Syringe Driver Survey Database migration to MedicinesComplete - January 2023

Syringe Driver Survey Database has moved to MedicinesComplete and is no longer available on palliativedrugs.com.

It has been renamed to PCF’s Syringe Driver Database and is now accessed through Drug Compatibility Checker.

Drug Compatibility Checker, through MedicinesComplete is a new tool providing essential compatibility knowledge to support the administration of injectable drugs combining published data and clinical practice reports.

Find out more about Drug Compatibility Checker:https://about.medicinescomplete.com/publication/drug-compatibility-checker/

If you have a subscription to Palliative Care Formulary through MedicinesComplete, you will have access to PCF’s Syringe Driver Database through Drug Compatibility Checker, at no charge through 2023. 

To contribute to PCF’s Syringe Driver Database please continue to submit a clinical practice report using palliativedrugs.com here: https://www.palliativedrugs.com/syringe-driver-database.html

To learn more about a subscription to the Palliative Care Formulary through MedicinesComplete, please contact us here: https://info.medicinescomplete.com/sales

If you have any questions regarding access to PCF’s Syringe Driver Database or would like to renew your subscription to Palliative Care Formulary, please contact pharmpress-support@rpharms.com.

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NPSA RRR: Harm from flushing of nasogastric tubes before confirmation of placement

27th March 2012

The UK National Patient Safety Agency (NPSA) has issued a Rapid Response Repost (RRR) following two patient deaths since 10 March 2011 where staff had flushed nasogastric tubes with water before initial placement had been confirmed. 

Misplaced nasogastric tubes leading to death or severe harm are ‘never events’. The patient safety alert Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants was issued by the NPSA on 10 March 2011 with an action complete date of 12 September 2011. Alongside other actions, the alert requires all organisations to ensure that ‘Nasogastric tubes are not flushed, nor any liquid/feed introduced through the tube following initial placement, until the tube tip is confirmed by pH testing or x-ray to be in the stomach.’ 

Confusion appears to have arisen over nasogastric tubes with water-activated lubricants. The above guidance is applicable for all nasogastric tubes including those with water-activated lubricants. The lubricant is not needed for placement, only to aid removal of the guidewire/ stylet from the tube after gastric placement has been confirmed. 

All organisations in the NHS and independent sector where nasogastric feeding tubes are placed and used for feeding patients should ensure that the following implemented by 21-09-2012:

1.     Assign a named clinical lead to coordinate implementation of the actions in this RRR with any actions outstanding from the earlier Alert 

2.     Remind all staff responsible for checking initial placement of nasogastric tubes (including staff who support parents/carers who check initial placement of nasogastric tubes):

a.    NOTHING should be introduced down the tube before gastric placement has been confirmed

b.    DO NOT FLUSH the tube before gastric placement has been confirmed

c.     Internal guidewires/ stylets should NOT be lubricated before gastric placement has been confirmed

3.    This reminder should be given through:

a.    Distributing this RRR to all relevant staff

b.    Providing warning notices and/ or overwraps with warning labels on all current and future stock of nasogastric tubes, until these are provided as standard by manufacturers

c.     Reviewing and, if necessary, amending all local policy, protocol and training materials.

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