Subcutaneous infusion pumps and syringe drivers
When to start a continuous subcutaneous infusion (CSCI), converting oral opioids to a 24-hour SC dose with a worked example, mixing and diluents, sites, what to check on a syringe driver chart, drugs that don't go in the driver, and common faults.
Tier 1Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- A continuous subcutaneous infusion (CSCI) delivers a 24-hour mixture of drugs from a battery-powered syringe pump. In Australia the usual device is the BD BodyGuard T (formerly the CME T34), with a lockbox and a rate set in mL/hour.
- Start one when the oral route fails: can't swallow, vomiting, bowel obstruction, malabsorption or unmanageable tablet burden. It isn't stronger than oral treatment and it doesn't mean someone is about to die.
- Typical mixture: an opioid, an antiemetic or antipsychotic and a benzodiazepine or antisecretory. Two or three drugs per syringe is common; check compatibility every time.
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Sources
- Therapeutic Guidelines: Palliative Care (eTG complete), version 5AU/NZTherapeutic Guidelines Limited, 2024 (version 5, December 2024; current at November 2026)
- Australian Injectable Drugs Handbook, 10th editionAU/NZAdvanced Pharmacy Australia (AdPha), 10th edition (addendum July 2026)
- Lovell MR et al. Update of the Australian Guideline for the Management of Cancer Pain in Adults. Asia Pac J Clin Oncol 2026;22(5):705-716AU/NZCancer Council Australia, 2026 (online November 2025)
- PS01(PM) Appendix 2: Opioid dose equivalenceAU/NZFaculty of Pain Medicine, Australian and New Zealand College of Anaesthetists, October 2025
- Zahid A et al. Continuous drug delivery is significantly affected by relative height changes between patient and syringe driver. J Patient Saf 2021;17:e15-e19Journal of Patient Safety, 2021
- Palliative Care ScheduleAU/NZPharmaceutical Benefits Scheme, Australian Government, accessed November 2026
- Last updated
- 14 November 2026
What changed
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