The lure of the Lüer connector: Non‐Lüer connectors in regional anaesthesia

Abstract

Health service professionals do not have perfect vigilance. There will always be the possibility that a serious untoward incident can occur due to crossover injections of medication being administered via the wrong route. The universality of the Lüer connector made it very easy to connect several medical devices for different therapeutic uses. Although this was considered a bonus, it also showed the downside as a string of incidents, leading to permanent harm and even death, occurred, warranting actions to prevent the chance of misconnections and wrong‐route injections. The International Organisation for Standardisation introduced specific ISO 80 369 connectors for use in different medical systems, with the ISO 80369‐6 series of standards specifically designed to improve safety in regional anaesthesia. Human error can never be completely eliminated, but the risk of a patient inadvertently suffering from an inadvertent wrong‐route injection can be reduced through the use of new ‘fit and no‐fit’ technology. This article focuses on the universality of the Lüer connector and the introduction of the newly engineered non‐Lüer connectors, for specific use in medical systems.

Oddities in the Evolution of Syringes in Anesthesia

“…Recently, ISO 80369 series of standards reduced the universality of the Lüer connector by introducing specific connectors for different systems. [13][14][15]…”

“…The screw device was replaced with a conical, 6% tapered, male, "slip" nozzle that fitted tightly against standardized "female" components without lubricant. 13 Lüer-slip (1894) and Lüer-lok (1925) syringes became an industry standard for leak-free syringes, and tubing connectors are still in use today in most medical applications (Figure 1E). The downside of the universal Lüer connectors was that medication intended for injection into one system could inadvertently be injected into another, and hundreds of "wrong-route" injections were reported, sometimes resulting in permanent harm or fatal outcome.…”