A syringe driver is a small battery-operated piece of medical equipment intended to deliver tiny doses of medication via a needle or tube inserted just under someone’s skin. This continuous subcutaneous infusion (CSI) method ensures that medication is released steadily over a specific period of time, usually 24 hours, to maintain a constant rate of medication in the body.
These devices are often referred to as syringe pumps and are commonly used to manage symptoms when other methods, such as oral medication, are not suitable. However, many family members associate syringe drivers with the end of life, which can cause understandable anxiety. It’s important to know that while they are used in palliative care, they are not limited to end-of-life situations.
This guide aims to shed light on what syringe drivers are, why they’re used, and how they work. A syringe driver can be a scary concept for a family. When first suggested for a relative, it can be daunting and raise huge concerns. However, a better understanding of syringe drivers can help reduce anxiety and show that a syringe driver does not necessarily mean the end of life. In this guide, we’re going to look at this important piece of medical equipment, and the reassurance it can bring.
A syringe driver is typically recommended in situations where medications need to be administered continuously and reliably and when oral medications are no longer an option. This could be due to several reasons, including:
Syringe drivers are not only used in palliative care. While they are frequently used towards the end of life, they can also be beneficial at earlier stages of illness. For example, they may be used during cancer treatment to manage side effects such as nausea from chemotherapy or in cases where people need pain relief but can’t take oral medications.
A syringe driver works by delivering a continuous and controlled amount of medication into the body over a set period. The device contains a syringe that holds the medication, which is slowly pushed into the body through a thin tube and needle inserted just under the skin. The most common period for the infusion is 24 hours, but this can vary depending on the patient’s needs and the medication being used.
The T34 syringe driver is one of the most widely used models in the UK. It’s a small, portable device that’s easy to carry around, allowing the person using it to move freely while still receiving their medication. The T34 syringe pump is programmed to deliver the medication at a constant rate throughout the hour period, ensuring that the patient receives a steady supply of the drug without any peaks or troughs in dosage.
Once the syringe driver is set up, the patient and their family members should know how to look after it. For example, the syringe pump is not waterproof and care should be taken to keep it dry when showering or bathing. Many patients place the pump in a plastic bag to protect it from water. Additionally, it’s important to regularly check the skin around the infusion site for any signs of irritation or swelling and to ensure the device is working properly.
If the syringe driver stops working for any reason, such as a battery running low or a blockage in the tube, an alarm will sound. When this happens, it’s important to contact the care team or nurse as soon as possible to resolve the issue. However, these problems are rare, and syringe pumps are generally very reliable and easy to use.
The drugs that are given through a syringe driver will vary depending on the symptoms being treated. Common symptoms managed by a syringe driver include pain, nausea and vomiting, breathlessness, agitation and anxiety.
Perhaps the most frequent reason for using a syringe driver is to administer steady, consistent pain relief. Relief of moderate to severe pain is one of the most common uses of a syringe driver – morphine, diamorphine and fentanyl are routinely used to treat pain that cannot otherwise be adequately controlled. These drugs are delivered at a steady rate in order to help the patient to maintain the desired pain relief, without the need for frequent dosing.
Nausea and vomiting can be controlled by a drug given through a syringe driver, such as cyclizine or metoclopramide, where the patient cannot tolerate taking tablets. This is useful during chemotherapy, for instance.
In the case of a patient who is anxious, restless or agitated, such as in palliative care, one can also use drugs such as midazolam in a syringe driver to calm the patient down. In this way, the patient remains comfortable and relaxed.
More commonly, morphine in the syringe driver can help those who are short of breath, particularly if they have an underlying illness involving the lungs or are approaching death. Shortness of breath is a common distressing symptom, often made worse by anxiety. Some patients are so frightened that they are convinced they are going to die.
Occasionally a syringe driver is used to give two or more medications at the same time. This can be helpful if a person has multiple symptoms, for example pain and nausea, that need to be managed at the same time. Not all medications can be mixed together, so it’s important a healthcare professional chooses a combination of medications for your syringe driver that are compatible with each other.
When a syringe driver is first introduced, it’s natural to feel a little unsure or anxious about how it works and what it means for your loved one’s care. Here’s what you can expect:
A healthcare professional will set up the syringe driver, programming it to deliver the correct amount of medication over the appropriate time period, usually 24 hours. They’ll also explain how the device works and what to do if any problems arise, such as an alarm sounding. It’s important to ask any questions you have during this time to make sure you feel comfortable with the device.
