---
title: "Management of Syringe Drivers"
canonical: "https://clinicaldecisions.refined.site/space/Palliative/18549361/Management+of+Syringe+Drivers"
format: markdown
---
## Monitoring infusion in progress

Check and document four hourly on the [Syringe Driver Monitoring Form](http://staffnet/QualityDocs/Clinical%20Forms/Corporate%20(organisation%20wide)/%5bF%5d%20Syringe%20Driver%20Monitoring%20Mar24.pdf):

- Site for leakage, oedema, dislodgement, inflammation and signs of infection
- Syringe driver for rate, VTBI (Volume to be Infused), TVI (Total Volume Infused), remaining infusion time, battery status.

### How do I check the syringe driver to confirm the infusion is running correctly?

Press the INFO key to check:

Check the LCD display to confirm the pump is still running at the same infusion rate as originally set. 

Check the Green LED is flashing intermittently and “<<<<<< Pump delivering” animation is appearing on the LCD display.

Check for signs of physical damage to the pump and accessories.

Single Press – Volume to Be Infused (VTBI) and Volume Infused (VI). The syringe graphic shows VTBI and VI in graphical form.

Double Press – for battery life remaining shown as a percentage and in graph form.

> ℹ️ <span style="color: #444444">**The Syringe driver will alert/alarm to indicate the need to replace the battery. **</span>

### Changing the battery mid - infusion

1. Unlock the keypad.
2. Stop the Infusion by pressing the STOP key.
3. Turn the pump off by holding down the OFF key.
4. Replace the battery.
5. Turn the pump ON.
6. Press “YES” to confirm syringe brand and size.
7. The screen will now display “Press YES to Resume” or “NO for New Program”.
8. Press “YES” to resume
9. Press “YES” to confirm “remaining volume, duration and rate of infusion
10. Screen will then display “Start Infusion” Press “Yes” to confirm.

### Starting a new syringe at completion of previous syringe

1. The syringe driver will stop automatically when the syringe is empty and an alarm will sound.
2. Press the OFF key to turn the pump off.
3. Remove the syringe.
4. Load the new syringe.

### Starting a new syringe before completion of previous syringe (eg new prescription)

1. If the infusion is to be stopped before the syringe is empty press the STOP key to interrupt the infusion.
2. Hold down the OFF key. Clamp the line or disconnect the patient from the syringe (to prevent accidental bolus) and then remove the syringe from the pump.
3. Load the new syringe.

### Changing an extension set only (eg set is occluded)

1. Stop the infusion by pressing the STOP button – DO NOT TURN THE PUMP OFF.
2. Clamp the extension set and remove the syringe from the pump.
3. Place the barrel clamp arm in the down position
4. Attach the new extension set to the syringe and prime the set manually. Clamp the line.
5. Use the FF key to reposition the actuator to fit the new volume in the syringe.
6. Place the syringe back into syringe driver.
7. Press “YES” to confirm syringe brand and size.
8. The screen will now display “Press YES to Resume” or “NO for New Program”.
9. Press “YES” to resume.
10. Press “YES” to confirm “remaining volume, duration and rate of infusion”.
11. Screen will then display “Start Infusion”. Unclamp the set and Press “Yes” to confirm.

> ℹ️ <span style="color: #444444">**The time remaining will adjust automatically to account for the volume removed from the syringe when priming the new line. **</span>

### Using the external lock box for the NIKI T34

1. The NIKI T34 lock boxes accommodates syringes <50mL. **In the instances when a 50ml **  
**syringe is required to be used, it is accepted that a lock box cannot be used.**
2. Open the lockbox using the standard key that operates all T34 lockboxes.
3. Place the pump into the lockbox so that the LCD display and keypad line up with the cut out opening.
4. Close the lockbox, guiding the administration set out the slot at the side of the top section of the box. Squeeze gently if necessary to ensure box closes securely.
5. Lock the box.

### What if my patient wants to have a shower?

The syringe driver must be stopped and then disconnected from the subcutaneous line 

Luer both the SC line and syringe with a Codan Combi-Lock.


### Related

[NIKI T34 syringe driver](https://clinicaldecisions.atlassian.net/wiki/spaces/Palliative/pages/18483916)


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Reviewed September 2024. [Send feedback](mailto:Palliativecare.team@waitematadhb.govt.nz) to page coordinator