ICHOR II Auto Hematology Analyzer Operator’s Manual Copyright © 2006-2007 Helena Laboratories, Inc All rights Reserved. Intellectual Property Statement HELENA LABORATORIES, INC. (hereinafter called Helena) owns the intellectual property rights to this Helena product and this manual. This manual may refer to information protected by copyrights or patents and does not convey any license under the patent rights of Helena, nor the rights of others. Helena does not assume any liability arising out of any infringements of patents or other rights of third parties. Helena intends to maintain the contents of this manual as confidential information. Disclosure of the information in this manual in any manner whatsoever without the written permission of Helena is strictly forbidden. Release, amendment, reproduction, distribution, rent, adaption and translation of this manual in any manner whatsoever without the written permission of Helena is strictly forbidden. Responsibility on the Manufacturer Party Contents of this manual are subject to changes without prior notice. All information contained in this manual is believed to be correct. Helena shall not be liable for errors contained herein nor for incidental or consequential damages in connection with the furnishing, performance, or use of this manual. Helena is responsible for safety, reliability and performance of this product only in the condition that: all installation operations, expansions, changes, modifications and repairs of this product are conducted by Helena authorized personnel. the electrical installation of the relevant room complies with the applicable national and local requirements. the product is used in accordance with the instructions for use. I z It is important for the hospital or organization that employs this equipment to carry out a reasonable service/maintenance plan. Neglect of this may result in machine breakdown or injury of human health. z Operate the analyzer under the conditions specified in this manual; otherwise, the analyzer will not work normally and the analysis results will be unreliable, which would damage the analyzer components and cause personal injury. z Federal law restricts this device to sale by or on the order of a physician z This equipment must be operated by skilled/trained medical professionals. II Warranty THIS WARRANTY IS EXCLUSIVE AND IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE. Exemptions Helena's obligation or liability under this warranty does not include any transportation or other charges or liability for direct, indirect or consequential damages or delay resulting from the improper use or application of the product or the use of parts or accessories not approved by Helena or repairs by people other than Helena authorized personnel. This warranty shall not extend to: any Helena product which has been subjected to misuse, negligence or accident. any Helena product from which Helena's original serial number tag or product identification markings have been altered or removed. any product of any other manufacturer. Return Policy Return Procedure In the event that it becomes necessary to return this product or part of this product to Helena, the following procedure should be followed: 1. Obtain return authorization: Contact the Helena Service Department and obtain a Customer Service Authorization (Helena) number. The Helena number must appear on the outside of the shipping container. Returned shipments will not be accepted if the Helena number is not clearly visible. Please provide the model number, serial number, and a brief description of the reason for return. 2. Freight policy: The customer is responsible for freight charges when this product is shipped to Helena for service (this includes customs charges) . 3. Return address: Please send the part(s) or equipment to the address offered by Customer Service department. III Company Contact Manufacturer: Helena Laboratories, Inc. Address: P.O. Box 752 – 1530 Lindbergh Dr. Beaumont, Texas 77704–0752, USA Phone: 409-842-3714 Fax: 409-842-6241 IV Product name: Auto Hematology Analyzer For this Operator’s manual, the issued Date is 2008-08 (Version: 1.0). Table of Contents 1 Using This Manual ................................................................................... 1-1 1.1 Introduction ............................................................................................ 1-1 1.2 Who Should Read This Manual ............................................................. 1-2 1.3 How to Find Information......................................................................... 1-3 1.4 Conventions Used in This Manual ......................................................... 1-4 1.5 Special Terms Used in This Manual....................................................... 1-5 1.6 Symbols ................................................................................................. 1-6 2 Understanding Your Analyzer................................................................. 2-1 2.1 Introduction ............................................................................................ 2-1 2.2 Intended Use.......................................................................................... 2-2 2.3 Parameters and Histograms .................................................................. 2-3 2.4 User Interfaces....................................................................................... 2-4 2.5 Instrument Software ............................................................................. 2-13 2.6 Reagents, Controls and Calibrator....................................................... 2-17 3 Understanding the System Principles ................................................... 3-1 3.1 Introduction ............................................................................................ 3-1 3.2 Aspiration ............................................................................................... 3-2 3.3 Dilution ................................................................................................... 3-3 3.4 WBC/HGB Measurement....................................................................... 3-5 3.5 RBC/PLT Measurement ......................................................................... 3-9 3.6 Wash .................................................................................................... 3-13 4 Performance Specifications and Characteristics ................................. 4-1 Introduction ............................................................................................ 4-1 4.2 Performance Specifications ................................................................... 4-2 4.3 Performance Characteristics.................................................................. 4-4 4.1 5 Installing Your Analyzer .......................................................................... 5-1 5.1 Introduction ............................................................................................ 5-1 5.2 Installation Requirements....................................................................... 5-2 5.3 Unpacking .............................................................................................. 5-4 5.4 Installation Procedure ............................................................................ 5-6 5.5 Starting the Analyzer ............................................................................ 5-17 6 Customizing the Analyzer Software ....................................................... 6-1 6.1 Introduction ............................................................................................ 6-1 6.2 Print........................................................................................................ 6-2 1 Table of Contents 6.3 Count time.............................................................................................. 6-7 6.4 Password ............................................................................................... 6-9 6.5 Ref. Range ........................................................................................... 6-12 6.6 Transmission........................................................................................ 6-16 6.7 Setting System Time (Date & Time)..................................................... 6-20 6.8 Gain...................................................................................................... 6-23 6.9 Auto Clean Time .................................................................................. 6-29 6.10 Reagent Exp. Date............................................................................... 6-31 6.11 Report Title (external keyboard needed) ............................................. 6-34 6.12 Parameter Units ................................................................................... 6-37 6.13 Other Settings ...................................................................................... 6-41 7 Operating Your Analyzer ......................................................................... 7-1 7.1 Introduction ............................................................................................ 7-1 7.2 Initial Checks.......................................................................................... 7-2 7.3 Power-on................................................................................................ 7-3 7.4 Daily Quality Control .............................................................................. 7-4 7.5 Select Sample Mode.............................................................................. 7-5 7.6 Sample Collection and Handling............................................................ 7-7 7.7 Running Whole-blood Samples ........................................................... 7-10 7.8 Running Prediluted Samples ............................................................... 7-19 7.9 Shutdown ............................................................................................. 7-28 8 Reviewing Sample Results ..................................................................... 8-1 8.1 Introduction ............................................................................................ 8-1 8.2 Browsing All Sample Results ................................................................. 8-2 8.3 Searching for Interested Sample Results ............................................ 8-20 9 Using the QC Programs .......................................................................... 9-1 Introduction ............................................................................................ 9-1 9.2 “L-J Analysis” Program........................................................................... 9-2 9.3 “X-B Analysis” Program........................................................................ 9-14 9.1 10 Using the Calibration Programs ........................................................... 10-1 10.1 Introduction .......................................................................................... 10-1 10.2 When to Calibrate ................................................................................ 10-2 10.3 How to Calibrate................................................................................... 10-3 11 Maintaining Your Analyzer .................................................................... 11-1 11.1 Introduction .......................................................................................... 11-1 11.2 Using the “Maintenance” Program ....................................................... 11-2 11.3 Using the “System Status” Program................................................... 11-17 11.4 Using the “Valve Test” Program ......................................................... 11-19 11.5 Using the “System Test” Program ...................................................... 11-21 2 Table of Contents 12 13 11.6 Using the “Prepare to ship” Program ................................................. 