
3. Turn plunger rod counter-clockwise until it unscrews from reservoir. Be careful not to pull out plunger rod from reservoir or insulin will spill out.
58
58
Needle guard
1.Press act so that REWIND COMPLETE appears. Insert newly filled reservoir into pump’s reservoir compartment.
2. Turn reservoir clockwise until it locks into place. 3.Press act to go to FILL TUBING screen. Be sure infusion set is NOT connected to your body. Then select
Yes and press act .
4. Press and hold act to fill tubing. The pump will beep as tubing fills. Release act when you see drops at tip of connector needle.
Then press
once.
ESC
5. If you see drops at end of Quick-set® needle and there are no air bubbles in the tubing, select Yes
and press act .
6. When the FILL CANNULA screen appears, you are ready to insert the Quick-set® infusion set.
connector
Changing the Quick-set® Infusion Set Using a Revel™ Insulin Pump
To Prepare Quick-serter®:
1. Place blue hub of Quick-set® into Quick-serter® insertion device. The handle and tubing should be lined up with tubing slot on Quick-serter®.
To Insert the Quick-set® Infusion Set:
1. Wipe the selected insertion
site with alcohol or other
antiseptic wipe.
Tubing slot
2. Use two fingers to seat the Quick-set® inside serter securely, but do not push it all the way down. Be careful not to press blue button or Quick-set® will not lock inside serter.
3. Peel paper from adhesive.
4. Pull blue button down until you hear it click. Be careful not to press white buttons on either side of serter.
Choose Insertion Site:
2. Carefully remove needle guard by turning it to loosen and lifting it away to expose needle of Quick-set®.
3. Hold serter against prepared site on body and locate the two white buttons on the serter.
4. Press the two white buttons at the same time. If they are not pressed at the same time the Quick-set® will not
insert properly.
5. Press down on the top of the blue button of serter to release the Quick-set® from the serter.
6. Pull serter away from body. Press adhesive securely against skin.
The best areas of the body to insert infusion set are
shown in shaded areas of this drawing.
59
59
Changing the Quick-set® Infusion Set Using a Revel™ Insulin Pump
To Insert the Quick-set® Infusion Set:
7. With one hand, place fingers on Quick-set®.
With other hand hold blue handle and pull straight out to remove needle
To Fill Cannula:
1. If pump has returned to HOME screen, press act . At FILL CANNULA screen, press act .
2. In order to fill empty cannula under skin press to enter 0.3 units of insulin
(if you are using a
6mm cannula) or 0.5 units (for 9mm cannula)
Press act .
OR
60
60
Quick-set and Quick-serter are registered trademarks and Revel is a trademark of Medtronic MiniMed, Inc.
9501414-011 20111005 ©Medtronic MiniMed, Inc. 2011. All rights reserved.
8. Fold blue handle in half until it locks into place. Dispose into sharps container.
Safety Rules Quick-Reference Guide for Insulin Pump Therapy
Glucose Monitoring
Schedule for Adjusting Pump Settings
When first starting pump therapy or any time pump
settings need adjusting:
• Check your glucose (BG)
– When you wake up
– Before each meal
– 2 hours after each meal
– Bedtime
– Mid-sleep or every 3–4 hours during sleep
• Do not eat between meals.
Schedule for Routine Monitoring
Once your pump settings are adjusted correctly
and your glucose levels are stable, establish a
routine that includes always checking your BG:
• When you wake up
• Before each meal
• Bedtime
• Occasionally mid-sleep
• Test more frequently during travel,
times of stress, and illness
Checking BGs at these times provides the information
needed to adjust and fine-tune pump settings.
Treating Low Blood Glucose Levels
How to Treat Mild/Moderate Lows
15–15 Rule
If BG drops below 70 mg/dL:
1. Eat 15 grams of fast-acting carbohydrate
2. Re-check BG in 15 minutes
3.If BG is still below 70 mg/dL, repeat Steps 1 & 2
every 15 minutes until BG is within range.
How to Treat a Severe Low
Keep a Glucagon Emergency Kit on hand in case
a severe low occurs. Glucagon can be given by
injection to raise glucose levels if you are unable to
eat or drink to treat a low, or if you are unconscious.
Items that contain 15 grams:
•
•
•
•
•
3 to 4 glucose tablets
5 jelly beans
4 oz juice or soda (not diet)
8 oz milk (low or non-fat)
1 Tbsp sugar or honey
If BG is lower than 50 mg/dL, start treatment by
eating 20 to 30 grams of carbohydrate.
A family member, co-worker, or friend should
be instructed on how to give glucagon.
61
61
Safety Rules Quick-Reference Guide for Insulin Pump Therapy
Treating High Blood Glucose Levels
Most highs can be easily lowered simply by giving a correction bolus.
