# Syringe driver (syringe pump): setting up and checking a continuous subcutaneous infusion in palliative care

Source: https://onco.cc/protocols/syringe-driver-continuous-subcutaneous-infusion/  
OnCo record `syringe-driver-continuous-subcutaneous-infusion` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A syringe driver is a small battery pump that pushes medicines for pain, sickness, agitation or chest secretions slowly under the skin over 24 hours, when swallowing is hard or tablets are not working. A nurse sets it up, refills it every day and checks it regularly; you or your family should not adjust it, and should call the nurses if it alarms, the skin is sore, or symptoms are not controlled.

## Summary

NICE NG31 (2015) says to consider a syringe pump for continuous symptom control in the last days of life if more than 2 or 3 as-needed doses have been given in 24 hours, to avoid intramuscular injections, to start at the lowest effective dose and to reassess at least daily. The Scottish Palliative Care Guidelines (2023 version, BD BodyGuard T) give the procedure: discuss the reasons and offer the leaflet; choose a site with loose subcutaneous tissue (outer arm, upper thigh, abdomen, chest wall, scapula for a confused person) and avoid oedema, ascites, bony prominences and irradiated or broken skin; use a dedicated cannula for the pump and a second one for breakthrough doses; mix only medicines known to be compatible, no more than three without specialist or pharmacy advice, dilute to the maximum volume and add dexamethasone or cyclizine last; change the battery in the community if it is below 50%; prime the line by hand and never connect the line to the patient while loading; keep the pump level with or below the site; select Start Infusion, not Resume, for a new syringe; lock the keypad; check 15 to 30 minutes after set-up, then 4-hourly in hospital and at least daily at home; renew the syringe every 24 hours; and report any infusion finishing more than an hour early or late. About a quarter of palliative medication incidents reported in England and Wales involve these infusions, most from failures of monitoring and supply, administration and prescribing.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: syringe driver; syringe pump; CSCI; continuous subcutaneous infusion; McKinley T34; BD BodyGuard T; palliative infusion pump; 24-hour subcutaneous infusion

## Connected records

- protocols: [Care in the last days of life: recognising dying, hydration, symptom control and anticipatory medicines](https://onco.cc/protocols/care-in-the-last-days-of-life/), [Opioid switching and dose conversion in adults with cancer pain](https://onco.cc/protocols/opioid-switching-and-conversion/), [Strong opioids for cancer pain: starting, titrating, rescue doses and preventing constipation](https://onco.cc/protocols/strong-opioids-for-cancer-pain/)
- technologies: [Hospice and end-of-life care](https://onco.cc/technologies/hospice-end-of-life/), [Syringe pumps and subcutaneous syringe drivers](https://onco.cc/technologies/syringe-drivers/)
- terms: [Care of dying adults in the last days of life](https://onco.cc/terms/last-days-of-life-care/)

---
JSON: https://onco.cc/api/v1/entities/syringe-driver-continuous-subcutaneous-infusion.json