11-23 11.7 Using the “Error Message” Program .................................................. 11-27 11.8 Replacing the Filter of the Vacuum Chamber .................................... 11-29 Troubleshooting Your Analyzer ............................................................ 12-1 12.1 Introduction .......................................................................................... 12-1 12.2 Errors without Error Messages ............................................................ 12-2 12.3 Errors Indicated by Error Messages .................................................... 12-3 Appendices ..............................................................................................A-1 Index ......................................................................................................A-1 B Technical Specifications .........................................................................B-1 C Precautions, Limitations and Hazards ...................................................C-1 D Communication ......................................................................................D-1 A 3 1 Using This Manual 1.1 Introduction This chapter explains how to use your ICHOR II operator’s manual, which is shipped with your ICHOR II auto hematology analyzer and contains reference information about the ICHOR II and procedures for operating, troubleshooting and maintaining the analyzer. Read this manual carefully before operating your analyzer and operate your analyzer strictly as instructed in this manual. z Operate your analyzer strictly as instructed in this manual. 1-1 Using This Manual 1.2 Who Should Read This Manual This manual contains information written for clinical laboratory professionals to: learn about the ICHOR II hardware and software. customize system settings. perform daily operating tasks. perform system maintenance and troubleshooting. 1-2 Using This Manual 1.3 How to Find Information This operator’s manual comprises 12 chapters and 4 appendices. Refer to the table below to find the information you need. If you want to … See … learn about the intended use and parameters of the ICHOR II Chapter 2 Understanding Your Analyzer learn about the hardware and software of the ICHOR II Chapter 2 Understanding Your Analyzer learn about how the ICHOR II works Chapter 3 Understanding the System Principles learn about how to install the ICHOR II Chapter 5 Installing Your Analyzer learn about how to define/adjust system settings Chapter 6 Customizing the Analyzer Software learn about how to use the ICHOR II to perform your daily Chapter operating tasks Analyzer learn about how to review the saved analysis results Chapter 8 Reviewing Sample 7 Operating Your Results learn about how to use the quality control programs Chapter 9 Using the QC Programs learn about how to calibrate the ICHOR II Chapter 10 Using the Calibration Programs learn about how to maintain/service the ICHOR II Chapter 11 Maintaining Your Analyzer learn about the meanings of the error messages and how to Chapter 12 Troubleshooting correct the problems Your Analyzer learn about the technical specifications of the ICHOR II Appendix B Technical Specifications see the summary of all safety messages included in this Appendix manual Limitations and Hazards learn about the transmission protocol of the ICHOR II Appendix D Communication 1-3 C Precautions, Using This Manual 1.4 Conventions Used in This Manual This manual uses certain typographical conventions to clarify meaning in the text: all capital letters enclosed in [ ] indicate a key name (either on the analyzer or the PS/2 keyboard), such as [ENTER]. all capital, bold and italic letters indicate a special operation defined in the following section, such as SELECT. bold letters included in “ ” indicate text you can find on the screen, such as “Prepare to ship”. bold letters indicate defined screen areas/fields, such as System Status area, or chapter titles, such as Chapter 1 Using This Manual. All illustrations in this manual are provided as examples only. They may not necessarily reflect your analyzer setup or data displayed. 1-4 Using This Manual 1.5 Special Terms Used in This Manual When you read … CLICK It means … to press the arrow keys ([←][→] [↑][↓]) as needed to move the cursor to a certain software button on screen and press [ENTER]. to press the arrow keys ([←][→] [↑][↓]) as needed to move cursor to the desired edit box and use the built-in keypad or the external keyboard to enter the desired characters ENTER or digits. Note that besides the numeric keys you may also use the [PgUp] or [PgDn] keys to enter digits; or to scan the number in using the bar-code scanner. to press the arrow keys ([←][→] [↑][↓]) as needed to move the cursor to the character or digit to the left of the one you want to delete and press [DEL]; or DELETE to press the arrow keys ([←][→][↑][↓]) as needed to move the cursor to the character or digit to the right of the one you want to delete and press [BackSpace] on the external keyboard. to move the cursor to the character or digit you want to change MODIFY and re-enter the desired one using either the built-in keypad or the external keyboard or the bar-code scanner. SELECT from “ ** ” pull-down list to press the arrow keys ([←][→] [↑][↓]) as needed to move the cursor to the desired edit box and press [ENTER] to display the pull-down list and press [↑] or [↓] to move the cursor to the desired item and press [ENTER] to select it. SELECT z to press the arrow keys ([←][→] [↑][↓]) as needed to move the cursor to the desired item and press [ENTER]. This analyzer adopts a fixed decimal point. You can enter the digits without bothering to look for the [.] on the external keyboard. 1-5 Using This Manual 1.6 Symbols You will find the following symbols in this manual. When you see… Then… read the statement below the symbol. The statement is alerting you to an operating hazard that can cause personnel injury. read the statement below the symbol. The statement is alerting you to a possibility of analyzer damage or unreliable analysis results. read the statement below the symbol. The statement is alerting you to information that requires your attention. read the statement below the symbol. The statement is alerting you to a potentially biohazardous condition. You may find the following symbols on the analyzer or the reagents. When you see… It means… EQUIPOTENTIALITY CAUTION, CONSULT ACCOMPANYING DOCUMENTS. BIOLOGICAL RISK HIGH VOLTAGE ALTERNATING CURRENT FOR IN VITRO DIAGNOSTIC USE 1-6 Using This Manual BATCH CODE USE BY SERIAL NUMBER DATE OF MANUFACTURE TEMPERATURE LIMITATION CONSULT INSTRUCTIONS FOR USE MANUFACTURER IRRITATING SUBSTANCE 1-7 Using This Manual Figure 1-1 Back of the Analyzer (1) Equipotentiality. (2) Connect only to a properly earth grounded outlet. To avoid electric shock, disconnect power cord prior to removing or replacing fuse. Replace fuse only with the type and rating specified. (3) Biological risk. . 1-8 Using This Manual Figure 1-2 Inside right of the analyzer (1) To avoid being injured, do not put hand under the motor when the machine is running! 1-9 Using This Manual Figure 1-3 Inside front of the analyzer (1) The probe is sharp and may contain biohazardous material. Exercise caution when working around the probe! 1-10 2 Understanding Your Analyzer 2.1 Introduction The ICHOR II auto hematology analyzer is a quantitative, automated hematology analyzer and leukocyte differential counter to be used in clinical laboratories for In Vitro Diagnostic purpose 2-1 Understanding Your Analyzer 2.2 Intended Use The ICHOR II auto hematology analyzer is a quantitative, automated hematology analyzer and leukocyte differential counter to be used in clinical laboratories for In Vitro Diagnostic purpose. The intended use of ICHOR II Auto Hematology Analyzer is to identify the normal patient, with all normal system-generated parameters, and to flag or identify patient results that require additional studies. 2-2 Understanding Your Analyzer 2.3 Parameters and Histograms The ICHOR II auto hematology analyzer determines 16 parameters and 3 histograms of whole-blood samples. White Blood Cell or leukocyte WBC Lymphocyte Lymph# Mid-sized cell Mid# Granulocyte Gran# Lymphocyte percentage Lymph% Mid-sized cell percentage Mid% Granulocyte percentage Gran% Red Blood Cell or erythrocyte RBC Hemoglobin Concentration HGB Mean Corpuscular (erythrocyte) Volume MCV Mean Cell (erythrocyte) Hemoglobin MCH Mean Cell (erythrocyte) Hemoglobin Concentration MCHC Red Blood Cell (erythrocyte) Distribution Width RDW Hematocrit HCT Platelet PLT Mean Platelet Volume MPV White Blood Cell Histogram WBC Histogram Red Blood Cell Histogram RBC Histogram Platelet Histogram PLT Histogram 2-3 Understanding Your Analyzer 2.4 User Interfaces Figure 2-1 Front view (1) 1 ---- LCD 2 ---- Keypad 3 ---- Recorder 4 ---- Power indicator 5 ---- [OPEN] key 6 ---- [ASPIRATE] key 7 ----Sample compartment 2-4 Understanding Your Analyzer Figure 2-2 Front view (2) 1 ---- Aspirating position 2 ---- Tube holder 3 ---- Sample compartment door 2-5 Understanding Your Analyzer Figure 2-3 Back view 1 --- Parallel port 2 --- RS-232 port(COM1) 3 --- RS-232 port(COM2) 4 --- Keyboard interface 5 --- Power supply for floppy disk drive 6 --- Main label of the product 7 --- Diluent inlet 8 --- Diluent sensor connector 9 --- Rinse sensor connector 10 --- Waste outlet 11 --- Waster sensor connector 12--- Rinse inlet 13--- Power switch 14--- Equipotentiality 15--- Warning label 2-6 Understanding Your Analyzer Figure 2-4 Inside front of the analyzer 1 --- Door switch 2 --- Sample probe mechanism 3 --- Sample probe 4 --- Probe wipe 5 --- RBC shielding box 6 --- WBC shielding box 7 --- Sample compartment assembly 2-7 Understanding Your Analyzer Figure 2-5 Inside right of the analyzer 1 --- Valve8 2 --- Volumetric metering unit 3 --- Vacuum chamber 4 --- Valve13 5 --- Valve14 6 --- Valve12 7 --- Valve11 8 --- Valve10 9 --- Valve2 10 --- Valve9 11 --- 50uL and 2.5mL syringe motor 12 --- 10mL syringe motor 13 --- 2.5mL syringe 14 --- 50µL syringe 15 --- 10mL syringe 16 --- Valve6 17 --- Valve4 18 --- Valve3 19 --- Valve1 20 --- Valve5 21 --- Valve15 22 --- Valve16 23 --- Valve17 24 --- Valve7 25 --- Valve18 2-8 Understanding Your Analyzer Figure 2-6 Inside left of the analyzer 1 --- Fluid pump 2 --- Gas pump 3 --- Pressure chamber 2-9 Understanding Your Analyzer 2.4.1 LCD The LCD is located on the front panel of the analyzer. It displays all alphanumeric and graphic data. 2.4.2 Input Devices The input devices include the [OPEN] key, [ASPIRATE] key, built-in keypad and PS/2 keyboard. [OPEN] key The [OPEN] key is located below the power indicator. You can press the key to open the sample compartment door. [ASPIRATE] key The [ASPIRATE] key is located below the [OPEN] key. You can press the key to start the selected analysis cycle or dispense diluent. Built-in keypad The 23-key keypad is located below the LCD. Figure 2-7 Built-in keypad PS/2 keyboard The analyzer can also be controlled by an external PS/2 keyboard that should be connected to the analyzer’s keyboard interface. See the Table 2-1 for the correspondence between the keypad keys and the keyboard keys and for their functions. 2-10 Understanding Your Analyzer Table 2-1 Key functions Keypad PS/2 keyboard Function [MENU] [Esc] Press it to enter/exit the system menu. [PRINT] [P] or [p] Press it to print out data by the recorder or printer. [DEL] [Delete] or [Del] Press it to delete data and characters. [ENTER] [Enter] Press it to confirm or execute an operation. [↑][↓][←][→] [↑][↓][←][→] Press it to move the cursor. [0]...[9] [0]...[9] Press it to enter digits. [PgUp][PgDn] [Page Up] [Page Down] Press it to scroll screen. [FLUSH] / Press it to unclog the apertures. [FEED] / Press it to advance the recorder paper. [MAIN] / Press it to go back to the “Count” screen. [DILUENT] [D] or [d] Press it to enter the dispensing diluent state. [STARTUP] / Press it to execute the startup procedure (flushing the fluidic lines and checking background). [ID] [I] or [i] Press it to call out the screen to enter sample ID. / Alphanumeric keys and Press it to enter alphanumeric data or initiate a other function keys. function. 