Syringe type, rates and volumes

Use a 10ml or 20ml Luer-lok syringe

"...Since the syringe bore volume varies with different manufacturers and syringe volumes, it is the length of the infusion fluid that is important...use a 48 mm length as the usual amount for daily infusion (1)."

This dilutes drugs enough to ensure compatibility in most circumstances.

The driver is calibrated to deliver fluid in a 24 hr period, in general

• two of commonest syringe drivers are:
  • Graseby MS16 (blue) - set at mm per hour, i.e. for a 48mm infusion set at 02mm per hour
  • Graseby MS26 (green) - set at mm per day, i.e. for a 48 mm infusion set at 48 mm per day

Note that staff using syringe drivers should be adequately trained and different rate settings should be clearly identified and differentiated; incorrect use of syringe drivers is a common cause of drug errors.

Notes:

• prescribing for the syringe driver
  • the dose of each drug to be given by infusion over a specified time period (usually 24 hours) should be clearly written using a dedicated form where this is available
  • if required, a range of drug dose to be administered over a specified time period may be indicated. Variable rates of infusion length (mm/time) should not be prescribed
  • bolus doses of drugs should be prescribed separately in anticipation of breakthrough symptoms
  • Do not
    • change the rate setting on the syringe driver in order to change a dose
    • add medication to an existing syringe
    • use the boost button

Reference:

1. West Midlands Palliative Care Physicians (2007). Palliative care - guidelines for the use of drugs in symptoms control.
2. Dr Michael Cushen, St Elizabeth Hospice, Ipswich 5/96.