Syringe drivers are often required to provide medicines for symptom management in patients who are terminally ill. They allow continuous subcutaneous administration of medicines to enable effective symptom control when medicines given by other routes are inappropriate or no longer effective. With guidance and support from the local hospice or district nursing services, General Practitioners can arrange a syringe driver infusion for a patient in their home or in a residential care facility, prescribe and monitor the appropriate mix of medicines and manage breakthrough symptoms. What is a syringe driver? A syringe driver is a small, portable, battery operated device that administers medicines subcutaneously over a selected time period, usually 24 hours. Medicines are drawn up into a syringe that is then attached to the driver, which is set to move the plunger of the syringe forward at an accurately controlled rate. Syringe drivers can be used either short-term or long-term, for patients who are ambulatory and those who are confined to bed. Syringe drivers can be placed into a carry bag or pouch when a patient is mobile or be tucked under a pillow if the patient is bed-bound. The Niki T34 is used in a community setting The lockable, battery operated, Niki T34 syringe driver is the current device available in New Zealand for the continuous subcutaneous administration of medicines in a community setting. The Graseby syringe driver has been gradually phased out of use as it was not tamper-proof. Concerns were also raised by the Health and Disability Commissioner after a number of cases occurred due to errors with syringe driver use.1 As a result, a recommendation was made that there be consistency in the type of syringe driver used throughout New Zealand. Initially the preferred replacement option was the AD Ambulatory Syringe Driver, however, the company involved was.
See also: End of Life Care written for patients Subcutaneous ( SC) drug infusion by portable syringe driver has had a significant impact on pain management.[1] It allows the continuous delivery of a range of therapies to aid patient comfort. It is most frequently used in palliative care (particularly cancer care bypassing problems such as: Dysphagia Inability to take medication orally Weakness Pain is experienced by most patients with advanced cancer. Severe pain is experienced by 66% of people with cancer at some point in their illness.[2] Sublingual administration is not always easy if the mouth is dry, co-ordination is poor or cognitive function is impaired. Rectal administration can be a challenge for carers both physically and emotionally. A syringe driver is only an alternative method of administering medication. It does not produce more effective analgesia than the oral route unless the patient cannot use oral medication, or has serious compliance problems. It should not be routinely used as a 'medical last rite' if there is no specific indication for medication. Other common indications for using a syringe driver in palliative care include the treatment of nausea and vomiting, excessive respiratory secretions, and agitation or restlessness. Although GPs provide the majority of palliative care services in the UK, there are often problems with symptom control and communication. See the separate articles on Palliative Care, Looking after People with Cancer and End of Life Care. Setting up the syringe driver They are used primarily when patients are no longer able to take medicines by mouth. This may be because of persistent nausea, vomiting, dysphagia, weakness or coma. Local palliative care guidelines should always be followed when mixing drugs in a syringe driver: A syringe driver takes 3-4 hours to establish a steady state drug level in plasma. If the patient is in pain.
Why syringe drivers are used Your nurse or doctor will explain to you why it’s being used and answer your questions. Syringe drivers are used, for example, when: there’s a lot of severe pain, and a regular flow of medication is needed for enough pain relief it’s difficult to swallow tablets or liquid because of a sore or dry mouth you’re feeling weak you’re vomiting or feel nauseous you’re agitated or distressed you have respiratory secretions (liquid discharge from your breathing) back to top Setting up and checking a syringe driver Your syringe driver will be set up for you by your district nurse, a Marie Curie Nurse, or a doctor. The syringe driver is usually set to dispense your medication for 24 hours. It will be changed or topped up each day by your nurse. Tell your nurse or doctor about your symptoms, so that they can check how well the medicine is working and make any adjustments that might be needed. Your nurse will also check that the syringe driver is working properly. Syringe drivers are easy to use and unlikely to cause any problems. You or your carer can check the syringe driver on a regular basis too. Look out for any changes in the area around the needle – like skin irritation, redness or discomfort – and keep the syringe driver and the area around the needle clean and dry. back to top Taking care when using a syringe driver In general, syringe drivers are reliable and don’t need a lot of care, but it’s important to: avoid dropping the syringe driver keep the syringe driver and area around the needle dry look out for signs of redness or discomfort where the needle meets the skin keep the syringe driver dry when washing or bathing – if you drop in into water contact your nurse or doctor If it stops working If the device stops working, don't worry as the effect of the medication will last for a while. Call your Marie Curie Nurse, district nurse or.
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