2.4.3 Sample Compartment The tube holder inside the sample compartment provides 4 numbered tube positions, Position 1 for the collection tube (φ13×75mm), Position 2 for the control vial (φ15×45mm), Position 3 for the collection tube (φ12×75mm), and Position 4 for the 1.5mL centrifugal tube (φ11×40mm). 2.4.4 Recorder The thermal recorder is located on the front panel. It prints out analysis reports and other related information. 2.4.5 Keyboard Interface The keyboard interface is located on the back panel. A PS/2 keyboard can be connected here. 2.4.6 RS-232 Ports The analyzer provides two RS-232 ports. The one labeled “COM1” for connecting the 2-11 Understanding Your Analyzer bar-code scanner and the one labeled “COM2” for connecting a computer (host). The two RS-232 ports are located on the back panel. 2.4.7 Parallel Port The analyzer provides a parallel port to connect a printer or a floppy disk drive (a floppy disk drive is needed to upgrade the system software; the drive can only be connected by a Helena-supplied cable). The parallel port is located on the back panel. 2.4.8 Power Supply for the Floppy Disk Drive The power supply for the floppy disk drive is located on the back panel. It supplies power to the connected floppy disk drive. Only the drive power cord supplied by Helena can be used. 2.4.9 Printer(Optional) An external printer can be connected to the parallel port at the back of the analyzer. You can use it to print out a detailed report and other related information. z For long-term storage of printouts, Helena recommends you using the printer to print data. 2.4.10 Scanner(Optional) A bar-code scanner can be connected to the “COM1” of the analyzer. You can use it to scan the bar-coded sample IDs and reagent information into the analyzer. z Use the printer and/or scanner of the specified model. 2-12 Understanding Your Analyzer 2.5 Instrument Software 2.5.1 Main Screen After finishing the startup procedure, the analyzer enters the “Count” screen, which is the screen to be used most frequently, hence the name “Main screen”. The main screen is shown in Figure 2-8. Error message area Menu area Title area Help area Status area Analysis result area Figure 2-8 “Count” screen Error message area The Error message area displays error messages one by one, alternating every two seconds. Title area The Title area displays the title of the current screen, which, in case of Figure 2-8, is “Count”. Status area System status area The System status area displays whether this analyzer is ready for the next analysis. When it displays “Ready”, it means this analyzer is ready and you can proceed to analyze the next 2-13 Understanding Your Analyzer sample. When it displays “Waiting”, it means the analyzer is not ready for the next run yet. When it displays “Running”, it means this analyzer is analyzing a sample. Count mode area The Count mode area displays in which analysis (count) mode, whole blood or predilute, the next sample is to be analyzed. Transmission status A live animation is displayed in this area when the transmission is in process. System time area The System time area displays the system time (in the 24-hour format). Analysis result area The Analysis result area displays the analysis result, including sample ID, analysis time of the current sample. Menu area When you press [MENU], this area displays the system menu. Help area The Help area reminds you how to proceed to the next step. 2.5.2 System Menu Press the [MENU] and the system menu shown in Figure 2-9 will pop up. Figure 2-9 System menu The system menu contains 9 programs. The programs followed by “ sub-menus. See the figure below for the fully expanded menu. 2-14 ”s have further Understanding Your Analyzer Figure 2-10 Fully expanded system menu 2-15 Understanding Your Analyzer You can select the desired program as instructed below. If you want to… Select… analyze samples Count select an appropriate analysis mode Sample Mode review sample results Review run the QC program Quality Control customize system software Setup maintain/service the analyzer Service calibrate the analyzer Calibration look for help Help shut down the analyzer Shutdown 2-16 Understanding Your Analyzer 2.6 Reagents, Controls and Calibrator Because the analyzer, reagents (diluent, rinse, lyse, probe cleanser and E-Z cleanser), controls, and calibrator are components of a system, performance of the system depends on the combined integrity of all components. You should only use the Helena-specified reagents (see Appendix B Technical Specifications), which are formulated specifically for the fluidic system of your analyzer in order to provide optimal system performance. If other reagents are used, the analyzer may not meet the performance specified in this manual and may provide unreliable results. All references related to reagents in this manual refer to the reagents specifically formulated for this analyzer. Each reagent package must be examined before use. Inspect the package for signs of leakage or moisture. Product integrity may be compromised in packages that have been damaged. If there is evidence of leakage or improper handling, do not use the reagent. z Store and use the reagents as directed by the instructions for use of the reagents. z When you have changed the diluent, rinse or lyse, run a background to see if the results meet the requirement. z Pay attention to the expiration dates and open-container stability days of all the reagents. Be sure not to use expired reagents. z After installing a new container of reagents, let the reagents stand for a while before using them. 2.6.1 Diluent The diluent is formulated to: dilute the whole-blood samples. stabilize cell membranes for accurate counting and sizing. conduct aperture current. wash analyzer components between analyses. 2-17 Understanding Your Analyzer 2.6.2 Lyse The lyse is formulated to: rapidly break down red blood cell walls and release the hemoglobin from the cell. convert hemoglobin to a complex whose absorbance is determined by the hemoglobin concentration. 2.6.3 Rinse The rinse is formulated to: rinse the baths and volumetric metering tubes. provide proper meniscus formation in the volumetric metering tubes and maintain it during each analysis cycle 2.6.4 E-Z Cleanser The E-Z cleaner is an enzyme-based isotonic, cleaning solution and wetting agent formulated to clean the fluidic lines and baths. 2.6.5 Probe Cleanser The probe cleanser is an alkaline cleaning solution formulated to clean the apertures and to sterilize the fluidic lines. 2.6.6 Controls and Calibrator The controls and calibrator are used to verify accurate operation of and calibrate the analyzer. The controls are commercially prepared whole-blood products used to verify that the analyzer is functioning properly. They are available in low, normal, and high levels. Daily use of all levels verifies the operation of the analyzer and ensures reliable results are obtained. The calibrator is commercially prepared whole-blood products used to calibrate the analyzer. Read and follow the instructions for use to use the controls and calibrator. All references related to controls and calibrator in this manual refer to the controls and calibrator specifically formulated for this analyzer. Controls and calibrator can be purchased from Helena or Helena-authorized distributors. 2-18 3 Understanding the System Principles 3.1 Introduction The two independent measurement methods used in this analyzer are: the impedance method for determining the WBC, RBC, and PLT data. the colorimetric method for determining the HGB. During each analysis cycle, the sample is aspirated, diluted and mixed before the determination for each parameter is performed. 3-1 Understanding the System Principles 3.2 Aspiration This analyzer provides two analysis modes – whole-blood mode and predilute blood mode. In the whole-blood mode, you can simply put the sample into the sample department for aspiration. In the predilute mode, you should first manually dilute the sample and then put the sample into the sample department for aspiration. 3-2 Understanding the System Principles 3.3 Dilution Usually in blood samples, the cells are too close to each other to be identified or counted. For this reason, the diluent is used to separate the cells so that they are drawn through the aperture one at a time as well as to create a conductive environment for cell counting. Moreover, red blood cells usually outnumber white blood cells by 1,000 times. For this reason, lyse needs to be added to the sample to eliminate the red cells before the WBC counting. In the whole-blood mode, this analyzer aspirates 13µL of the sample and follows the procedure presented in Figure 3-1 to dilute it before proceeding to the actual analysis. 13uL of blood sample 3.5mL of diluent 15.6uL About 1:269 dilution 0.5mL of lyse About 2.6mL of diluent About 1:308 dilution for About 1:44872 dilution for the WBC/HGB analysis the RBC/PLT analysis Figure 3-1 How a blood sample is diluted in the whole-blood mode 3-3 Understanding the System Principles In the predilute mode, you should first collect 20µL of sample and dispense 0.9mL of diluent from this analyzer to predilute it. Then the analyzer aspirates 0.3mL of the prediluted sample for further dilution, as Figure 3-2 shows. 20uL of blood sample 0.9mL of diluent 1:46 dilution 0.3mL 2.9 mL of diluent About 1:491 dilution 30uL About 2.8mL of diluent 0.36 mL of lyse About 1:546 dilution for About 1:45827 dilution WBC/HGB measurement for RBC/PLT measurement Figure 3-2 How a sample is diluted in the predilute mode 3-4 Understanding the System Principles 3.4 WBC/HGB Measurement 3.4.1 Volumetric Metering An accurate cell count cannot be obtained unless the precise volume of diluted sample that passes through the aperture during the count portion of the analysis cycle (the count cycle) is known. This analyzer uses a volumetric metering unit to control the count cycle and to ensure that a precise volume of sample is analyzed. The metering unit controlling the WBC count cycle consists of a metering tube with two optical sensors mounted on it. This tube ensures that a precise amount of diluted sample is measured during each count cycle. The exact amount is determined by the distance between the two optical sensors. The rinse is used to create a meniscus in the metering tube. The count cycle starts when the meniscus reaches the upper sensor and stops when the meniscus reaches the lower sensor. The amount of time required for the meniscus to travel from the upper sensor to the lower sensor is called the WBC Count Time and is measured in seconds. At the end of the count cycle, the measured count time is compared to the pre-defined reference count time (see Chapter 6.3 for details). If the former is less than or greater than the latter by 2 seconds or more, the analyzer will report a “WBC Bubbles” or “WBC Clog” error. Seeing the error message, you can refer to Chapter 12 Troubleshooting Your Analyzer for solutions. Upper sensor Upper sensor Lower sensor Lower sensor 1 The tube is empty 2 The meniscus falls down through the metering tube. Upper sensor Upper sensor Lower sensor Lower sensor 3 Counting starts when the meniscus 4 Counting passes the upper sensor. meniscus passes the lower sensor. Figure 3-3 Volumetric metering process 3-5 finishes when the Understanding the System Principles 3.4.2 Measurement Principles WBC measurement WBCs are counted and sized by the impedance method. This method is based on the measurement of changes in electrical resistance produced by a particle, which in this case is a blood cell, suspended in a conductive diluent as it passes through an aperture of known dimensions. An electrode is submerged in the liquid on both