The Syringe Driver / Pump

The following guidelines acknowledge that subtle changes in clinical practice may occur between hospital, hospice and community practice and endeavour to promote safe and consistent methods of practice, based on collaborative experience around the West Midlands Region.

At the time of writing it is assumed that all palliative care teams have phased out the use of Graseby syringe driver/pumps in accordance with NPSA Alert Dec 2010. The guidance, therefore focuses on the use of McKinley T34 devices, however please check which device is being used locally and follow device-specific operating guidelines accordingly.

The syringe driver/pump is a small portable battery-driven infusion pump, used to deliver medication as a continuous sub-cutaneous infusion (CSCI) usually over 24 hours. It can be used when other routes (e.g. oral, buccal, rectal, transdermal) are unsuitable.

The syringe driver is programmed to deliver a fixed rate of medication.

If extra doses of medication for symptom control are required then these must be given as a separate subcutaneous injection as needed. It is good practice to ensure that for patients with a syringe driver, PRN subcut injection options are available for breakthrough symptoms.


This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.

Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.

While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.