If High BG is lower than 250mg/dL
If BG is Higher than 250 mg/dL — CHECK FOR KETONES
If ketone test is negative:
1.Enter BG into pump/consult Bolus Wizard to
see if correction dose is needed
• Use pump to give correction dose
2Recheck BG in 1 hour
• If BG is starting to decrease, continue to
monitor until normal.
• If BG is same or higher:
– G
ive correction dose using a syringe.
– C
hange infusion site, infusion set,
reservoir, and insulin.
– C
ontinue to check BG every hour until
BG returns to normal.
If ketone test is positive:
1. Take correction dose using a syringe.
2.Change infusion site, infusion set, reservoir,
and insulin.
3. Troubleshoot pump.
4.Check BG every 1 to 2 hours. Give correction
boluses as needed.
5. Drink non-carbohydrate fluids.
6.If BG continues to rise or if you have
moderate to high ketones, nausea, vomiting,
or difficulty breathing, notify physician or go
to the nearest emergency room.
DKA Prevention
Sick Day Guidelines
How to Check for Ketones
Illness and/or infection usually cause BGs to
run higher than normal. Therefore, the risk of
developing DKA is increased when you are ill.
Ketones are a waste product made when the
body
is forced to use fat instead of glucose as its main
fuel (due to a lack of insulin).
Because DKA symptoms are similar to flu and
stomach virus symptoms, check your BG and
monitor for ketones often during illness.
• Check BG every 2 hours
• Check urine for ketones each time you urinate
• Nausea or vomiting:
Immediately check ketones
• Notify doctor if ketones are moderate or high
Also, consider using a temporary basal rate to
temporarily increase your basal insulin. Increasing
basal insulin slightly can help to keep your BG in
better control when you are ill.
62
62
To check for ketones:
1. Collect a urine sample
2. Dip ketone strip into your urine
3. C
ompare color indicator on strip to color
guide on bottle.
Unexplained highs that do not decrease with a correction bolus may be
caused by a dislodged or kinked infusion set or a weak vial of insulin.
See the Appendix in “The Basics of Insulin Pump Therapy” to troubleshoot.
Paradigm and Bolus Wizard are registered trademarks and Revel is a trademark of Medtronic MiniMed, Inc. The glucagon design is a trademark of Eli Lilly and Company. © 2011 Medtronic MiniMed, Inc. All rights reserved. 9501405-011 20110920
1. Enter the BG reading into your pump.
3. Confirm the bolus amount and press the ACT
button to deliver.
2. Allow the Bolus Wizard® feature to calculate
echeck your BG in one hour to make sure your
4.
R
the correction bolus amount.
BG is back within target range.
Never ignore high BG readings. Always consult the Bolus Wizard to see if a correction bolus should be taken.
Notes
63
64
Appendix: Alerts and Alarms
Alerts
If the pump is operating and delivering insulin using a special feature or condition such as a
temporary basal setting, low battery, or low reservoir volume, it will beep or vibrate to remind you
that it is operating in the Special mode (an open circle will appear on the pump screen).
Low Reservoir
Low Battery
INSULIN REMAINING IN
RESERVOIR IS LOW.
Change as soon as possible.
LESS THAN 10% BATTERY LIFE
LEFT. Replace as soon as possible,
always before going to sleep.
Alarms
Your pump has a sophisticated network of safety checks and systems. If the pump is not delivering
insulin because it has been placed in suspend or another condition has caused the pump to stop,
the pump will sound an alarm or vibrate periodically to notify you that you are not receiving insulin.
A closed black circle will appear on the screen as a reminder of this condition.
Weak Battery
Empty Reservoir
BATTERY NOT FULLY CHARGED.
Pump will operate, but battery life
will be shorter than normal.
CHANGE THE RESERVOIR
immediately.
Failed Battery Test
No Delivery
BATTERY TOO WEAK TO OPERATE
PUMP. Install a new battery.
BLOCKAGE DETECTED: insulin
delivery stopped. Check blood
glucose and ketones.
Clearing Alerts and Alarms
When your pump beeps or vibrates notifying you that an alert condition exists, read and follow
the instructions on the screen. Press ESC , then act to silence an alert. Check the STATUS screen to
determine what caused the alert.
Appendix: Possible Battery Problems
Possible Battery Problems
ProblemSolution
Blank ScreenCheck and make sure that the battery is inserted
correctly.
Remember, the negative (flat) end must be facing
down in the pump.
Weak Battery
• You may have inserted a battery that has been
used for a short time.
• You can clear this message and continue, but
• Clear the alert by pressing the
the battery may not last as long as a new
battery.
then the
act
ESC
button, and
button.
• The HOME screen should appear.
Remember, if this occurs, the pump will operate
normally but the battery life may be shorter than
expected.
Failed Battery TestReplace the battery. Occasionally new batteries
are damaged.