sides of the aperture to create an electrical pathway. As each particle passes through the aperture, a transitory change in the resistance between the electrodes is produced. This change produces a measurable electrical pulse. The number of pulses generated indicates the number of particles that passed through the aperture. The amplitude of each pulse is proportional to the volume of each particle. Each pulse is amplified and compared to the internal reference voltage channels, which only accepts the pulses of certain amplitude. If the pulse generated is above the WBC threshold, it is counted as a WBC. Diluted sample Negative pressure Aperture Voltage Electrodes Circuit Consistent current source Impulse Time Figure 3-4 Impedance method of counting and sizing HGB measurement HGB is determined by the colorimetric method. The WBC/HGB dilution is delivered to the WBC bath where it is bubble mixed with a certain amount of lyse, which converts hemoglobin to a hemoglobin complex that is measurable at 525 nm. A LED is mounted on one side of the bath and emits a beam of monochromatic light, whose central wavelength is 525nm. The light passes through the sample and is then measured by a photo-sensor that is mounted on the 3-6 Understanding the System Principles opposite side. The signal is then amplified and the voltage is measured and compared to the blank reference reading (readings taken when there is only diluent in the bath). The HGB is calculated per the following equation and expressed in g/dL. HGB (g/dL) = Constant × Log 10 (Blank Photocurrent/Sample Photocurrent) 3.4.3 Derivation of WBC-Related Parameters WBC WBC (103/μL) is the number of leukocytes measured directly by counting the white blood cells passing through the aperture. Note that NRBCs (nucleated red blood cells) do not react with the lyse and can be mistaken by the analyzer for white cells. If you observe NRBCs in the microscope, be sure to correct the system-generated result by the following formula, WBC'=WBC × 100 100+NRBC where WBC represents the system-generated white cell number, NRBC the number of NRBCs counted in 100 white cells and WBC′ the corrected white cell number. WBC differential With the help of the diluent and lyse, this analyzer can size the white cells into three sub-populations - lymphocytes, mid-sized cells (including monocytes, basophils and eosinophils) and granulocytes. Based on the WBC histogram, this analyzer calculates Lymph %, Mid% and Gran% as follows and express the results in percents. Lymph% = Mid% = Gran% = PL PL + PM + PG PM PL + PM + PG PG PL + PM + PG × 100 × 100 × 100 where PL = particles in the lymphocyte region(103/µL) PM = particles in the mid-sized region (103/µL) PG = particles in the granulocyte region (103/µL). Having achieved the three parameters above, this analyzer proceeds to calculate the Lymph#, Mid# and Gran# per the following equations and express them in 103/µL. 3-7 Understanding the System Principles Lymph# = Lymph% × WBC 100 Mid # = Mid % × WBC 100 Gran # = Gran % × WBC 100 WBC histogram Besides the parameters mentioned above, this analyzer also presents a WBC histogram, whose x-coordinate represents the cell volume (fL)and y-coordinate represents the number of the cells. The histogram is presented in the Analysis result area of the “Count” screen when the analysis is done. You can also review the histograms of the stored patient results (see Chapter 8 Reviewing Sample Results). The first three discriminators of the WBC histogram can be adjusted in case you are not satisfied with the result. Note that you cannot adjust them if the WBC result is less than 0.5 or out of the operating range. 3.4.4 HGB Using the colorimetric method, this analyzer calculates hemoglobin concentration (g/dL) as follows. HGB (g/dL)=Constant × Log 10 (Blank Photocurrent/Sample Photocurrent) 3-8 Understanding the System Principles 3.5 RBC/PLT Measurement 3.5.1 Volumetric Metering An accurate cell count cannot be obtained unless the precise volume of diluted sample that passes through the aperture during the count cycle is known. This analyzer uses a volumetric metering unit to control the count cycle and to ensure that a precise volume of sample is analyzed for the measurement. The metering unit controlling the RBC/PLT count cycle consists of a metering tube with two optical sensors mounted on it. This tube ensures that a precise amount of diluted sample is measured during each count cycle. The exact amount is determined by the distance between the two optical sensors. The rinse is used to create a meniscus in the metering tube. The count cycle starts when the meniscus reaches the upper sensor and stops when the meniscus reaches the lower sensor. The amount of time required for the meniscus to travel from the upper sensor to the lower sensor is called the RBC Count Time and is measured in seconds. At the end of the count cycle, the measured count time is compared to the pre-defined reference count time (see Chapter 6.3 for details). If the former is less than or greater than the latter by 2 seconds or more, the analyzer will report a “RBC Bubbles” or “RBC Clog” error. Seeing the error message, refer to Chapter 11 Troubleshooting Your Analyzer for solutions. Upper sensor Upper sensor Lower sensor Lower sensor 1 The tube is empty. 2 The meniscus falls down through the metering tube. Upper sensor Upper sensor Lower sensor Lower sensor 3 Counting starts when the meniscus 4 Counting passes the upper sensor.. meniscus passes the lower sensor. Figure 3-5 Volumetric metering process 3-9 finishes when the Understanding the System Principles 3.5.2 Measurement Principles RBC/PLT measurement RBCs/PLTs are counted and sized by the impedance method. This method is based on the measurement of changes in electrical resistance produced by a particle, which in this case is a blood cell, suspended in a conductive diluent as it passes through an aperture of known dimensions. An electrode is submerged in the liquid on both sides of the aperture to create an electrical pathway. As each particle passes through the aperture, a transitory change in the resistance between the electrodes is produced. This change produces a measurable electrical pulse. The number of pulses generated signals the number of particles that passed through the aperture. The amplitude of each pulse is proportional to the volume of each particle. Each pulse is amplified and compared to the internal reference voltage channels, which only accepts the pulses of certain amplitude. If the pulse generated is above the RBC/PLT lower threshold, it is counted as a RBC/PLT. Diluted sample Negative pressure Aperture Voltage Electrodes Circuit Consistent current source Impulse Time Figure 3-6 Coulter method of counting and sizing 3.5.3 Derivation of RBC-Related Parameters RBC RBC (106/µL) is the number of erythrocytes measured directly by counting the erythrocytes passing through the aperture. 3-10 Understanding the System Principles MCV Based on the RBC histogram, this analyzer calculates the mean cell volume (MCV) and expresses the result in fL. This analyzer calculates the HCT (%), MCH (pg) and MCHC (g/dL) as follows: HCT = RBC × MCV 10 MCH = MCHC = HGB ×10 RBC HGB × 100 HCT where the RBC is expressed in 106/µL, MCV in fL and HGB in g/dL. RDW Based on the RBC histogram, this analyzer calculates the CV (Coefficient of Variation) of the erythrocyte distribution width. RBC Histogram Besides the parameters mentioned above, this analyzer also presents an RBC histogram, whose x-coordinate represents the cell volume (fL)and y-coordinate represents the number of the cells. The histogram is presented in the Analysis result area of the “Count” screen when the analysis is done. You can also review the histograms of the stored patient results (see Chapter 8 Reviewing Sample Results). The two discriminators of the RBC histogram can be adjusted in case you are not satisfied with the result. Note that you cannot adjust them if the RBC result is less than 0.2 or out of the operating range. 3.5.4 Derivation of PLT-Related Parameters PLT PLT (103/µL) is measured directly by counting the platelets passing through the aperture. MPV Based on the PLT histogram, this analyzer calculates the mean platelet volume (MPV, fL). 3-11 Understanding the System Principles PLT Histogram Besides the parameters mentioned above, this analyzer also presents a PLT histogram, whose x-coordinate represents the cell volume(fL)and y-coordinate represents the number of the cells. The histogram is presented in the Analysis area of the “Count” screen when the analysis is done. You can also review the histograms of the stored patient results (see Chapter 8 Reviewing Sample Results). The two discriminators of the PLT histogram can be adjusted in case you are not satisfied with the result. Note that you cannot adjust them if the PLT result is less than 10 or out of the operating range. 3-12 Understanding the System Principles 3.6 Wash After each analysis cycle, the elements listing below are washed. The sample probe is washed internally and externally with diluent. The WBC bath is washed with diluent and rinse. The RBC/PLT bath is washed with diluent and rinse. The metering tube is washed with rinse. 3-13 4 Performance Specifications and Characteristics 4.1 Introduction This chapter introduces performance specifications and characteristics of the ICHOR II. 4-1 Performance Specifications and Characteristics 4.2 Performance Specifications 4.2.1 Operating Range Parameter Operating range WBC (103 /µL) 0.0 - 299.9 RBC (106 /µL) 0.00 - 19.99 HGB (g/dL) 0.0 - 29.9 MCV (fL) 0.0 - 249.9 PLT (103 /µL) 0 - 2999 4.2.2 Normal Background Parameter Background result WBC ≤ 0.3 × 103 /µL RBC ≤ 0.03 × 106 /µL HGB ≤ 0.1 g / dL PLT ≤ 10 × 103 /µL 4.2.3 Linearity Range (Whole-blood mode) Parameter Linearity range Deviation range WBC (103 /µL) 0.3 - 99.9 ×103 /µL ±0.3 ×103 /µL or ±5% RBC (106 /µL) 0.20 – 7.99 ×106 /µL ±0.05 ×106 /µL or ±5% HGB (g/dL) 1.0 - 24.9 g/dL ±0.2 g/dL or ±3% PLT (103 /µL) 10 – 999 ×103 /µL ±10 ×103 /µL or ±10% 4.2.4 Reproducibility (Whole-blood mode) These reproducibility requirements apply only to the situation in which 11 normal-level controls have been run and the results of the 2nd to 11th runs are used to calculate the reproducibility. 4-2 Performance Specifications and Characteristics Parameter Condition Reproducibility (CV%) WBC 7.0 - 15.0 × 103 /µL ≤ 3.0 RBC 3.50 - 6.00 × 106/µL ≤ 2.5 HGB 11.0 - 18.0 g/dL ≤ 2.0 MCV 80.0 - 110.0 fL ≤ 2.0 PLT 200 - 400 × 103 /µL ≤ 6.0 4.2.5 Carryover (Whole-blood mode) Parameter Carryover WBC ≤ 0.5 % RBC ≤ 0.5 % HGB ≤ 0.5 % PLT ≤1% 4-3 Performance Specifications and Characteristics 4.3 Performance Characteristics 4.3.1 Reproducibility Reproducibility is stated in terms of both Standard Deviation (SD) and Coefficient of Variation (CV%). Reproducibility was determined by replicate testing (n = 11) with samples of low, normal and high concentrations, three samples for each concentration. For each sample, results of the 2nd to 11th runs were adopted to calculate the SD and CV%. See the tables below. Imprecision, low concentration samples WBC RBC HGB MCV PLT (×103 / μL) (×106 /μL) (g/dL ) (fl) (×103 /μL) mean 4.1 2.88 9.2 64.6 162 SD 0.07 0.04 0.1 0.40 5.06 CV(%) 1.63 1.45 0.8 0.62 3.12 WBC RBC HGB MCV PLT (×10 / μL) 6 (×10 /μL) (g/dL ) (fl) (×103 /μL) 3.2 3.02 9.3 72.9 155 1 2 mean 3 SD 0.03 0.03 0.1 0.21 7.02 CV(%) 0.99 1.06 1.0 0.28 4.53 WBC RBC HGB MCV PLT (×10 / μL) 6 (×10 /μL) (g/dL ) (fl) (×103 /μL) mean 3.1 1.91 5.6 61.0 61 SD 0.06 0.03 0.1 0.24 5.11 CV(%) 1.84 1.76 1.1 0.39 8.39 3 3 4-4 Performance Specifications and Characteristics Imprecision, normal concentration samples WBC RBC HGB MCV PLT (×103 / μL) (×106 /μL) (g/dL ) (fl) (×103 /μL) mean 10.1 4.60 13.1 83.3 244 SD 0.12 0.03 0.09 0.38 8.05 CV(%) 1.18 0.73 0.7 0.45 3.30 WBC RBC HGB MCV PLT (×10 / μL) 6 (×10 /μL) (g/dL ) (fl) (×103 /μL) mean 9.8 5.34 15.2 83.1 249 SD 0.10 0.04 0.12 0.27 4.86 CV(%) 0.99 0.78 0.8 0.33 1.95 WBC RBC HGB MCV PLT (×10 / μL) 6 (×10 /μL) (g/dL ) (fl) (×103 /μL) mean 11.3 5.27 15.0 85.9 231 SD 0.13 0.04 0.06 0.21 8.53 CV(%) 1.11 0.73 0.4 0.25 3.70 1 2 3 3 3 Imprecision, high concentration samples RBC HGB MCV PLT (×10 / μL) 6 (×10 /μL) (g/dL ) (fl) (×103 /μL) mean 16.7 6.98 22.4 112.1 419 SD 0.31 0.09 0.2 0.79 9.73 CV(%) 1.85 1.24 0.7 0.71 2.32 WBC RBC HGB MCV PLT (×10 / μL) 6 (×10 /μL) (g/dL ) (fl) (×103 /μL) mean 25.1 6.22 18.8 / 408 SD 0.26 0.05 0.2 / 6.45 CV(%) 1.03 0.84 0.8 / 1.58 WBC RBC HGB MCV PLT (×103 / μL) (×106 /μL) (g/dL ) (fl) (×103 /μL) mean 18.5 6.09 18.0 / 495 SD 0.17 0.04 0.2 / 11.44 CV(%) 0.93 0.60 0.8 / 2.31 1 2 3 WBC 3 3 4.3.2 Linearity Linearity was determined by running diluted samples. RBC, HGB are diluted by blood plasma of the sample, while WBC and PLT are diluted by specified diluent. Concentrations from 0 to 100% were tested, each concentration twice. The average of the two runs is taken as the result, together with the concentration, to calculate per the linear regression equation. See the tables below. 