By: Barbara Bradley
Your insertion sites are red. You wonderif you did something wrong during sitepreparation or insertion, and you wonderwhat you should you do about it now and dodifferently next time.
First of all, change the site to a differentlocation, and be sure always to do carefulcleaning and site preparation.
Where do the infection-causing bacteriacome from? Typical sources include yourhands, the skin at the insertion site, andyour own breath. Other organisms can makecontact with insertion set equipment fromcountertops and any other surface areas.
What Are the Signs and Symptoms ofInfection?
Symptoms of serious infections includedifficulty breathing, malaise, fever or chills.
A minor infection may appear as a smallred, tender area at the needle or cannulainsertion site. It may clear with daily soapand water cleansing and a topical antibioticrecommended by your physician.
A more serious infection could lead toan abscess or cellulitis. Fungus infectionsalso can develop when sites havebeen maintained for longer than therecommended duration.
An abscess is a “pocket” of infection thatforms at the site of insertion (injury). It isusually filled with pus. The red, painful andswollen skin surrounding the abscess feelswarm to the touch, and it may feel as ifthere is a lump under the skin. An abscessoften requires incision and drainage of theinfected site, and some infections requiretreatment with antibiotics. Warm, moistcompresses applied to the area will likely berecommended. Insertion sites in the infectedarea must be avoided for several days orweeks.
Cellulitis is an infection of the underlyinglayers of the skin, usually involving a greaterarea of inflammation than an abscess.There may or may not be a lump under thereddened area.
Staphylococcus aureus is the most commonbacteria to cause site infections, but otherorganisms can also cause serious infectionssuch as bacteremia (bloodstream infection).If you are a “carrier” of S. aureus, you shouldconsider wearing a mask to cover yourmouth and nose during site preparation andinsertion.
Remember, always use proper hygiene,follow good practices for site prep andinsertion and be on the lookout for any signsof trouble. When it comes to site infections,like so many things, prevention is the bestmedicine.
Tips for Preventing Infection
Careful preparation of insertion sites should include washinghands thoroughly with soap and warm water and usingantiseptic cleansing solution for the skin.
Placing a sterile protective barrier over the cleaned site before set insertion is sometimes recommended.
Skin cleansing products include IV Prep, Betadine solutionsor Hibiclens. A two- to three-inch area around the intendedinsertion site should be cleaned and allowed to dry.
Avoid touching any part of any equipment that will touch orenter the skin: the needle or cannula tip, the end of the cartridgeor reservoir, infusion set connections or the cleaned top of theinsulin bottle.
Carefully follow the directions for set insertions and site rotationsrecommended by your pump trainer, physician or pump manufacturer.