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.

On this page:

What is a syringe driver?

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.

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.

Why are syringe drivers used?

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

• if you're being sick or feel sick regularly
• if you find it difficult or impossible to swallow medicines
• as an alternative to having lots of injections
• if your body cannot absorb medicines properly
• if you are more sleepy and cannot swallow medicines
• if your symptoms are not being managed by medicines you're taking in other ways, such as tablets.

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.

Syringe driver medications

Medicines in syringe drivers are used to treat symptoms including:

• pain 
• feeling sick and being sick
• agitation
• fitting (also called seizures)
• noisy breathing caused by a build-up of mucus in the throat and airways
• shortness of breath (also called breathlessness).

Here we talk about some of the medicines used in syringe drivers to treat these symptoms. Your doctor or specialist nurse will prescribe the medicines best suited to manage your symptoms. And they may suggest other medicines too.

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.

Setting up a syringe driver

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.

1. Your nurse will put your medicines into a syringe, which goes into the syringe driver.
2. They will place a very small needle just under the skin on your arm, leg, tummy, or back.
3. The needle is usually used to place a very small tube just under your skin. It's then removed as soon as the tube is in place.
4. Your nurse will put a clear dressing over the small needle or tube, to help keep it in place.
5. They will use a long tube to connect the syringe driver to the small tube under your skin.
6. They will switch the syringe driver on, which pushes the medicines through the tubes, and into your body.
7. A green light will flash when the syringe driver is giving you your medicine.

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. Read about things that might help if you're worried about needles. 

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. Read more about changes to the skin.

Using the shower, bath and toilet with a syringe driver

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.

Things to be aware of when you have a syringe driver

Changes to the skin

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:

• On lighter skin tones there might be redness.
• On darker skin tones, the skin might be a different colour to the surrounding area (usually darker).

If you still have symptoms

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:

• your symptoms are not manageable while the medicines reach a steady level in your body
• your symptoms temporarily come back while having a syringe driver.

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.

If the syringe driver alarm goes off

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.

Taking care with your syringe driver

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

• Try not to get the syringe driver wet or drop it in water.
• Try not to drop the syringe driver.
• Try not to pull the tubes out – take extra care when washing and dressing.

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

Worries about how long people live with a syringe driver

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.

Worries about needles

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:

• Use something to numb the skin so you cannot feel the needle.
• Hide the needle when they are preparing the syringe driver.
• Explain what the needle is for and where it will go (some people feel more relaxed if they understand exactly what will happen).
• Book to spend more time with you than usual – this might help if you need more time to ask questions, prepare for the needle, or get used to the tube.

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

• Have something with you that makes you feel relaxed. For example, a stress ball, fidget toy, or some music.
• If possible, laying down or sitting back in the chair might help you feel more relaxed.
• Ask someone to be there to support you, such as a friend, family member or carer.
• Try not to look at the needle when it's being used. Some people like to distract themselves with their phone or a book, or by talking to someone.

Getting support with syringe drivers

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.

Read more about the free Marie Curie Support Line.

Marie Curie's Online Community is a good place to connect with others going through similar situations to you. You may be able to speak with others having a syringe driver, or supporting someone that's having one. Visit Marie Curie's Online Community.