4-5 Performance Specifications and Characteristics WBC linearity Proportional Dilution(%) Test 1 Test 2 Mean Ideal Error 100 117.1 115.9 116.50 120.01 3.51 2.9 80 99.8 100.1 99.95 96.01 -3.94 -4.1 60 73.4 72.1 72.75 72.00 -0.75 -1.0 40 47.8 48.6 48.20 48.00 -0.20 -0.4 20 23.1 23.1 23.10 23.99 0.89 3.7 10 12.1 12.0 12.05 11.99 -0.06 -0.5 5 6.0 6.2 6.10 6.00 -0.10 -1.7 2.5 3.0 2.9 2.95 2.99 0.04 1.3 1.25 1.3 1.3 1.30 1.49 0.19 12.8 0.625 0.5 0.5 0.50 0.74 0.24 32.4 0.3125 0.2 0.1 0.15 0.36 0.21 58.3 0 0 0 0.00 -0.01 -0.01 / Slope 1.2002 Intercept -0.0129 error RBC Linearity Proportional Dilution(%) Test 1 Test 2 Mean Ideal Error 100 8.46 8.43 8.445 8.519 0.074 0.9 80 6.91 6.86 6.885 6.819 -0.066 -1.0 60 5.12 5.17 5.145 5.119 -0.026 -0.5 40 3.42 3.46 3.440 3.419 -0.021 -0.6 20 1.71 1.69 1.700 1.719 0.019 1.1 10 0.89 0.87 0.880 0.869 -0.011 -1.3 5 0.46 0.46 0.460 0.444 -0.016 -3.6 2.5 0.21 0.22 0.215 0.232 0.017 7.3 1.25 0.10 0.13 0.115 0.125 0.010 8.0 0 0.00 0.00 0.000 0.019 0.019 / Slope 0.0850 Intercept 0.0191 4-6 error Performance Specifications and Characteristics HGB linearity Proportional Dilution(%) Test 1 Test 2 Mean Ideal Error 100 25.6 25.6 25.60 25.40 -0.20 -0.8 80 20.5 20.1 20.30 20.33 0.03 0.1 60 15.1 14.9 15.00 15.26 0.26 1.7 40 10.1 10.1 10.10 10.19 0.09 0.9 20 5.2 5.0 5.10 5.11 0.01 0.2 10 2.7 2.6 2.65 2.58 -0.07 -2.7 5 1.4 1.4 1.40 1.31 -0.09 -6.9 2.5 0.7 0.7 0.70 0.68 -0.02 -2.9 1.25 0.4 0.4 0.40 0.36 -0.04 -11.1 0 0.0 0.0 0.00 0.04 0.04 / Slope 0.2536 Intercept 0.0425 error PLT linearity Proportional Dilution(%) Test 1 Test 2 Mean Ideal Error 100 1014 1008 1011.0 1040.3 29.3 2.8 80 850 858 854.0 832.5 -21.5 -2.6 60 631 650 640.5 624.8 -15.7 -2.5 40 425 419 422.0 417.0 -5.0 -1.2 20 221 208 214.5 209.3 -5.2 -2.5 10 109 101 105.0 105.4 0.4 0.4 5 53 53 53.0 53.5 0.5 0.9 2.5 23 17 20.0 27.5 7.5 27.3 1.25 8 5 6.5 14.5 8.0 55.2 0 0 0 0.0 1.6 1.6 / Slope 10.3871 Intercept 1.5618 4-7 error Performance Specifications and Characteristics 4.3.3 Carryover Carryover was determined by first running the high concentration sample three consecutive times (i1, i2, i3) and then the low concentration sample three consecutive times (j1, j2, j3), and finally calculating per the following equation: Carryover (%) = [(j1 – j3)/ (i3-j3)] × 100% The test was then repeated using the high level control. See the tables below. Carryover, high concentration sample Parameter High concentration Low concentration sample (whole blood) sample (whole blood) i1 i2 i3 j1 j2 j3 WBC(×103 / μ 20.4 20.0 1.9 1.9 1.9 6 0.46% RBC(×10 /μ L) HGB(g/dL) 3 PLT(×10 /μL) % 0% 19.7 L) Carryover 6.34 6.24 6.2 1.87 1.96 1.85 25.4 25.0 24.8 3.3 3.2 3.2 0.46% 404 390 396 31 34 33 0% Carryover, high level control Parameter High concentration Low concentration sample (high level sample (specified Carryover control) diluent) % i1 i2 i3 j1 j2 j3 3 0% WBC(×10 / μ 21.7 L) 21.3 21.7 0.0 0.0 0.0 6 0% RBC(×10 /μ L) HGB(g/dL) 3 PLT(×10 /μL) 5.88 5.79 5.79 0.00 0.00 0.00 18.8 18.7 18.9 0.0 0.0 0.0 0% 453 438 429 0 0 0 0% 4-8 Performance Specifications and Characteristics 4.3.4 Correlation Correlation is determined by comparing the results (both CBC and DIFF) obtained by the ICHOR II to those by the Coulter AC·T diff 2TM and by comparing the DIFF results obtained by the ICHOR II to those by manual differential. See the tables below. Correlation to Coulter AC·T diff 2TM Correlation to manual differential Mean Parameter Samples(n) ICHOR II Manual differential Slope(a) Intercept(b) Correlation coefficient(r) Lymph% 196 26.8 30.4 0.7575 3.7958 0.95 Mid% 196 9.2 9.0 0.3739 5.822 0.57 Gran% 196 64.0 60.6 0.8456 12.721 0.94 4-9 Performance Specifications and Characteristics 4.3.5 Ability to Flag Abnormal WBC Histograms ICHOR II’s ability to flag abnormal WBC histograms was determined by comparing 200 sample results obtained by the ICHOR II to those obtained by manual differential. See the table below. Ability to flag abnormal WBC histograms ICHOR II Manual differential Positive (39) Negative (161) Positive (40) TP (22) FN (18) Negative (160) FP (17) TN (143) False Positive Ratio False Negative Agreement(%) (%) Ratio (%) 82.5 10.6 45 4.3.6 Reference Ranges A Normal Ranges Study was conducted to assess the Reference Ranges for the ICHOR II analyzer. Whole-blood samples were collected from 121 donors. Normal Population Study Mean 90%Confidence Low Limit High Limit Parameter Units WBC 3 M/F 6.86 3.47 10.25 RBC 6 ×10 cells /µL M/F 4.56 3.54 5.58 HGB g/ dL M/F 13.40 10.27 16.52 HCT % M/F 40.12 30.98 49.26 MCV fL M/F 88.18 80.82 95.55 MCH pg M/F 29.36 26.57 32.15 MCHC g/ dL M/F 33.33 32.09 34.56 3 ×10 cells /µL Sex 90%Confidence PLT ×10 cells /µL M/F 209.92 119.62 300.22 RDW % M/F 12.81 11.53 14.10 MPV fL M/F 8.47 7.07 9.87 LY % M/F 27.33 18.11 36.55 MO % M/F 9.45 5.23 13.67 GR % M/F 63.26 51.62 74.89 4-10 5 Installing Your Analyzer 5.1 Introduction This chapter introduces the installation procedure of the ICHOR II. To ensure all system components function correctly and to verify system performance, a Helena-authorized representative will handle the installation and initial software setup. z Installation by personnel not authorized or trained by Helena may damage your analyzer. Do not install your analyzer without the presence of Helena-authorized personnel. 5-1 Installing Your Analyzer 5.2 Installation Requirements Before installation, you should ensure that the following space, power and environmental requirements are met. 5.2.1 Space Requirements Check the site for proper space allocation. In addition to the space required for the analyzer itself, arrange for at least 28 cm on each side, which is the preferred access to perform service procedures. at least 10 cm behind for cabling and ventilation. enough room on or below the countertop to accommodate the diluent, rinse and waste containers. 5.2.2 Power Requirements Check the availability of a power outlet that is: 100-240 VAC 50/60 Hz properly grounded 180VA installed with a 250 V T4A fuse z Make sure the analyzer is properly grounded. z If a power outlet with confirmed third-wire earth ground is not available, connect the equipotentiality pole at the back of the analyzer to the ground. z Only install a 250V T4A fuse on the analyzer. z Before turning on the analyzer, make sure the input voltage meets the above requirements. z Before connecting the power cord, make sure the power switch at the back of the analyzer is at the “O” position. 5-2 Installing Your Analyzer 5.2.3 General Environment Optimal operating temperature: 15 ℃ - 30 ℃ (59 ℉ - 86℉). Relative humidity: 30% - 85%. Atmospheric pressure: 70.0 kPa -106.0 kPa. The environment should be as free as possible from dust, mechanical vibrations, loud noises, and electrical interference. Do not place the analyzer near brush-type motors, flickering fluorescent lights, and electrical contacts that regularly open and close. Do not place the analyzer in direct sunlight or in front of a source of heat or drafts. z Do not place the analyzer in a flammable or explosive environment. z The specified temperature range is necessary to obtain reliable analysis results. 5-3 Installing Your Analyzer 5.3 Unpacking 5.3.1 Unpacking and Inspecting the Analyzer Your analyzer is tested before it is shipped from the factory. International symbols and special handling instructions tell the carrier how to treat this electronic instrument. When you receive your analyzer, carefully inspect the carton. If you see any signs of mishandling or damage, contact Helena customer service department or your local distributor immediately. When you are sure the carton is fine, follow the steps below to unpack the analyzer: 1. Place the carton on the floor upright with the arrows on the side upwards. 2. Remove the tape and take out the accessory box. Check the accessories against the packing list. Notify Helena customer service department or your local distributor immediately if you find anything missing. 3. Open the main box and check the items inside against the packing list. Notify the Helena customer service department or your local distributor immediately if you find anything missing. 4. Remove the top protective foam. Firmly grip the two cardboard handles and lift the analyzer out of the box and place it on the floor. Carry the analyzer away from the foam and set it on the countertop. z Retain the shipping carton and all the packing materials, as they can be used for packaging if analyzer must be reshipped. 5.3.2 How to move the analyzer If your analyzer has been used for a while, do the ”Drain Tubing” procedure (see Chapter 11.2.10) and shut it down before moving it. z Never move the analyzer without draining the fluidic lines. z When moving the analyzer, face the front of the analyzer and carry it from the bottom with hands! 5-4 Installing Your Analyzer For short - distance moving on a smooth ground, you may use a trolley to facilitate the transportation. During the moving process, protect the LCD and the sample probe from excessive force and from contact with other objects. Keep the analyzer upright during the moving process. Do not tilt or incline it. Do your best to minimize the mechanical shock when moving the analyzer. After a long-distance moving, check and tune the analyzer before using it. 5-5 Installing Your Analyzer 5.4 Installation Procedure z To avoid personal injury, keep your clothes, hair and hands away from such moving parts as the sample probe. z The sample probe tip is sharp and may contain biohazardous materials. Exercise caution to avoid contact with the probe when working around it. 5.4.1 Releasing Sample Probe Before the analyzer is shipped out, the sample probe is fixed by a plastic cable tie. After unpacking the analyzer, you need to release the sample probe as follows: 1. Push the right door latch in the direction indicated in Figure 5-1 to open the right door. Figure 5-1 Push the right door latch 2. Lift up the front door latch as indicated in Figure 5-2 and open the front door. 5-6 Installing Your Analyzer Latch Figure 5-2 Lift up the front door latch 3. Cut the plastic cable tie to release the probe, as Figure 5-3 shows. Plastic cable tie Figure 5-3 The plastic cable tie 5-7 Installing Your Analyzer 4. The released sample probe is shown in Figure 5-4. Figure 5-4 Released sample probe 5. Lift the front door latch and close the front door and then release the latch to lock it. 6. Close the right door. 5.4.2 Connecting Reagent Containers Locate three plastic caps of fluidic connections at the back of the analyzer. Take off these caps by unscrewing them and keep them in a safe place for future transportation. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Dispose of reagents, waste, samples, consumables, etc. according to government regulations. 