Syringe drivers

A syringe driver (or syringe pump) is a small device used to give medicines that help manage symptoms. It can be used at any stage of treatment, and is not just used in end of life care. Here we talk about why syringe drivers are used, medicines used in syringe drivers, and some common worries.

A syringe driver is a small battery-powered pump. It gives a steady flow of medicines through a small tube just under the skin on your arm, leg, tummy, or back. Medicines in syringe drivers are used to help manage symptoms.

If you're moving around, you can carry your syringe driver with you. Your nurse may give you a bag for the syringe driver, or you might like to use your own.

Syringe drivers can help manage symptoms at any stage of treatment. It's important to know they are not only used towards the end of life (see Worries about how long people live with a syringe driver below).

A syringe driver is sometimes called a syringe pump, or CSCI, which stands for continuous subcutaneous infusion. Subcutaneous means under the skin, and an infusion is a way of giving medication through a tube or needle.

There are lots of reasons someone might use a syringe driver. For example, it might be helpful:

Your doctor or nurse should explain why they have suggested a syringe driver. They should also give you the chance to ask questions and talk about any concerns you have.

Although syringe drivers are often used towards the end of life, they are not only used at this stage. They can be useful for managing symptoms at any stage of your illness.

Here we talk about some of the medicines used in syringe drivers. Your doctor or specialist nurse will prescribe the medicines best suited to manage your symptoms. And they may suggest other medicines not listed here.

Your syringe driver might give you different medicines at the same time if you have more than one symptom.

All medicines come with possible side effects. Your doctor or nurse should talk to you about these. Speak to them or contact your local pharmacist if you have any questions about your medicines.

Click on the symptoms below to see the medicines used to treat these:

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.

You may feel a little scratch when your nurse puts the needle under your skin. After that, having a syringe driver should be painless. Sometimes your nurse might use a needle that gets left in place. You should not be able to feel it under the skin, as it's very short and thin.

Let your nurse know if you have any discomfort or are scared of needles (see Worries about needles below).

Syringe drivers have a small screen. This shows how much medicine you are being given, and how long it will take.

The syringe driver will often be kept in a clear locked box, to protect it from being damaged.

Your nurse will usually top up or change your medicines once every 24 hours. And they will usually change the tubes every three to seven days. They may change the tubes more often, if you have changes to the skin around where the tube goes in (see Things to be aware of when you have a syringe driver below).

You can have a shower or bath when using a syringe driver. But the syringe driver is not waterproof, so you'll 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 and keep the clear dressing clean and dry. If you get this wet, gently pat it dry and check it's still in place. If it's coming off, contact your nurse for advice. They may change the dressing on their next visit. Ask your nurse if you need advice on keeping the syringe driver or dressing dry.

When you go to the toilet, you can put the syringe driver in a bag and take it with you.

If you get the syringe driver wet or drop it in water, contact your doctor or nurse as soon as you can.

Check the skin around the tube regularly. Tell your doctor or nurse if you have any swelling, discomfort, or changes in colour.

Colour changes to look out for:

We have an illustration of how these colour changes may look on different skin tones.

It can take at least three to four hours for medicines in a syringe driver to reach a steady level in your body. This means you might not feel an effect straight away. How long it takes is different for each medicine – your doctor or nurse should be able to tell you more about this.

Your doctor or nurse may give you an extra dose of medicine if:

This is sometimes called a breakthrough dose. This may be given as an injection, or a tablet or liquid that you swallow.

The doses in the syringe driver can be adjusted over time to meet your needs.

Syringe drivers have an alarm to tell you when something is not working as it should. For example, if the battery is low, or if there’s a blockage. A blockage can sometimes happen if you accidentally lie on one of the tubes.

If the alarm goes off or the syringe driver stops working, try not to worry. Contact your doctor or nurse as soon as you can. They will arrange to visit you and fix the cause of the alarm.

Syringe drivers are safe, reliable and do not need a lot of care. But there are some things to take extra care with:

If any of these things happen, try not to worry. Contact your doctor or nurse as soon as you can, and follow their advice.

Lots of people ask how long someone will live after having a syringe driver. It's not possible to give a definite answer to this, because people can have a syringe driver at any stage of their illness. Syringe drivers are not only used for end of life care.

Some people use a syringe driver for a short time to manage their symptoms. For example, it can be helpful for taking anti-sickness medicines if someone is having chemotherapy. Sometimes, with the guidance of doctors and nurses, syringe drivers are stopped. People can then switch to different ways of taking medicine, such as tablets or liquids that you swallow, injections, or patches.

Some people also worry that having a syringe driver can speed up dying. But it's important to know there is no evidence for this.

When someone is already approaching the end of their life, they may be more sleepy, and find it hard to swallow medicines. So having a syringe driver can be the easiest way to give someone the medicines they need to feel comfortable at this stage.

It's important you have the information you need to feel comfortable with your care. Your doctor or nurse should explain why they have suggested a syringe driver. They should also give you the chance to ask questions and talk about any concerns you have. You might find it helpful to write down any questions you have before you see them.

If you're scared of needles, or struggle with how they feel, you are not alone.

It's a good idea to speak to your nurse before you see them, and let them know about any worries you have. They might be able to suggest things to help you feel more comfortable.

You may find specific adjustments helpful. For example, you could ask your nurse if they could do any of the following:

Here are some things you could try yourself that might help you feel more comfortable:

We know lots of people feel nervous about having a syringe driver, and it's important to know where you can get support.

If you have any worries about your syringe driver, contact your doctor or nurse. If you have any questions about your medicines, you could also contact your pharmacist.

You could also call the free Marie Curie Support Line on 0800 090 2309 or email support@mariecurie.org.uk. They can provide emotional support, or you can speak to an Information and Support Nurse if you'd like practical information.