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Palliative Care in the Home$

Derek Doyle and David Jeffrey

Print publication date: 2000

Print ISBN-13: 9780192632272

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780192632272.001.0001

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(p.162) Appendix 4 Setting up a syringe driver

(p.162) Appendix 4 Setting up a syringe driver

Palliative Care in the Home
Oxford University Press

There are two syringe drivers in use in palliative care:

  • Graseby Model MS 26, which is calibrated in millimetres per day and is the most commonly used in palliative care

  • Graseby Model MS 16, which is calibrated in millimetres per hour

Providers of palliative care both in hospital and in the community should evolve a common syringe-driver policy which uses one of the above. Having two different types of syringe drivers available in a practice can lead to drug administration errors.

  • The boost button is useful to check the function of the driver and is not a means of giving breakthrough subcutaneous analgesia.

  • A 10 ml, 20 ml, or rarely a 30 ml syringe can be used. The commonest size is a 10 ml syringe.

  • The syringe-driver setting chosen is the distance the plunger of the syringe will travel in 1 day for the MS26 and in 1 hour for the MS16.

  • The speed is set at 48 mm per hour on the MS26 and 2 mm per hour on the MS16.

  • The butterfly needle is inserted subcutaneously in the anterior abdominal wall, upper chest wall, or upper arm, and is held in. place with adhesive film such as Tegaderm.

  • The battery is inserted and the booster button pressed to check function.

  • The drugs require changing every 24 hours.

  • The patient and relative should be educated to check that the driver is functioning.

  • The site of infusion is inspected daily and changed every 3 days, or earlier if any redness is developing.

(p.163) Troubleshooting

  • Cannula blockage-change the cannula

  • Leaking tubing-again replace

  • Blocked tube due to drug precipitation-review drug combination, consider dilution using larger volume syringe

  • Syringe may become dislodged if dropped-reposition

  • Battery failure-s-replace

  • Inspect skin site for local irritation-change site

  • Remember that syringe pumps are not waterproof-they need disconnecting if the patient is having a shower.

  • Readers are referred to Dickman, A., Littlewood, C. and Varga J. “he Syringe Driver” Oxford University Press, 2002, for detailed information about syringe drivers and their use.