The benefits and drawbacks of syringe drivers in palliative care

Abstract

This article will outline the use of continuous subcutaneous infusion pumps, known as syringe drivers, including their benefits and drawbacks in a palliative care context. There have been over 5000 articles published globally describing syringe drivers in the medical and nursing literature within the last decade. Many provide guidance on their use, although much of the data are repetitious, disease or age-group specific, and focused on pragmatic issues to do with clinical application. Several trusts and hospices across the UK are carrying out trials of the recently launched McKinley T34 syringe driver. Therefore, it seems timely to consider their wider use internationally. Globally, practitioners in palliative care are very familiar with their use, although the literature lacks specific guidance and, at times, the information is ambiguous. Having briefly reviewed their benefits, the article considers the limitations of using syringe drivers and comments on some of the lesser known/reported practical and patient-focused drawbacks associated with their use. We conclude by considering why, when so much education and training exists to help practitioners use these devices effectively, so many human errors occur.

Bags, batteries and boxes: A qualitative interview study to understand how syringe drivers are adapted and used by healthcare staff

“…For palliative care, there have been no accounts of this type of behaviour. This study complements existing understanding regarding the safe and efficient use of syringe drivers (Costello et al, 2008;Cruickshank et al, 2010;McCormack et al, 2001;West, 2014); it can also inform the approach to the future introduction of technology. For example, investigation focused on a specific type of technology can be used to build theories outlining the relationship between user-device interactions and system wide consequences (for example technology acceptance) as in (Sharples et al, 2012).…”

Reflections on the provision of community palliative care for terminally ill children in Ireland

“…Syringe drivers The use of syringe drivers or continuous subcutaneous infusion to control difficult symptoms with medication is detailed in the literature (McNeilly et al 2006, Costello et al 2008 and can enable effective children's terminal care at home. Medications commonly administered by subcutaneous infusion include analgesics, anti-emetics, antipyretics, sedatives and anti-secretory drugs (Watson et al 2006), possibly as combinations of some 28 different compounds.…”

A guide to cancer pain management

“…Over 5 000 articles describing syringe drivers have been published globally in the last decade (Costello, 2008), yet many community nurses still lack confidence in how to set up a syringe driver. Local hospices, primary care teams or hospital pain and palliative care teams are a good place to turn to for advice and/ or training.…”