Midazolam dose syringe driver

Only use drugs that are known to be effective via the sc route. When and how to use a syringe driver in palliative. Anticipatory medication stat dose and syringe pump driver guidance. Rectal administration of the ampoule solution is performed by means of a. If the patient is in pain, vomiting or very agitated, give a stat sc injection of appropriate medication while setting up the syringe driver. Syringe driver drug compatibilities guide to palliative. Haloperidol antiemetic dose is 1 2 mg for 24 hours. There is no maximum dose for midazolam however the dose should be titrated carefully according to the response. Once stable, combine midazolam with other compatible medications to simplify the syringe driver regime. The mckinley t34 is calibrated in mlhour a 30ml luer lock syringe is recommended the maximum volume of fluid in a 30ml syringe is 22ml. Prescribing anticipatory drugs nhs north kirklees ccg.

If an optimal sedation level is not reached, doses may be readministered every 2 to 3 minutes, up to a maximum dose of 0. A syringe driver takes 34 hours to establish a steady state drug level in plasma. Clinical protocol for the use of syringe drivers in palliative care patients. Midazolam subcutaneous and nasal palliative care adults. Syringe drivers are often required to provide medicines for symptom. Anticipatory medication stat dose and syringe pump driver. Thcontinue with prn midazolam calculate dose as 16 of syringe driver dose. Diazepam, chlorpromazine and prochlorperazine are too. Principles for deciding on appropriate drug doses will also be discussed. Subcut midazolam dose equivalencies of commonly used benzodiazepines. If seizures persist despite midazolam 60mg24hrs, seek advice from the. Subcutaneous ketamine infusion in a syringe pump 2 drug combinations. If midazolam 30mg in syringe driver is reached and symptoms are not controlled, please seek advice.

When added to a syringe driver the recommended diluent is water for injection. Syringe driver drug compatibilities guide to palliative care practice 2016 sodium chloride 0. Starting setting up a syringe driver mckinley t34 if symptomatic give stat dose as syringe driver takes 2 4 hours from setting up to achieve effect. This is because the niki t34 syringe driver simplifies administration by detecting the syringe size and volume of medicine, and sets the rate to deliver the infusion over the required time period, e. Rationale for any decision to deviate from these guidelines should be documented in the. If doses in excess of 30mg 24 hours are required, seek advice from the palliative care team. Midazolam 1 mgml solution for injection or infusion. A boost dose rarely provides sufficient analgesia to. Increase the dose of midazolam accordingly up to 30mg in syringe driver over 24 hours.