5-8 Installing Your Analyzer z Do not place reagents on or above the analyzer. z Use the manufacturer-specified reagents. z Let the reagents stand for a while before using them. z Do not use expired reagents. z To prevent contamination, tighten the container caps when the installation is finished. Connecting the lyse container 1. Take out the lyse pickup tube (the one with an orange connector) from the accessory box. 2. Install the lyse container. Figure 5-5 Lyse container 3. Remove the container cap and insert the double-pronged end of the tube into the container and tighten the cap until properly secured. 4. Push the left door latch in the direction indicated in Figure 5-6 to open the left door. 5-9 Installing Your Analyzer Figure 5-6 Push the left door latch 5. Locate the black and orange fittings as shown in Figure 5-7. Figure 5-7 Black and orange fittings 6. Place the lyse container onto the shelf and connect the black connector on the cap to the black fitting and the orange connector to the orange fitting, as Figure 5-8 shows. Figure 5-8 Connect the fittings 7. Close the left door. 5-10 Installing Your Analyzer Connecting diluent container 1. Take out the diluent pickup tube (the one with a green connector) from the accessory box. 2. Take out the diluent container and place it on or below the countertop. Figure 5-9 Diluent container 3. Remove the seal of the diluent package. Remove the container cap and insert the double-pronged end of the tube into the diluent container and tighten the cap until properly secured. 4. Locate the green fitting, marked “DILUENT”, in the lower right corner of the back of the analyzer. Plug the green connector of the tube into the fitting and turn it clockwise until properly secured. 5. Locate the transducer fitting besides the green fitting. Connect the wire by pushing it in and turning it until properly secured. Connecting rinse container 1. Take out the rinse pickup tube (the one with a blue connector) from the accessory box. 2. Take out the rinse container and place it on or below the countertop. 3. Remove the container cap and insert the double-pronged end of the tube into the rinse container and tighten the cap until properly secured. 5-11 Installing Your Analyzer Figure 5-10 Rinse container 4. Locate the blue fitting, marked “RINSE”, in the lower right corner of the back of the analyzer. Plug the blue connector of the tube into the fitting and turn it clockwise until properly secured. 5. Locate the transducer fitting besides the blue fitting. Connect the wire by pushing it in and turning it until properly secured. Connect waste container 1. Take out the waste tube (the one with a red connector) from the accessory box. 2. Locate the red fitting, marked “WASTE”, in the lower right corner of the back of the analyzer. Plug the red connector of the tube into the fitting and turn it clockwise until properly secured. 3. Locate the transducer fitting besides the red fitting. Connect the wire by pushing it in and turning it until properly secured. 4. Prepare a container to receive the waste and place it on or below the countertop. 5. Insert the waste tube into the waste container. 5-12 Installing Your Analyzer Figure 5-11 Waste container 5.4.3 Installing Recorder Paper Follow the procedure below to install the recorder paper. z Improper installation of recorder paper may jam the paper and/or result in blank printouts. 1. Locate the projecting part in the upper right corner of the recorder and press it in the direction shown in Figure 5-12 to open it. Figure 5-12 Open the recorder door 2. Flip the paper tension lever upwards. Keep the printing side face-down. Insert the pointed end of the paper into the slot below the paper rod and push the paper until it comes out 5-13 Installing Your Analyzer from above the rod. Pull the paper out. Keep the paper centered and place the paper into the paper holder. See Figure 5-13. Figure 5-13 Paper tension lever z The recorder paper is treated on one side for printing. To determine which side is the printing side, gently scratch both sides with a finger nail and the one with visible nail trace left is the printing side. 3. Flip the paper tension level downwards to lock the paper in place, as Figure 5-14 shows. Figure 5-14 Flip the paper tension lever 5-14 Installing Your Analyzer 4. Close the recorder door, as Figure 5-15 shows. Figure 5-15 Close the recorder door 5.4.4 Connecting the Keyboard z Do not connect or disconnect the keyboard when the analyzer is on. z Use the supplied keyboard only. Connect the keyboard to the keyboard interface marked “KB” at the back of the analyzer. 5.4.5 Connecting the Printer (Optional) z Do not connect or disconnect the printer when the analyzer is on. z Use the printer of the specified model only. Follow the printer’s instructions for use to connect the printer to the parallel port marked “PARALLEL” at the back of the analyzer. 5-15 Installing Your Analyzer 5.4.6 Connecting the Bar-Code Scanner (Optional) z Do not connect or disconnect the bar-code scanner when the analyzer is on. z Use the scanner of the specified model only. Follow the scanner’s instructions for use to connect the scanner to the RS-232 port marked “COM1” at the back of the analyzer. 5-16 Installing Your Analyzer 5.5 Starting the Analyzer Take out the power cord from the accessory box. Plug the non-pronged end into the AC input at the back of the analyzer and the pronged end into a power outlet. Place the power switch at the back of the analyzer in the ON position (I) to turn on the analyzer. The power indicator light will be on and the screen will display “Initializing…“. The analyzer will sequentially initialize the file, hardware and fluidic systems and the whole initializing process lasts 3 to 5 minutes, depending on how the analyzer was previously shut down. During the initialization of the fluidic system, the analyzer will automatically do the background check and display the result in the “Count” screen. A “Background Abnormal” error will appear if the result exceeds the normal background. Refer to Chapter4 Performance Specifications and Characteristics for normal background of parameters. z In a background check, the analyzer counts diluent as opposed to patient samples. z Running sample with the background abnormal error present will lead to unreliable results. If any error occurs during the initialization, the analyzer will display the error messages in the upper left corner of the screen. You should remove all the errors before running any sample. See Chapter 12 Troubleshooting Your Analyzer for solutions. 5-17 6 Customizing the Analyzer Software 6.1 Introduction The ICHOR II is a flexible laboratory instrument that can be tailored to your work environment. The screen you see at the first time you start the analyzer is defaulted. You can use the “Setup” program to customize the software options as introduced in chapters 6.2 - 6.13. 6-1 Customizing the Analyzer Software 6.2 Print The “Print” screen is where you set printing options. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.2.1 Entering the “Print” screen Press [MENU] to enter the system menu. Figure 6-1 System menu SELECT “Setup → Print” (Figure 6-1 ) to enter the “Print” screen (Figure 6-2). 6-2 Customizing the Analyzer Software Figure 6-2 “Print” screen 6.2.2 Selecting Printing Device You can select either the built-in recorder or an external printer (if available) as the printing device, as Figure 6-3 shows. Figure 6-3 Selecting printing device If you prefer the recorder, SELECT “Recorder” from the “Device” pull-down list. 6-3 Customizing the Analyzer Software If you prefer the printer, SELECT “Printer” from the “Device” pull-down list. z For long-term storage of printouts, Helena recommends you using the printer to print data. 6.2.3 Selecting Printing Format If you have selected the printer, you can choose any of the following printing formats: One page with histogram One page without histogram One page with histogram (CBC Para) One page without histogram (CBC Para) To choose the desired format, SELECT the desired format from the “Print Format” pull-down list, as Figure 6-4 shows. Figure 6-4 Selecting printing format for the printer If you have selected the recorder, you can choose any of the following 7 printing formats. Format 1 - parameter values + histograms (horizontal) Format 2 – parameter values only (horizontal) Format 3 - parameter values + histograms (vertical) Format 4 - parameter values only (vertical) 6-4 Customizing the Analyzer Software Format 5 – parameter (CBC Para) only (horizontal) +histograms Format 6 – parameter (CBC Para) (horizontal) Format 7 – Parameter (CBC Para) +histograms (vertical) Format 8 – Parameter (CBC Para) (vertical) To choose the desired format, SELECT the desired format from the “Print Format” pull-down list, as Figure 6-5 shows. Figure 6-5 Selecting printing format for the recorder 6.2.4 Activating/deactivating Auto Print If the “Auto Print” function is on, the analysis result will be automatically printed out once the analysis is finished. To activate (or deactivate) this function, SELECT “ON” (or “OFF”) from the “Auto Print” pull-down list, as Figure 6-6 shows. 6-5 Customizing the Analyzer Software Figure 6-6 Activating/deactivating auto print 6.2.5 Exiting the “Print” Screen Press [MENU] to exit to the system menu or [MAIN] to exit to the “Count” screen. The changes will be saved automatically. 6-6 Customizing the Analyzer Software 6.3 Count time The “Count Time” screen is where you view and set (if you have the administrator password) the reference time for the WBC and RBC count portion of the analysis cycle. If the actual WBC or RBC count time (see Chapter 3.4.1 and 3.5.1) deviates from the reference time by 2 seconds or more, the analyzer will alarm you to clogging or bubbles and invalidate the results of all related parameters. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.3.1 Entering the “Count Time” screen and viewing the settings Press [MENU] to enter the system menu. Figure 6-7 System menu SELECT “Setup → Count Time” (Figure 6-7) to enter the “Count Time” screen (Figure 6-8). 6-7 Customizing the Analyzer Software Figure 6-8 “Count Time” screen 6.3.2 Setting Count Time 1. Enter the administrator password as instructed by Chapter 6.4.1. 2. Enter the “Count Time” screen. 3. ENTER the desired number into the ”WBC Count Time” box or ”RBC Count Time” box to set the reference WBC or RBC count time. 6.3.3 Exiting“Count Time”screen Press [MENU] to exit to the system menu or [MAIN] to exit to the “Count” screen, and the changes will be saved automatically. 6-8 Customizing the Analyzer Software 6.4 Password The ICHOR II classifies users into two categories: common users (default) and administrators. You need to enter the administrator password to adjust certain options such as WBC/RBC Count Time, Gain, etc. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.4.1 Entering the Administrator Password 1. Press [MENU] to enter the system menu. Figure 6-9 System menu 2. SELECT “Setup → Password” (Figure 6-9) to enter the ”Password” screen (Figure 6-10). 6-9 Customizing the Analyzer Software Figure 6-10 “Password” screen 3. ENTER “3000” and a message box will pop up to remind you of the current user level, as Figure 6-11 shows. Figure 6-11 A message box to confirm the user level 4. CLICK “Enter” to confirm the password and exit to the system menu. 6.4.2 Resuming the Common User Password 1. Enter the “Password” screen and the default password is the common user password. 2. Press [MENU] again and a message box will pop up to remind you of the current user level, as Figure 6-12 shows. 6-10 Customizing the Analyzer Software Figure 6-12 A message box to confirm the user level 3. CLICK “Enter” to confirm the password and exit to the system menu. 6-11 Customizing the Analyzer Software 6.5 Ref. Range The ”Ref. Range” screen is where you set and view the high or low limits for your patients. The analyzer flags any parameter value above (H) or below (L) these limits. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z To properly use the analyzer, you need to establish your own reference ranges based on your laboratory’s patient population. The CLSI Document C28-A “How to Define and Determine Reference Intervals in the Clinical Laboratory; Approved Guideline” contains guideline to how to determine reference values and ranges for quantitative clinical laboratory tests. 