Feedback: new non-Luer devices

Dr Gary Bryan
Consultant Anaesthetist

September 2012
Our Trust has been trialling Surety needles and accessories for ~ 3 months (Sprotte and Quincke type). There have been minor criticisms of ‘fiddliness’ attaching syringe to needle, but overall staff have been able to make the system work in obstetric, general, orthopaedic and cardiothoracic anaesthesia. Physicians have been able to perform lumbar punctures and obtain csf samples. However, our neonatologists are unwilling to continue using spinal needles (22G x 38mm) using the Surety system because the sometimes miniscule drop of csf from the neonate gets ‘lost’ in the hub surrounding the male part of the connector. This has necessitated a repeat lumbar puncture using a standard luer type needle with female hub. This has happened on a number of occasions. It was believed that further familiarisation with the needle would not improve the situation. I believe there is advice each hospital should only have one type of connector for all its intrathecal devices. We are therefore abandoning the Surety system and will re-evaluate the other remaining systems.
Dr Graham Bell
Consultant Anaesthetist 
April 2012

Ive been through the local desktop evaluation organised by NHS procurement where 5 companies presented their new items. None had needles for trial shorter than 40mm & most did 50 mm upwards.

I do spinals for neonates regularly but almost always with a 25mm needle. The remit given to the manufacturers appears to have forgotten this end of the spectrum. It is very low volume in terms of equipment sales but we have specific requirements and would be greatly disadvantaged by some of the new designs that have been proposed.

The other main use of these needles is paediatric oncology, small infants sometimes require intrathecal chemotherapy.

100% of neonates move when they have a lumbar puncture and the distances are smaller. These factors combine to make the process technically challenging with speed of identification of the space to injection of medication being a key factor in success. Any extra manouvre over simple connection of a syringe will adversely affect the successful completion of the procedure. I do not wish to align the hub with a shape, or a notch or worse still have to perform a locking twist of needle to syringe.

Dr Andrew Kitching
Consultant Anaesthetist

March 2012
We are sitting tight at the moment. Awaiting some decent products.

Dr Vicki Clark
Consultant Anaesthetist

March 2012
"There are no plans to introduce the non-Luer lock devices in Lothian in the foreseeable future. As far as I am aware, the Scottish procurement group have not made a decision and even though individuals have samples from the companies to try we have been expressly forbidden to do so."

Dr David Uncles
Consultant Anaesthetist

March 2012

What a mess!

I very much agree that in principle this is a good idea- I also agree that the primary problem is to do with epidural catheters/infusions rather than single shot spinal injections.

After limited testing we have REJECTED the surety based systems- we think they are flawed.

We are impressed by the simplicity of both the BD system ( which we have tried) and the Portex system (which we haven't).

We along with many other small-to-medium departments are looking for guidance based on the more formal trials that are currently being conducted. Ultimately, however, surely the right approach is to agree what is generally perceived to be the best system and then to ensure a comprehensive introduction of the one system Nationwide?

Dr A Ravalia
Consultant Anaesthetist
Kingston Hospital, Surrey

13 February 2012

I have now had the opportunity of using the 25G surety connector needles-they seem to be satisfactory-you have to make sure you have the right size syringes and needles. However this does still not prevent you injecting the wrong drug into the CSF-most of our non-anaesthetic colleagues are not aware at all about these changes until we told them.

One of our haematologists does undertake intrathecal injections and they have their drugs prepared off-site-I just wonder how aware these people are of these impending changes.Do they know that they may have to change the size of their syringes or do the changes not apply to them.

This is very confusing and could potentially lead to more problems-we have all heard of ‘The Law of Unintended Consequences’

Dr Raka Srivastava
Consultant Anaesthetist 
24 January 2012

I wish to share my experience with new safety spinal needles with everyone concerned. Download PDF letter »