://module 4 The syringe driver page 5/8 <previous next >
Syringe driver prescription
The exact method of prescribing drugs via a syringe driver will differ depending on where you are working. Please check locally for precise details. The following is just a basic guide to key points of note. The route can be given as either "continuous subcutaneous infusion", "subcutaneously via syringe driver". To avoid ambiguity, it is preferable to clarify as follows:
Drug |
Dose |
Route |
Frequency |
Notes |
|---|---|---|---|---|
| Diamorphine | 40mg | CSCI via SD | 24 hourly | |
| Midazolam | 10mg | CSCI via SD | 24 hourly |
CSCI = Continuous SubCutaneous Infusion SD = Syringe Driver
In patients whose pain is unstable, it is often preferable to prescribe a dose range rather than a single dose. It is important to make sure that all responsible health care workers are aware that they may move up or down within this range according to the patient's needs. An example is given below:
Drug |
Dose |
Route |
Frequency |
Notes |
|---|---|---|---|---|
| Diamorphine | 60mg-90mg | CSCI via SD | 24 hourly | |
| Midazolam | 10-20mg | CSCI via SD | 24 hourly | increase if severely agitated |
It is important to ensure that an adequate breakthrough dose of analgesia is also prescribed. The principle is still the same - the breakthrough dose should be a range equivalent to the four hourly dose equivalent. In this case, this would be 10mg - 15mg of subcutaneous diamorphine.
We will now look at commonly used drugs and drug combinations for the syringe driver.