6.5.1 Setting the Limits (e.g. “Range 1”) There are 5 blank reference ranges provided by the analyzer. Set the desired limits as instructed below: 1. Press [MENU] to enter the system menu. 2. Enter the administrator password as introduced in Chapter 6.4.1. 3. SELECT “Setup → Ref. range →Range 1” (Figure 6-13) to enter the “Range 1” screen. 6-12 Customizing the Analyzer Software Figure 6-13 System menu 4. ENTER the limits as desired (Figure 6-14). Figure 6-14 “Range 1” screen 6.5.2 Viewing the Limits (e.g. “Range 1”) After setting the limits, you can view them as instructed below: Press [MENU] to enter the system menu. Then SELECT “Setup → Ref. range → Range 1” (Figure 6-15) to view the limits. 6-13 Customizing the Analyzer Software Figure 6-15 “Range 1” screen (after the limis are set) 6.5.3 Selecting the default limits SELECT “Setup → Ref. range → Defalut” (Figure 6-16) to enter the “Default” screen. Figure 6-16 “Default” screen 6-14 Customizing the Analyzer Software SELECT the desired item from the “Default Range” pull-down list ( Range 1 is pre-selected)as the default range, as Figure 6-17 shows. Figure 6-17 Selecting the default range 6.5.4 Exiting the Patient Limits Screen Press [MENU] to exit to the system menu or [MAIN] to return to the “Count” screen. If you have made any changes, a message box will pop up to ask you to save the changes, as Figure 6-18 shows. CLICK “Enter” to save the changes and exit to the system menu or the main screen; CLICK “Cancel” to abort the changes and exit to the system menu or the “Count” screen. Figure 6-18 A message box to confirm the changes 6-15 Customizing the Analyzer Software z At the “General” screen, you can press [PRINT] to print out the displayed limits. 6.6 Transmission The “Transmission” screen is where you set transmission parameters. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.6.1 Entering the “Transmission” Screen Press [MENU] to enter the system menu. Figure 6-19 System menu SELECT “Setup→Transmission” (Figure 6-19) to enter the “Transmission” screen (Figure 6-20). 6-16 Customizing the Analyzer Software Figure 6-20 “Transmission” screen 6.6.2 Selecting Baud Rate Five baud rate options are available: “19200”, “9600” (default), “4800”, “2400” and “1200”. To select the desired baud rate, SELECT the desired rate from the “Baud Rate” pull-down list, as Figure 6-21 shows. Figure 6-21 Selecting baud rate 6-17 Customizing the Analyzer Software 6.6.3 Selecting Parity Two parity options are available: “Odd” (default) and “Even”. To select the desired option, SELECT the desired item from the “Parity” pull-down list, as Figure 6-22 shows. Figure 6-22 Selecting parity check 6.6.4 Activating/deactivating Auto Transmission When the auto transmission function is on, the analyzer will automatically transmit the analysis result to the host once the analysis is finished. To activate (or deactivate) the auto transmission function, SELECT ”ON” (or ”OFF”) from the “Auto Trans.” pull-down list, as Figure 6-23 shows. 6-18 Customizing the Analyzer Software Figure 6-23 Activating/deactivating auto transmission 6.6.5 Exiting the “Transmission” Screen Press [MENU] to exit to the system menu or [MAIN] to exit to the “Count” screen. The changes will be saved automatically. 6-19 Customizing the Analyzer Software 6.7 Setting System Time (Date & Time) The “Date & Time” screen is where you set the system date and time. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.7.1 Entering “Date & Time” Screen Press [MENU] to enter the system menu. Figure 6-24 System menu SELECT “Setup→Date & Time” (Figure 6-24) to enter the “Date & Time” screen (Figure 6-25). 6-20 Customizing the Analyzer Software Figure 6-25 “Date & Time” screen 6.7.2 Selecting Date Format Three date formats are available: “YYYY-MM-DD”, “MM-DD-YYYY” and “DD-MM-YYYY”. To select the desired format, SELECT the desired format from the “Format” pull-down list, as Figure 6-26 shows. Figure 6-26 Selecting date format 6-21 Customizing the Analyzer Software 6.7.3 Setting System Time Respectively ENTER desired numbers into the ” Year”, “Month”, “Day”, “Hour”, “Minute” and “Second” boxes. 6.7.4 Exiting the “Date & Time” Screen Press [MENU] to exit to the system menu or [MAIN] to exit to the “Count” screen. The changes will be saved automatically. 6-22 Customizing the Analyzer Software 6.8 Gain The ”Gain” screen is where you view and set (if you have the administrator password) gains of the “WBC (Whole Blood)”, “WBC (Predilute)”, “RBC” and “HGB” z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.8.1 Entering the “Gain” Screen Press [MENU] to enter the system menu. Figure 6-27 System menu SELECT “Setup→Gain” (Figure 6-27) to enter the ”Gain” screen (Figure 6-28). 6-23 Customizing the Analyzer Software Figure 6-28 “Gain” screen 6.8.2 Setting WBC Channel Gain You can adjust the shape of the WBC histogram by adjusting the gain of the WBC channel. When WBC histograms of most samples are similar to Figure 6-29, it implies too small a WBC gain and you need to increase the gain appropriately. Figure 6-29 WBC gain too small When WBC histograms of most samples are similar to Figure 6-30, it implies too large a WBC gain and you need to decrease the gain appropriately. 6-24 Customizing the Analyzer Software Figure 6-30 WBC gain too large To increase (or decrease) the WBC gain: 1. Enter the administrator password as introduced in Chapter 6.4.1. 2. Enter the ”Gain” screen and ENTER the desired gain into the “WBC (Whole) ”, as Figure 6-31 shows, or “WBC (Predilute)”, as Figure 6-32 shows. Figure 6-31 Setting WBC(Whole)gain 6-25 Customizing the Analyzer Software Figure 6-32 Setting WBC(Predilute)gain 6.8.3 Setting the RBC Gain If the MCV results of most calibration or QC runs deviate from the expected result by 6%, you need to follow the rule below to change the RBC gain to adjust the MCV results. Assume the expected MCV result is 90.0fL and the obtained MCV result is 82.0fL. Then ExpectedMCV 90.0 × 100%= × 100% = 109.8% ActualMCV 82.0 1. Enter the administrator password as introduced in Chapter 6.4.1. 2. Enter the “Gain” screen and ENTER a number into the ”RBC” box, as Figure 6-33 shows, so that RBC “Factor” is as close to 109.8% as possible. 6-26 Customizing the Analyzer Software Figure 6-33 Setting RBC gain 6.8.4 Setting HGB Channel Gain You can adjust the HGB blank voltage by adjusting the HGB gain. Normally the HGB blank voltage should be within 3.4 - 4.8 V (4.5V is recommended). To set the HGB channel gain: 1. ENTER the administrator password as introduced in Chapter 6.4.1. 2. ENTER the “Gain” screen and ENTER the desired gain into the ”HGB” box so that the HGB voltage falls between 3.4 - 4.8 V, as Figure 6-34 shows. Figure 6-34 Setting HGB gain 6-27 Customizing the Analyzer Software 6.8.5 Exiting the “Gain” Screen Press [MENU] or [MAIN] to exit the ”Gain” screen and a message box will pop up to ask you to save the changes, as Figure 6-35 shows. Figure 6-35 A message box to confirm the changes CLICK “Enter” to save the changes and exit to the system menu or the “Count” screen. CLICK “Cancel” to abort the changes and exit to the system menu or the “Count” screen. 6-28 Customizing the Analyzer Software 6.9 Auto Clean Time The “Auto Clean Time” screen is where you set the interval for auto cleaning of the fluidic lines and the baths. The valid interval is 2 - 24 hours and the default interval is 4 hours. To set the interval: z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 1. Press [MENU] to enter the system menu. Figure 6-36 System menu 2. SELECT “Setup→Auto Clean Time” (Figure 6-36) to enter the “Auto Clean Time” screen (Figure 6-37). 6-29 Customizing the Analyzer Software Figure 6-37 “Auto Clean Time” screen 3. ENTER the desired interval. 4. Press [MENU] to exit to the system menu or [MAIN] to exit to the “Count” screen. The changes will be saved automatically. 6-30 Customizing the Analyzer Software 6.10 Reagent Exp. Date The ”Reagent Exp. Date” screen is where you set expiration dates for the diluent, rinse and lyse. The analyzer will alarm you to expired reagents when the system time exceeds any of the three expiration dates. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.10.1 Entering the “Reagent Exp. Date” screen Press [MENU] to enter the system menu. Figure 6-38 System menu SELECT ”Setup→Reagent Exp. Date” (Figure 6-38) to enter the ”Reagent Exp. Date” screen (Figure 6-39). 6-31 Customizing the Analyzer Software Figure 6-39 “Reagent Exp. Date” screen 6.10.2 Setting the Expiration Date ENTER the desired expiration dates into the ”Diluent”, “Rinse” and ” Lyse” boxes. z For any reagent, the entered expiration date should be either the expiration date printed on the labeling or the open-container expiration date, whichever is earlier. z The open-container expiration date is calculated as follows: the date that container is opened + the open-container stability days. 6.10.3 Exiting the “Reagent Exp. Date” Screen Press [MENU] or [MAIN] to exit the ” Reagent Exp. Date” screen and a message box will pop up to ask you save the changes, as Figure 6-40 shows. Figure 6-40 A message box to confirm the changes 6-32 Customizing the Analyzer Software CLICK “Enter” to save the changes and exit to the system menu or the “Count” screen. CLICK “Cancel” to abort the changes and exit to the system menu or the “Count” screen. 6-33 Customizing the Analyzer Software 6.11 Report Title (external keyboard needed) The “Report Title” screen is where you set the title and the user information of the report to be printed. To set the report title and the user information: z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 1. Press [MENU] to enter the system menu. Figure 6-41 System menu 2. SELECT “Setup→Report Title” (Figure 6-41) to enter the ”Report Title” screen (Figure 6-42). 6-34 Customizing the Analyzer Software Figure 6-42 “Report Title” screen 3. ENTER the desired title in the ”Report Title (by recorder) ” or ” Report Title (by printer) ” box, depending on the printing device you choose to print out the report. 4. ENTER the desired information (up to 50 characters for each box) in the “User Information(by printer only)” boxes and SELECT the check box in front of the entered box to determine the final user information to be printed out. Figure 6-43 Entering and selecting the user information 6-35 Customizing the Analyzer Software 5. Press [MENU] or [MAIN] to save the changes and exit to the system menu or the “Count” screen. z To correct any erroneous entry, DELETE the wrong character. 6-36 Customizing the Analyzer Software 6.12 Parameter Units The “Parameter Units” screen is where you view and set (if you have the administrator password) the reporting units of the parameters. See Table 6-1 for the available units for every parameter groups. Note that if you choose g/L or g/dL for the HGB/MCHC group, the MCH unit will automatically change to pg and its reporting format will be ***.*; if you choose mmol/L for the HGB/MCHC group, the MCH unit will automatically change to fmol and its reporting format will be **.**. Table 6-1 Reporting unit Parameter group Reporting format Reporting unit Remarks WBC ***.* 10 /µL Lymph# ***.* 9 10 /L / Mid# **** 2 10 /µL / ***.* % Default **.* g/dL Default *** g/L / ***.* g/dL Default **** g/L / **.** 106/µL Default **.** 1012/L / **** 104/µL / ***.* % Default *.*** L/L / MCV ****.* fL Default RDW **.* % Default PLT **** 103 /µL Default **** 109 /L / ***.* 104 /µL / **.* fL Default 3 Default Gran# Lymph% Mid% Gran% HGB MCHC RBC HCT MPV 6-37 Customizing the Analyzer Software z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.12.1 Entering the “Parameter Units” Screen and Viewing the Settings Press [MENU] to enter the system menu. Figure 6-44 System menu SELECT ”Setup→ Parameter Units” (Figure 6-44), to enter the “Parameter Units” screen (Figure 6-45 ). 