Management of Subcutaneous Infusions in Palliative Care

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• Package Guide
• Learning Modules
  • Introduction:
  • Section 1: The Patient and Family/Carer Experience
  • Section 2: General Equipment
  • Section 3: Selection and Preparation of the Site
  • Section 4: Drugs and Diluents
  • Section 5: Patient and Family/Carer Education
  • Section 6: Patient Assessment and Troubleshooting
• The Guidelines
• References
• Resources
• Printable Documents
• CPCRE Home

References

Combined reference list

• Abbas S, Yeldham M, Bell S. The use of metal or plastic needles in continuous subcutaneous infusion in a hospice setting. American Journal of Hospice and Palliative Medicine 2005;22(2):134-138.
• Breckenridge A. Report of the working party on the addition of drugs to intravenous infusion fluids [HC(76)9] [Breckenridge report]. London: Department of Health and Social Security;1976.
• British National Formulary. Syringe drivers. <www.bnf.org>. Accessed 26 January 2005. Centre for Palliative Care Research and Education. Guidelines for subcutaneous infusion device management in palliative care (Revised Edition). Brisbane, Queensland: Queensland Health;2010.
• CHRISP (Centre for Healthcare Related Infection Surveillance and Prevention). Occupational exposures to blood and body fluids: Recommended practices for preventing hollow-bore needle stick injuries (Recommendation 2: Winged infusion sets for subcutaneous and intravenous infusions). Queensland Government (Queensland Health);2007. <http://www.health.qld.gov.au/chrisp/resources/hollbore_rec_prac.pdf>. Accessed 28 June 2010.
• Coleridge-Smith E. The use of syringe drivers and Hickman lines in the community. British Journal of Community Nursing 1997;2(6):292,294,296.
• Government of Western Australia, Department of Health. Palliative care medicine and symptom guide. WA Cancer and Palliative Care Network; 2010. Available from: http://www.healthnetworks.health.wa.gov.au/cancer/docs/Consumer_Book.pdf
• Cruikshank S, Adamson E, Logan J, Brackenridge K. Using syringe drivers in palliative care within a rural, community setting: capturing the whole experience. International Journal of Palliative Nursing 2010;16(3):126-132.
• Dickman A, Littlewood C, Varga J. The syringe driver: continuous subcutaneous infusions in palliative care. Oxford: Oxford University Press;2002.
• Dickman A, Schneider J, Varga J. The syringe driver: continuous subcutaneous infusions in palliative care. 2nd ed. Oxford: Oxford University Press;2005.
• Driscoll A. Managing post discharge care at home: an analysis of patients’ and their carer’s perceptions of information received during their stay in hospital. Journal of Advanced Nursing 2000;31(5):1165-1173.
• Fletcher C. Report on comparative evaluation of Graseby syringe driver replacements. Auckland, NZ: North Shore Hospice Trust;2009. Retrieved 4 October 2010 from http://www.cme-infusion.com/documents/pub/Report%20on%20Comparative%20 Evaluation%20of%20Graseby%20Syringe%20Driver%20Replacements.pdf
• Flowers C, McLeod F. Diluent choice for subcutaneous infusion: a survey of the literature and Australian practice. International Journal of Palliative Nursing 2005;11(2):54-60.
• Gomez Y. The use of syringe drivers in palliative care. Australian Nursing Journal 2000;(2):suppl 1-3.
• Graham F. The syringe driver and the subcutaneous route in palliative care: the inventor, the history and the implications. Journal of Pain and Symptom Management 2005;29(1):32-40.
• Joint Therapeutics Commission. A survey of doctors on their preferred medications for various symptoms in palliative care. Brisbane: Unpublished data;2005.
• Lichter I, Hunt E. Drug combinations in syringe drivers. The New Zealand Medical Journal 1995;108(1001):224-226.
• Lloyd-Williams M, Rashid A. An analysis of calls to an out-of-hours palliative care advice line. Public Health 2003;117(2):125.
• McNeilly P, Price J, McCloskey S. The use of syringe drivers: a paediatric perspective. International Journal of Palliative Nursing 2004;10(8):399-404.
• Mitten T. Subcutaneous drug infusions: a review of problems and solutions. International Journal of Palliative Nursing 2001;7(2):75-85.
• Morgan S, Evans N. A small observational study of the longevity of syringe driver sites in palliative care. International Journal of Palliative Nursing 2004;10(8):405-412.
• Negro S, Salama A, Sanchez Y, Azuarat M, Barcia E. Compatibility and stability of tramadol and dexamethasone in solution and its use in terminally ill patients. Journal of Clinical Pharmacy and Therapeutics 2007;32:441-444.
• O’Doherty C, Hall E, Schofield L, Zeppetella G. Drugs and syringe drivers: a survey of adult specialist palliative care practice in the United Kingdom and Eire. Palliative Medicine 2001;15:149-154.
• Palliative Care Expert Group. Therapeutic guidelines: palliative care. Version 3. Melbourne: Therapeutic Guidelines Ltd;2010, p.292.
• Palliative Care Matters. <www.pallcare.info>. Accessed 10 August 2010
• Palliative Care Outcomes Collaborative (PCOC) website http://chsd.uow.edu.au/pcoc/
• Palliative Care Outcomes Collaborative. <http://chsd.uow.edu.au/pcoc/>. Accessed 13 August 2010.
• PalliativeDrugs.com. ‘Syringe drivers.’ <www.palliativedrugs.com>. Accessed 25 January 2005.
• Peterson G, Miller K, Galloway J, Dunne P. Compatibility and stability of fentanyl admixtures in polypropylene syringes. Journal of Clinical Pharmacy and Therapeutics 1998;23:67-72.
• Ratcliffe N. Syringe drivers. Community Nurse 1997;3(6):25-26.
• Reymond E, Charles M. An intervention to decrease medication errors in palliative patients requiring subcutaneous infusions: Brisbane South Palliative Care Service and Adverse Drug Event Prevention Program; unpublished report presented to Clinical Services Evaluation Unit; Princess Alexandra Hospital. Brisbane, Queensland;2005
• Reymond L, Charles MA, Bowman J, Treston P. The effect of dexamethasone on the longevity of syringe driver subcutaneous sites in palliative care patients. Medical Journal of Australia 2003;178:486-489.
• Ross JR, Saunders Y, Cochrane M, Zeppetella G. A prospective, within-patient comparison between metal butterfly needles and Teflon cannulae in subcutaneous infusion of drugs to terminally ill hospice patients. Palliative Medicine 2002;16:13-16.
• World Health Organization. http://www.who.int/cancer/palliative/definition/en/ Accessed 28 July 2010.
• Yates et al. 2004 in Cruikshank S, Adamson E, Logan J, Brackenridge K. Using syringe drivers in palliative care within a rural, community setting: capturing the whole experience. International Journal of Palliative Nursing 2010;16(3):126-132.