The tube or needle giving the medicine will go into the skin just under the surface – usually in the upper arm, thigh or abdomen. That area is called the infusion site and you should check the skin around it regularly for any redness, swelling or discomfort. These can be signs of irritation or infection and you should tell a healthcare professional if you notice any changes.
On lighter tones, the skin may turn red or pink from irritation, and on darker tones, it may appear darker than the surrounding skin. In either case, any noticeable changes should be checked out by a healthcare professional.
Keep in mind also that it might take several hours for the medications infused with a syringe pump to reach a steady level in the body. For that reason, a patient’s symptoms, such as pain or nausea will not be immediately under control after the device has been set up. However, when the level of the medication has been reached, it should provide consistent symptom relief.
If the patient’s symptoms are still present while the medication builds up in their body, a ‘breakthrough dose’ of medication is given – this is usually a short-acting injection to help control symptoms in the short term while the syringe driver is building up.
Syringe drivers come with in-built alarms that go off if there is a problem, such as a low battery or a tube blockage. If the alarm sounds, don’t panic. Instead, call your nurse or care team for advice. They will guide you on how to troubleshoot the problem and get the device working again.
Using a syringe driver doesn’t mean that your loved one will be confined to bed or restricted in their daily activities. Most people can continue with their usual routine, although there are some precautions to take. For example, the syringe pump is not waterproof, so care should be taken when bathing or showering. The device can be placed in a plastic bag to keep it dry while the patient washes.
Patients are also advised to handle the device with care, avoiding any sharp movements or pulls on the tube that could dislodge it. If you have concerns about how to manage daily activities while using a syringe driver, don’t hesitate to ask a healthcare professional for advice.
One of the most common concerns family members have when a syringe driver is introduced is whether it signals that their loved one is near the end of life. While syringe drivers are frequently used in palliative care, they’re not exclusively for those nearing the end of life.
A few people might use a syringe driver for a limited time to help deal with symptoms, for instance, nausea while undergoing chemotherapy, then transfer to oral medication once the condition improves. Others may require the device for a longer period to manage ongoing symptoms. In both cases, the use of a syringe driver is about symptom control and maintaining comfort, not hastening death.
No evidence says the syringe driver shortens life; instead, it manages symptoms effectively. If you’re concerned about how long your loved one will live after starting a syringe driver, it’s a good idea to speak with their GP, who can explain their specific situation in more detail.
It’s also worth noting that some patients worry that a syringe driver will make them drowsy or less aware of their surroundings. While certain medications, like sedatives, can cause drowsiness, not all medications delivered by a syringe pump have this effect. If your loved one feels overly sleepy or sedated, their care team can adjust the medication dosage to ensure they remain comfortable but alert.
Knowing what a syringe driver is and how it works can help reduce the fears that often come with using it. These devices are useful for managing symptoms when oral medications aren't an option. They provide a steady and controlled way to deliver the necessary medications to keep your loved one comfortable.
Although syringe drivers are often associated with palliative care, they’re not limited to end-of-life care. Many people use these devices to manage symptoms at earlier stages of their illness, and some may only need them temporarily. The key takeaway is that a syringe driver is designed to improve the patient’s quality of life, not to hasten the end of it.
Suppose your loved one has been recommended a T34 syringe pump or any other syringe driver for continuous subcutaneous infusion for a specific hour period. In that case, it’s important to know how it works and to ask any questions you may have. Your care team is there to support you and provide reassurance, ensuring that both you and your loved one understand the role the syringe driver plays in their care.
A syringe driver is a small, battery-powered device that delivers medication under the skin over a set period. It’s often used when patients cannot take oral medication due to difficulty swallowing, vomiting, or other health issues.
The purpose of a syringe driver is to help control symptoms like pain, nausea, or agitation when oral medications aren't effective or suitable. It provides a steady, consistent release of medication, ensuring patients stay comfortable without the need for frequent doses or injections.
The duration a patient uses a syringe driver depends on their condition and the GP's prescription. Some may need it for a short time to manage specific symptoms, like nausea, while others may use it long-term for ongoing symptom control. It’s tailored to individual needs.
No, a syringe driver does not hasten death. It’s used to manage symptoms and improve comfort. There’s no evidence that it shortens life. Its purpose is to provide relief from symptoms like pain or nausea, helping patients feel more comfortable, not to accelerate death.
Get in touch with Tiggo Care today to see how we can help you or your loved one.
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