Adult Medical Emergency Handbook - Scottish Intensive Care Society

• Damaged syringes and siphonage: Air leaks can occur if the seal
between barrel and plunger is broken or if the syringe is cracked.
Siphonage then occurs without movement of syringe plunger.
What are the consequences?
• Free-flow and syphonage can cause over-infusion – in severe cases
this can lead to death.
What steps should be taken to prevent free-flow?
Syringe pumps:
• Use anti-siphon valve where possible. Use Luer-lock syringes.
• Check that the syringe is not damaged.
• Clamp the syringe securely in the pump (plunger and barrel
secured and syringe lip in pump groove) before attaching the line
to the patient.
• Pump Height. Ideally, mount syringe pumps and drivers at or
below the height of the infusion site.
Never mount higher than 2 feet above the infusion site.
• Clamp the infusion line before removing the syringe from a syringe
pump or driver.
Volumetric pumps
• Ensure that the correct infusion line is selected for use with
volumetric pumps.
• Clamp the line before opening the door and removing the line from
the pump.
What checks to make before starting an infusion?
• Check infusion rate. Does it match the prescription? Ask a
colleague to tell you the rate.
• After an end-of-infusion alarm, don’t
restart the pump before checking
if the prescribed volume has been
infused.
• Syringe pumps: Check that the pump
correctly registers the syringe size
being used (Graseby 3000 series and
Alaris Asena series pumps).
Ask a colleague to confirm rate.
Don’t prompt the answer.
Ye o
What rate is
this pump
set to?
Is the rate
20ml/hr?
292 adult medical emergencies handbook | NHS LOTHIAN: UNIVERSITY HOSPITALS DIVISION | 2009/11