Key notes on symptom control issues in Palliative Care

Indications for the use of a syringe driver in palliative care

• 
  uncontrolled nausea and/or vomiting
  
• 
  bowel obstruction
  
• 
  severe weakness
  
• 
  dysphagia
  
• 
  maintenance of symptom control in the dying phase
  

Except in the case of poor absorption, pain that is non-responsive to oral morphine sulphate will be non-responsive to parenteral diamorphine sulphate.

If a patient is well symptom controlled using other routes of administration and these can be maintained in the dying phase, a syringe driver does not have to be set up as a matter of routine in the terminal phase.

Written September 2002. Dr Susan Salt & Dr Mary Kiely

Revision Date March 2003.