Syringe drivers

A syringe driver is a small, battery-powered pump that delivers medication from a syringe at a constant rate throughout the day and night. It’s common to feel nervous about having a syringe driver but most people find that they are very helpful for managing pain and other symptoms and give a feeling of reassurance.

What is a syringe driver?

A syringe driver is a small, battery-powered device that holds a syringe with medication. The device delivers the medication over a set time, from a few hours to 24 hours. The medication is given slowly through an injection under your skin (this is sometimes called continuous subcutaneous infusion). You might have a syringe driver for medicines to help manage pain, sickness (nausea or vomiting), seizures, agitation or breathing problems. In New Zealand, the Niki T34 syringe driver is the device used in the community.

When are syringe drivers used? 

Syringe drivers are usually used if you can't take medications by mouth (tablets, capsules or liquids), for example, if you:

  • have ongoing nausea (feeling sick) and vomiting (being sick)
  • have swallowing difficulties or are too weak to swallow
  • have obstruction in the stomach or gut
  • are not alert enough to swallow.

Syringe drivers can be used either short term or long term. 

Syringe drivers may be used in the last few weeks and days of life but they can be useful at any stage. Some people are worried that a syringe driver can make death come sooner. There is no evidence to suggest that this is true. Syringe drivers are often used at the end of life because they are the easiest way to give someone the medicines they need to feel comfortable at that time.

What does having a syringer driver involve?

Your medicines are put into a syringe, and the syringe driver pushes the medicines through a soft plastic tube and into your body. The needle is very fine. It is usually inserted just under the skin on your arm, leg or abdomen (tummy). Your syringe driver has a computer and a small screen. It calculates the rate your medicines should be given and displays this on the screen.

  • Your syringe driver will be set up for you by your nurse.
  • The medicines will be changed or topped up each day by your nurse.
  • Your nurse will change the needle every few days. It might hurt a little bit when your nurse puts the needle under your skin, but after that, having a syringe driver should be painless.
  • The medicines take a few hours to reach a steady level in your body so you might not feel an effect straight away.

Having your medicines in a syringe driver shouldn’t make you any less mobile than before. If you are active, you can carry it around with you in a special bag.

What are the advantages and disadvantages of having a syringe driver? 

Advantages Disadvantages
  • Don't need repeated doses of medication and a consistent dose is delivered.
  • A combination of medicines can be used in one syringe to manage many symptoms.
  • Giving medicines slowly under your skin (subcutaneous administration) is more comfortable than injections into your muscle (intramuscular injections).
  • The syringe driver can be placed in a carry bag or pouch, so you can be mobile. 
  • Your doctor or nurse will have to predict your medicine needs for a 24-hour period. Changes in your symptoms may require more injections for relief.
  • Your symptoms and the effectiveness of the medicines must be reassessed regularly.
  • You can get pain, redness and swelling or infection at the injection site, which can cause discomfort and interfere with the delivery and absorption of the medicines.

Special instructions

In general, syringe drivers are safe, reliable and don’t need a lot of care, but it’s important to:

  • keep the syringe driver and area around the needle dry
  • avoid dropping it
  • keep the syringe driver dry when washing — if you drop it into water, contact your nurse or doctor
  • take extra care when washing and dressing to make sure the tube isn’t pulled out.

Things to look out for

Your nurse will come to visit you and check the syringe driver every day, but there are things you or your carer can check too.

  • Keep the syringe driver and the area around the needle clean and dry. Your nurse will show you how to do this.
  • Look out for any changes in the area around the needle such as skin irritation, redness or discomfort. 
  • Let your nurse or doctor know if your symptoms are not under control. Your doctor can change or adjust your medicines.
  • If the syringe driver stops working, don't worry, the effect of the medicines will continue for a while. Call your doctor or nurse as soon as possible.
  • If the alarm goes off, there may be a problem with the syringe driver. Let your nurse know so they can come and check it. An alarm may just mean it needs a new battery. Your nurse will provide batteries and a spare one. The driver display will alert you if there are any blockages or leaks. Blockages can happen if you accidentally lie on one of the tubes, for example.

Learn more

Learn more about how to use the syringe driver and how to care for it at home
Syringe driver handbook - A guide for patients and families Mercy Hospice, Auckland

References

  1. When and how to use a syringe driver in palliative care BPAC, NZ, 2012
  2. Guidelines for syringe driver management in palliative care in New Zealand Ministry of Health, NZ, 2009 
  3. NIKI T34 Syringe Pump Instruction Manual Caesarea Medical Electronics, 2008
  4. The palliative care handbook NZ, 2016
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 29 Aug 2018