If you still do not see the HOME screen, call
Medtronic’s 24-Hour HelpLine (800.646.4633) for
assistance. We are available to assist you 24 hours
a day.
Remember, you will need to provide your pump’s
serial number. Your pump’s serial number can be
found in the pump’s STATUS screen or on the back of
your pump.
65
66
Appendix: Expanded Menu Map
Main Menu
Bolus MENU
Set Bolus1
Use Bolus Wizard2
Manual Bolus2
Set Bolus
Bolus History
Bolus Setup
Bolus Wizard Setup
Edit Settings
Wizard
Carb Units
Carb Ratios
BG Units
Sensitivity
BG Target
Active Ins Time
Review Settings
Max Bolus
Max Bolus Setup
Scroll Rate
Scroll Rate Setup
Dual/Square Bolus
Off
On
Easy Bolus
Off
On/Set
BG Reminder
Off
On
Missed Bolus Reminder
Off
On/Set
Bolus
Suspend
Sensor
Capture Event
Basal
Reservoir + Set
Utilities
Note All
screens are
samples only.
Actual screens depend
on the current active
functions. Blue Arrows
( ) indicate submenus.
SENSOR MENU
Calibrate3
Enter BG
Alert Silence4
Off
Hi Alerts
Lo Alerts
Hi and Lo Alerts
All Sensor Alerts
Link to Sensor4
New Sensor
Reconnect Old Sensor
Find Lost Sensor
Turn Off Sensor
Transmtr ID
Edit Settings
Sensor
Glucose Alerts
Glucose Limits
Hi Repeat5
Lo Repeat5
Predict Alert
Rate Alerts
Cal Repeat
Cal Reminder
BG Units
Transmtr ID
Weak Signal
Graph Timeout
Sensor Demo
Calibration Hist4
Sensor Alert Hist4
Review Settings4
Turn Off Sensor4
SUSPEND MENU
Press act to Stop
3
isplays only when the sensor is communicating
D
with the pump.
1
Displays only when the Bolus Wizard® feature is off.
4
Displays if Sensor is on.
2
Displays only when the Bolus Wizard® feature is on.
5
Displays if Glucose Alerts feature is on.
Status Screens
utilities menu
Lock Keypad
Alarm
Alarm History
Alert Type
Auto-Off
Low Resv Warning
Insulin Units
Time
Daily Totals
Time / Date
12 Hour Setup
24 Hour Setup
Alarm Clock
Off
On / Set
Connect Devices
Meters
Remotes
Other Devices
Block
Off
On
Selftest
User Settings10
Save Settings
Restore Settings11
Clear Settings
History
Capture Option
Off
On
Language
Getting Started
capture event6 MENU
Enter BG
Insulin marker
Meal marker
Exercise marker
Other
History
BG Units
Carb Units
basal menu
Set/Edit Temp Basal
Set Duration
Cancel Temp Basal7
Select Patterns8
Basal Review
Basal Setup
Set/Edit Basal
Set Basal Rate 1
Max Basal Rate
Patterns
Off
On
Temp Basal Type
Insulin Rate
Percent of Basal
reservoir + set menu
Reservoir Setup
Fill Tubing9
Fill Cannula
History
6
isplays if Capture Option is turned on in
D
Utilities Menu.
7
Displays only after setting Temp Basal.
10
8
Displays only when the Patterns feature is on.
Displays only when you hold
11
9
Displays only after a rewind.
isplays only after the patient settings have
D
been saved.
and press
Press the ESC button to go to
the SENSOR STATUS screen.
Pump Status Screen
STATUS U100
Last Alarm:
24APR 11:30 LoBat
Active ins: 1.050U
Last Bolus N 3.800U
9:07 24 MAR
Basal 1: 0.15U/H
Reservoir Started:
23APR, 12:44
Units left: 144.0U
Time left: > 24 hours
BG Reminder in 2:04h
Meter: On
Battery: Normal
Auto Off - 12HR
Fri 25 APR 2008
S/N# 123456
Paradigm 523
VER X.XX X.X
Sensor Status Screen
sensor status
Next Cal: 08:30
Sensor Age: 2d 3h
Sensor Isig: 25.97
Transmtr Batt: Good
Transmtr Ver: 1.1
Transmtr ID: 2111111
Pump S\N#: 123456
act
.
67
68
Notes
Medtronic Diabetes
18000 Devonshire Street
Northridge, CA 91325
1.800.646.4633
Paradigm, Bolus Wizard, Quick-set, Quick-serter, Silhouette, Sure-T and Polyfin are registered
trademarks, and CareLink, mio and Revel are trademarks of Medtronic MiniMed, Inc.
9501223-014 20131220 ©2013 Medtronic MiniMed, Inc. All rights reserved.
www.medtronicdiabetes.com
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