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Managing Damaged CSCI Syringe — SCE Palliative Medicine MCQ

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EasySyringe Driver & Drug CompatibilityManaging Damaged CSCI SyringeSCE Palliative Medicine

A dying 75-year‑old man with advanced lung cancer is receiving a continuous subcutaneous infusion (CSCI) via syringe driver, delivering morphine 20 mg and midazolam 5 mg over 24 hours. The syringe driver is accidentally knocked onto the floor; the syringe is cracked and leaking. What should the nurse do?

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

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Correct answer: B — Stop the syringe driver, discard the damaged syringe and its contents (witnessed destruction of controlled drugs), set up a new syringe with fresh medication, and give a PRN dose if needed while the new infusion is prepared

A cracked, leaking syringe clearly compromises drug delivery and patient safety. Option B is the only appropriate response in line with UK practice: immediately stop and safely destroy the damaged CSCI under controlled‑drug destruction protocols, set up a new infusion to restore accurate dosing, and administer a PRN subcutaneous dose to maintain symptom control during the setup delay. Other choices risk harm—waiting delays symptom control, re‑injecting leaked fluid is unsafe and non‑sterile, taping a crack does not restore integrity, and ignoring the issue may lead to sudden under‑ or overdosing.

Reference: Lancashire & South Cumbria Palliative Care Prescribing Guidelines (2014); Managing Controlled Drugs in Community Policy (UK NHS, by May 2024)