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Temporary CSCI Disconnection for Outing — SCE Palliative Medicine MCQ

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ModerateSyringe Driver & Drug CompatibilityTemporary CSCI Disconnection for OutingSCE Palliative Medicine

A patient on subcutaneous morphine 30 mg/24 h and midazolam 5 mg/24 h via continuous subcutaneous infusion (CSCI) is comfortable. His family asks whether the syringe driver can be temporarily disconnected for a 2‑hour family outing in a wheelchair. What would you advise?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — The CSCI can be temporarily disconnected for short periods (1–2 h); morphine from the SC depot continues; reconnect promptly after the outing and use PRN if needed.

Option C is correct. Scottish Palliative Care Guidelines endorse temporary cessation of CSCI (e.g. for bathing or outings), with instructions for stopping and resuming safely ([rightdecisions.scot.nhs.uk](https://www.rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/scottish-palliative-care-guidelines/medicines/syringe-pump-driver-guidelines/syringe-pump-driver-guideline/monitoring-maintaining-the-infusion/?useNavigation=true&utm_source=openai)). The subcutaneous depot of morphine maintains analgesia during a 2‑hour break. PRN dosing after reconnection safeguards symptom control. Option A is false—it’s overly rigid and conflicts with UK practice. Option D risks harm via unnecessary bolus and is not supported by guidance. Option E is unjustified—comfort permits an outing. Option B is unnecessary escalation; no IV pump is required for a short interruption.

Reference: Scottish Palliative Care Guidelines – “Monitoring & maintaining the infusion” and Appendix on temporary disconnection procedure (Right Decisions Scotland, ~2023)