What is a syringe driver?

A syringe driver is a small battery operated pump designed to deliver medication sub cutaneously (just under the skin) over a 24 hour period.

The pump holds a syringe containing medication and this is connected to the patient via a small needle and a line.

A syringe driver

The syringe driver pump is able to deliver a combination of medications and does so continuously without any inconvenience to the patient.

Syringe Driver Uses

Syringe drivers have many applications. They are useful for treating multiple symptoms when the patient is unable to take oral medications. For example:

  • A regular flow of medication controls pain effectively. A continuous infusion avoids peaks and troughs by maintaining plasma drug concentrations.
    Simply put, this means that pain medication is not stronger when first taken and then wears off so that the patient experiences pain again
  • The patient is unable to swallow oral medication either because they are too unwell or because they have swallowing problems (dysphagia)
  • Nausea and vomiting means that the medication cannot be taken orally

What are the advantages to using a syringe driver?

There are several advantages to Continuous sub cutaneous infusions (CSCI):

  • Control of multiple symptoms
  • Maintaining a constant level of medication, no peaks and troughs
  • Avoids the need for 2-4 hourly injections and invasive treatment
  • Patients can remain mobile and independent with a driver in place
  • Ideal for people who cannot take oral medications

Are there any disadvantages to using a syringe driver?

It is important to explain the rationale behind using a syringe driver fully to the patient. There is a common misconception that they are the last resort and that using one means that you are close to passing away. This is of course untrue and some patients use the drivers intermittently when their symptoms present.

Remember: Not everyone who is dying needs a syringe driver and not everyone with a syringe driver is dying.

Some disadvantages include:

  • The device uses a 9V battery and currently these only last a few days in the driver, so users will need to maintain a good level of stock
  • Inflammation and infection can occur at the needle site, although generally they are tolerated well. Other giving sets without a needle as the needle is removed at insertion

Symptoms commonly treated with a syringe driver

  • Pain
  • Agitation
  • Respiratory secretions
  • Nausea as well as vomiting
  • Convulsions

These are some of the common indications for use, although this list is not exhaustive.

 

Medications commonly used in a syringe driver

Drugs used in syringe drivers

Consult a medical practitioner or palliative care specialist for support and advice regarding doses and the compatibility of medications.

Many hospices have a helpline staffed by medical professionals.

Care home staff as well as patients at home in the community can seek help and advice via these helplines. 


For more Nursing Notes check out our recent articles on Stoma Care: Parts One and Two.