Monitoring & maintaining the infusion

The syringe pump is programmed to run over 24 hours. When set up, reloaded or resited an initial check should be carried out within the first 15-30 minutes to ensure the infusion is running correctly. Then every 4 hours in an inpatient setting and at every visit (at least daily) in the community setting.

Checks to be carried out:

• pressing the  key will display volume to be infused and volume infused
• a visual check of the contents of the syringe and extension line for cloudiness, discolouration or precipitation (if noted discard)
• evidence of redness, swelling, discomfort, leakage at cannula site
• battery light is flashing
• opportunity to review symptom management

Any actions taken should be documented on the syringe pump ‘recording chart’. If an infusion is discontinued before the syringe contents are empty, the amount of any solution remaining should be documented on the recording chart before being discarded.

Key Point: Monitoring the ‘volume infused’ and the ‘volume to be infused’, as well as a visual check, will help to ensure the infusion is running as expected.

The syringe pump medicines require to be changed every 24 hours.

If there are NO changes required to the prescription only the syringe and contents need to be renewed:

• Disconnect the subcutaneous extension line from the syringe
• Remove the syringe from the pump
• Refer back to step by step guide for loading the new syringe.

If there are ANY changes to the prescription:

Increased medicine dose(s):

• renew the syringe contents as per prescription
• renew the subcutaneous extension line and leave the existing cannula in place
• Disconnect the extension line from the syringe
• Remove the syringe from the pump
• Refer back to step by step guide for loading the new syringe

 Addition of new medicine(s):

• renew the syringe contents as per prescription
• renew the subcutaneous extension line
• Consider changing the existing cannula if there are any medicine compatibility issues
• Disconnect the extension line from the syringe
• Remove the syringe from the pump
• Refer back to step by step guide for loading the new syringe

To prevent an accidental bolus of medicines being given, please ensure the line is not attached to the patient’s cannula when placing the syringe in the pump. All changes must be recorded on the syringe pump ‘recording chart’.

Key Points: When renewing or changing the syringe it is important to select ‘START INFUSION’ instead of ‘RESUME’ as this will ensure that the syringe pump delivers the infusion over a new 24 hour period.

When the infusion is nearing completion, a warning will be displayed on the display screen 15 minutes before the end.

When the infusion is complete and the syringe is empty, the pump will stop automatically and a continuous alarm will sound.

If the syringe pump is no longer required, press  to confirm the end of the infusion, disable the keypad lock, then press and hold the  key until the pump is switched off.  

BD recommends keeping the battery in situ when the Bodyguard T syringe pump is not in use however please check your local SOP for guidance.

Clean the pump and lockbox (if used) as per cleaning and decontamination guidance (see Section on cleaning and decontamination in Safety and Risk Management).

Key Point: For patient safety, if the syringe is not empty, disconnect the syringe pump from the patient before removing the syringe. This prevents the patient from receiving an accidental bolus dose.

This should only be used in exceptional circumstances under the supervision of a registered nurse e.g. showering or bathing.

How to STOP:

• Press , disable the keypad lock then press and hold the key until pump is switched off
• do not remove the syringe from the syringe pump
• detatch the line from the subcutaneous cannula
• ensure both exposed ends are covered with a sterile cap until reconnection takes place
• the pump should be stored in a secure place e.g. a lockable cupboard
• record the time the syringe pump was stopped on the ‘recording chart’

How to RESUME:

• check the prescription and syringe label match the patient’s details.
• Remove the sterile caps and reconnect the line to the cannula
• press and hold the   key until the pump switches on
• select the matching size and brand of syringe using the and  arrows
• press to confirm
• select to RESUME the previous programme
• screen will display volume, duration and rate - check against the recording chart
• press  to confirm
• screen will display ‘Start Infusion?’
• press   to confirm.
• Note the time the infusion resumed on the recording chart.

If the death is expected, the syringe pump can be stopped following the steps in section "stopping the infusion and removing the syringe pump" above. The date, time, amount of solution (ml) remaining and subsequent destruction should be documented on the syringe pump recording chart by those person(s) present and any witnesses.  

If the death is unexpected, or there are concerns about the circumstances of death, the lead nurse/manager should be contacted in or out of hours for advice on how to proceed. All equipment should be left in situ until advised on next steps.

In the community setting, after the patient has died, community nurses will remove the syringe pump along with any other associated equipment from the home. Families/carers will be asked to return unused medicines to their local community pharmacy.  

In a hospital setting, the syringe pump should be returned to the appropriate team / department, such as the equipment library or store.

Patients may be transferred between hospital and community settings with a syringe pump in place.  It is important to liaise with the teams involved and follow the process agreed for the equipment to be returned safely.