This leaflet has been created in partnership between:
- Wirral Community Health and Care NHS Foundation Trust
- Wirral Hospice St John’s
- Wirral University Teaching Hospital
What is a syringe driver?
A syringe driver (also known as a syringe pump) is a small battery powered pump that gives a continuous
steady flow of medicines in a syringe through a small tube just under the skin, usually over 24 hours. These medicines are used to help your symptoms and will be reviewed on a regular basis and changed if needed. A syringe driver can be used in all clinical settings e.g. hospital, hospice, at home or in a care home.
Why do I need a syringe driver?
There are lots of reasons someone might use a syringe driver. For example, it may be helpful:
- if you are being sick or feel sick regularly
- if you find it difficult or impossible to swallow medicines
- if your body cannot absorb medicines properly
- if the medicine you need to help your symptoms can only be given as an injection
- if your symptoms are not being managed by medicines you are taking in other ways, such as tablets
- as an alternative to having lots of injections to help your symptoms. Instead of having repeated
injections the syringe driver can provide a simpler more comfortable way to receive medications
continuously.
Starting a syringe pump does not mean your medications have stopped working or aren’t strong enough,
only that this is a more effective and reliable way of getting the medications in to the body. Your doctor or nurse should explain why they have suggested a syringe driver and talk about any concerns or questions you have.
Will I always need a syringe driver?
You may only need a syringe driver for a short period of time. If it is felt that the oral (swallowed) medicines will work effectively again, the need for the syringe driver will be reviewed. If you wish to try being without a syringe driver, please do not stop this yourself as your symptoms may come back. You, and your family if you wish, wherever possible should be involved in discussions around any proposed medication changes. Syringe drivers can be used at any point of your illness. If you have any concerns about this, please do discuss this with your nurse or doctor.
Setting up a syringe driver
Your nurse will set up your syringe driver. Not every nurse will do this in the same way, but the steps below might help you know what to expect.
- Your nurse(s) will put your medicines into a syringe, which then goes into the syringe driver box.
- They will place a very small needle in just under the skin on your arm, leg, tummy or back.
- The needle is used to place a very small tube just under your skin. The needle is then removed as
soon as the tube is in place. - Your nurse(s) will put a clear dressing over where the small tubing goes in, to help keep it in place.
- They will connect this small tube to a longer tube to connect to the syringe driver. This means you
can then move around with the syringe driver in or put it in a bag to help you carry it. - They will then switch the syringe driver on and check it is working, before putting it inside a clear
locked box to keep it safe from getting damaged if it was dropped or knocked by mistake
You may feel a little scratch when your nurse puts the needle under your skin. After that, having a syringe
driver should be painless. Let your doctor or nurse know if you have any discomfort or are scared of needles.
Who will look after my syringe driver?
Your nurses at home, in the hospice, hospital or care home will refill your medicines in the syringe once a
day. The syringe containing the medicines is set to run over 24 hours, so will need replacing usually at the
same time of day. Your symptoms will also be reviewed, and the dose or medicines may change to help keep your symptoms under control.
The syringe driver will be checked every day, including the battery, to make sure it is working well and the
medication is being delivered correctly. The nurses will also check your skin where the tubing goes in. The
tubing will need to be changed every 3-7 days so your skin does not get sore. They may need to change
the tubes more often, if you have changes to the skin around where the tube goes in which may mean the medicine is not getting absorbed well.
How will I know the syringe driver is working?
Syringe drivers have a small screen which shows how much medicine you are being given, and how long it will take. If the syringe driver is working normally a green light will flash twice a minute next to the on/off button. If the syringe driver has stopped for any reason this light will turn red. If this happens, or the tubing becomes disconnected from the syringe driver, call your nurse to check. Please do not attempt to remove the syringe driver or press any of the buttons on the pump, unless instruct to by your nurse.
What do I do if the syringe driver alarm goes off?
The syringe driver may start to bleep if there is an error with the syringe driver. This could be that the battery is low or if there is a blockage in the tubing. A blockage can sometimes happen if you accidentally lie on one of the tubes. If the alarm goes off, try not to worry. Contact your nurse or doctor as soon as you can and they will come and check on you as soon as possible and fix the cause of the alarm.
You may also hear an alert sound towards the end of the 24 hours of medication when the syringe is ready to be refilled (2 beeps every 2 minutes). The nursing team will be on their way to refill the medicine in the syringe driver, as they will know when the syringe driver is due to be refilled. Remember this is not an emergency. Even when the syringe driver stops working or has run out, the medication already in your body will continue to work for a number of hours.
Things to be aware of when you have a syringe driver
You can still have a shower or bath when using a syringe driver, but the syringe driver is not waterproof, so you will need to take care to keep it dry. For example, you could put it in a plastic bag on a stool next to the bath or shower cubicle. You should also try to keep the clear dressing over the tubing clean and dry. If you get this wet, gently pat it dry and check it is still in place. If it is coming off, contact your nurse for advice. Try to keep the syringe driver away from direct sunlight. You can put the syringe driver in a bag to carry around with you or tuck the syringe driver under a pillow in bed so you don’t roll onto it.
Check the skin around the tube regularly. Tell your doctor or nurse if you have any pain, swelling or change in colour to the skin around the tubing. Sometimes the medicines in the syringe driver can cause a minor skin reaction. If this happens, the nurses may change the site of the tubing into your skin more regularly or suggest other options to stop it from happening.
If you are home, you will have been given a small supply of injectable medications to go in the syringe driver. It is important to keep all medication in a safe place away from children. Your community nursing team will provide a locked bag for these to go into, but this may take a day or two to arrange.
What did I do if I still have symptoms?
When a syringe driver is first started, or the medicine doses are changed, it can take at least three to four
hours for the medicines in the syringe driver to reach a steady level in your body. This means you may not
feel an effect straight away.
If you still have symptoms, you can have an extra dose of medicine to help. This is sometimes called a top-up or breakthrough dose. It can be given as a liquid or tablet for you to take yourself, or may be as an injection for the nurses to give you. The medicines you can take with a syringe driver will be tailored to your needs and your doctor or nurse should go through these with you to explain what you can take and when. If you are still needing several breakthrough doses, the doses in the syringe driver can be adjusted over time to meet your needs.
Useful contacts
Out of Hours Community Nurses via The Right Care Hub
- Monday to Friday 5.00pm – 8.30am
- Weekends and bank holidays 24-hour service
- 0151 514 2222 option 1
Wirral Palliative Care Services Advice Line
- Specialist advice can be accessed 24/7 in Wirral
- 0151 343 9529 option 1
Community Specialist Palliative Care Team
- Monday to Friday 9.00am – 5.00pm
- 0151 328 0481
Supportive and Palliative Care Team (Arrowe Park)
- 7 days a week 9.00am – 5.00pm
- 0151 552 1892
Your own Community Nursing Team
- Monday to Friday 8.30am – 5.00pm
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