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Syringe Drivers

Syringe Drivers. Dr Pauline Love End Of Life Clinical Lead Derby & Derbyshire CCG. Pauline’s Simple Mind. Recognize patient needs for syringe driver Liaise with DN team

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Syringe Drivers

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  1. Syringe Drivers Dr Pauline Love End Of Life Clinical Lead Derby & Derbyshire CCG

  2. Pauline’s Simple Mind • Recognize patient needs for syringe driver • Liaise with DN team • Write prescription using symptom management guidelines with standard drugs unless patient allergic or needs differ, can call PC team if unsure • Prescription via EPS to stocked pharmacy or dispense if able • Ensure at least 5 of each prescribed meds - include water • Write Prescription form for DN to administer – this allows for tweaks when needed • Leave prescription form and symptom management guidelines • Review patient after 24 hours • Tweak dose as per JIC meds needed in previous 24 hours • If need tweaking then just need to readjust dose on prescription form • Review after 24 hours etc.

  3. What is in the JIC box? • Syringes • Needles • Diamorphine 10mg ampoules x 5 • Midazolam 10mg ampoules x 5 • Hyoscine butylbromide 20mg ampoules x 5 • Haloperidol 5mg ampoules x 5 • Water x 5 • https://derbyshire.eolcare.uk

  4. What Paperwork Should be With the Box? • Anticipatory Prescription Sheet and syringe driver prescription sheet to be left a patient’s home or DN to collect. • Symptom Management Guidance • Health and Social Care Summary • DNACPR/ReSPECTForm • Recognising dying form if used • Use EoL template/EPaCCS template • Can use EPS2 – may need to change nominated pharmacy, change back when finished

  5. https://derbyshire.eolcare.uk • Community professionals • GP • Symptom management • Syringe driver prescription sheet • Please try and get the prescription to the • pharmacy before 3pm for same day delivery. • If dispensing practice consider doing this for your • patients

  6. Symptom Management in last days of Life • Seek specialist advice if uncertain • In working hours call – 01332 788794 and the secretary will locate an available Consultant. • OOH please call RDH switchboard and ask for Palliative Medicine Consultant on call

  7. Other drugs • You may need medications other than the usual for the syringe driver. • E.g. Dexamethasone 3.3mg – this is the standard preparation –please be aware this has been subject to stock issue, please contact your pharmacy if problems arise.

  8. DN Training • Preparation of Syringe with meds for syringe driver • Demonstrate understanding of compatibility of meds used • Evidence the use of the Rights of Drug Administration throughout the process – Link Access Palliative Care Network guidelines on phone • Access Symptom management guidelines via https://derbyshire.eolcare.uk

  9. Derby Hospitals will continue to make up syringes on request until end Jan 2020 for those DN’s/Nursing homes unable to support this initially with script going to hospital

  10. Recognising Dying Signed by most senior doctor available Justification for decision Discussion with family and patient Professionals Involved

  11. Guidance All on reverse of the form!!

  12. Contact Details Dr Pauline Love pauline.love@nhs.net Tel #: 01629 816636

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