6-38 Customizing the Analyzer Software Figure 6-45 “Parameter Units” screen 6.12.2 Setting Reporting Units (e.g. RBC) 1. Enter the administrator password as instructed in Chapter 6.4.1. 2. Enter the “Parameter Units” screen. 3. SELECT the desired unit from the corresponding pull-down list (e.g. RBC in Figure 6-46). Figure 6-46 Selecting a unit for RBC 6-39 Customizing the Analyzer Software 6.12.3 Exiting the “Parameter Units” Screen Press [MENU] or [MAIN] to exit to the system menu or the “Count” screen. The changes will be saved automatically. 6-40 Customizing the Analyzer Software 6.13 Other Settings The “Other Setting” screen is where you define miscellaneous system settings. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 6.13.1 Entering the “Other Settings” Screen Press [MENU] to enter the system menu. Figure 6-47 System menu SELECT “Setup→Other Settings”(Figure 6-47) to enter the ”Other Settings” screen (Figure 6-48). 6-41 Customizing the Analyzer Software Figure 6-48 “Other Settings” screen 6.13.2 Setting LCD Contrast The analyzer divides the LCD contrast into different levels and the higher the level, the higher the contrast. To set a desired LCD contrast level, ENTER the desired number (0 -10) into the ”LCD contrast” box (Figure 6-49). Figure 6-49 Selecting LCD contrast 6-42 Customizing the Analyzer Software 6.13.3 Setting Alarm Time for Error Messages The alarm time of the errors listed in Table 6-2 can be set from 2 to 120 seconds. When the alarm times out, both the alarm sound and the corresponding error message will disappear. You can mute the beeper by pressing any key (except for the [ASPIRATE] key and the [OPEN] key). Table 6-2 Errors with adjustable display time No. Error No. Error No. Error 1 Com Error 2 Barcode Error 3 Barcode Com Error 4 Recorder out of Paper 5 Background Abnormal 6 HGB Error 7 HGB Adjust 8 WBC Clog 9 WBC Bubbles 10 RBC Clog 11 RBC Bubbles 12 Printer Offline 13 Printer out of Paper 14 Recorder too Hot 15 Recorder Com Error 16 Press Bar Up / / / / To set the alarm time, ENTER the desired time into the “Alarm time (s)” box. Figure 6-50 Selecting alarm time 6.13.4 Reminder of Predilute Mode If you have activated the “Reminder of Predilute mode” function and selected the 6-43 Customizing the Analyzer Software “Predilute” mode, the analyzer will ask you whether to count in the predilute mode when you press [ASPIRATE] at “Count” screen. To activate (or deactivate) the “Reminder of Predilute mode” function, SELECT “ON” (or “OFF”) from the “Reminder of Predilute mode” pull-down list, as Figure 6-51 shows. Figure 6-51 Activating/deactivating the “Reminder of Predilute mode” function 6.13.5 Selecting How to Enter Sample Info. This analyzer provides two ways to enter the sample information, “ID only” (to enter the sample ID only) and “All Info.”(to enter all the sample information). You select the desired way from the “Enter Sample Info.” pull-down list, as Figure 6-52 shows. 6-44 Customizing the Analyzer Software Figure 6-52 Selecting sample Info. entering mode 6.13.6 Exiting the “Other Settings” Screen Press [MENU] or [MAIN] to exit to the system menu or the “Count” screen. The changes will be saved automatically. 6-45 7 Operating Your Analyzer 7.1 Introduction This chapter provides step-by-step procedures for operating your analyzer on a daily basis. A flow chart indicating the common daily operating process is presented below. Initial Checks Power on Daily Quality Control Sample Collection and Handling No Whole Blood Mode? Yes Run Whole-blood samples Shutdown 7-1 Run prediluted samples Operating Your Analyzer 7.2 Initial Checks Perform the following checks before turning on the analyzer. 1. Check and make sure the waste container is empty. 2. Check and make sure there are enough reagents. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Dispose of reagents, waste, samples, consumables, etc. according to government regulations. 3. Checking tubing and power connections Check and make sure the diluent, rinse and waste tubes are properly connected and not bent. Check and make sure the power cord of the analyzer is properly plugged into a power outlet. 4. Checking the printer (optional), bar-code scanner (optional) and recorder. Check and make sure enough printer or recorder paper is installed. Check and make sure the power cords of the printer and the scanner are properly plugged into power outlets. Check and make sure the printer and scanner are properly connected to the analyzer. 5. Checking keyboard connection Check and make sure the keyboard is properly connected to the keyboard interface (marked KB) of the analyzer. 7-2 Operating Your Analyzer 7.3 Power-on Place the power switch at the back of the analyzer in the ON position (I) to turn on the analyzer. The power indicator light will be on and the screen will display “Initializing…“. The analyzer will sequentially initialize the file, hardware and fluidic systems and the whole initializing process lasts 3 to 5 minutes, depending on how the analyzer was previously shut down. During the initialization of the fluidic system, the analyzer will automatically do the background check and display the result in the “Count” screen. A “Background Abnormal” error will appear if the result exceeds the normal background. Refer to Chapter4 Performance Specifications and Characteristics for normal background of the parameters z In a background check, the analyzer counts diluent as opposed to patient samples. z Running sample with the background abnormal error present will lead to unreliable results. If any error occurs during the initialization, the analyzer will display the error messages in the upper left corner of the screen. You should remove all the errors before running any sample. See Chapter 12 Troubleshooting Your Analyzer for solutions. 7-3 Operating Your Analyzer 7.4 Daily Quality Control Before running any samples, run the controls. See Chapter 9 Using the QC Programs for details. 7-4 Operating Your Analyzer 7.5 Select Sample Mode z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] and SELECT “Sample Mode” (Figure 7-1) to enter the ”Sample Mode” screen, as Figure 7-2 shows. Figure 7-1 System menu SELECT “Whole Blood” or “Predilute” from the “Sample Mode” pull-down list. 7-5 Operating Your Analyzer Figure 7-2 “Sample Mode” screen 7-6 Operating Your Analyzer 7.6 Sample Collection and Handling z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Do not re-use disposable products. z Use clean K2EDTA anticoagulant collection tubes, plastic centrifugal tubes and 20µL borosilicate glass capillary tubes. 7.6.1 Whole-blood Samples Collect and handle the whole blood sample as follows: 1. Collect venous blood with a K2EDTA(1.5 - 2.2mg/mL)anticoagulant collection tube. 2. Mix the sample according to your laboratory’s protocol. z Collect at least 2mL whole blood sample. z To prevent overflow, keep the level of the fluid from the top of the vial by certain distance . z Whole-blood samples to be run for WBC differential or PLT count should be stored at room temperature and run within 8 hours of collection. z If you do not need the PLT, MCV and WBC differential results, you can store the samples in a refrigerator 2℃ - 8℃ (35.6 ℉ - 46.6℉)for 24 hours. You need to warm the refrigerated samples at room temperature for at least 30 minutes before running them. z Mix any sample that has been prepared for a while before running it. 7-7 Operating Your Analyzer 7.6.2 Prediluted Samples Collect and handle the prediluted sample as follows. 1. Press [MENU] and SELECT ”Count” to enter the ”Count” screen. Be sure the System Status area displays “Ready“ and the Count Mode area displays “Predilute” 2. Press [DILUENT] and a message box will pop up to instruct you how to dispense the diluent into the sample tube, as Figure 7-3 shows. Figure 7-3 A message box showing you how to dispense diluent z Load the tube to the right tube position and double check the position before proceeding to the next step. 3. Press [OPEN] to open the sample compartment door. 4. Rotate Position 4 to the aspirating position. 5. Load a clean 1.5mL centrifugal tube to Position 4 and make sure the tube is not capped. 6. Close the sample compartment door. Then follow the instruction shown in Figure 7-4. 7-8 Operating Your Analyzer Figure 7-4 A message box showing you how to dispense diluent 7. Press [ASPIRATE] key to dispense diluent. The dispensing progress is displayed on the screen. 8. When the dispensing is finished, the sample compartment door will automatically open. Then press [ENTER] to close the message box. 9. Take the tube out and add 20µL of blood sample to the diluent and shake the tube to mix the sample. z Keep dust from the prepared diluent. z After mixing the blood sample with the diluent, wait 3 minutes before running the sample. z Run the prediluted samples within 30 minutes after the mixing. z Mix any sample that has been prepared for a while before running it. z Evaluate predilute stability based on your laboratory’s sample population and sample collection techniques or methods. 7-9 Operating Your Analyzer 7.7 Running Whole-blood Samples z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] and SELECT ”Count” to enter the ”Count” screen, as Figure 7-5 shows. Figure 7-5 “Count” screen Check the “Count” screen. Be sure the System Status area displays “Ready“ and the Count Mode area displays “Whole“. z Select proper reference range as instructed in Chapter 6.5 before running the samples. Otherwise, the obtained results may be erroneously flagged. z When switching from the predilute mode to the whole blood mode, the analyzer will automatically wash the fluidic system. 7-10 Operating Your Analyzer 7.7.1 Entering Sample Information You can enter the sample information one of the two ways, ID only or All Info., depending on the configuration of your analyzer (see Chapter 6.13.5 for how to select the entering mode). z If the analyzer is restarted, you will lose all the information of the samples that have not been analyzed yet. All Info. (external keyboard needed) At the “Count” screen, press [ID] to enter the edit window, as Figure 7-6 shows. Figure 7-6 Entering all sample information Entering sample ID ENTER the ID number in the “ID” box. If you have the bar-code scanner installed, you can simply scan the sample ID into the analyzer. Selecting patient gender SELECT the desired item from the “Gender” pull-down list, as Figure 7-7 shows. Note that you can select blank in case you are not aware of the patient gender. 7-11 Operating Your Analyzer Figure 7-7 How to select the patient gender Selecting the reference range SELECT the desired reference range from the “Range” pull-down list, as Figure 7-8 shows (see Chapter 6.5 for how to set the reference range). Figure 7-8 How to select the reference range Entering the patient name ENTER the patient name into the “Name” box. Entering the patient age This analyzer provides three ways for you to enter the patient age – in years, in months and 7-12 Operating Your Analyzer in days. The first way is designed for the patients no younger than one year; the second for the patients one month to one year; the third for the patients no older than one month. You can choose only one of the three ways to enter the patient age. To enter the patient age in years: ENTER the desired number, an integer from 0 to 200, into the “Years” box. To enter the patient age in months: ENTER the desired number, an integer from 0 to 12, into the “Months” box. To enter the patient age in days: ENTER the desired number, an integer from 0 to 31, into the “Days” box. Entering the chart number ENTER the number of the patient’s medical chart into the “Chart No.” box. Entering the bed number ENTER the number of the patient’s bed into the “Bed No.” box. Entering the department name You can either directly ENTER the name of the department, from which the sample came, into the “Depart.” box or SELECT the desired department from the “Department” pull-down list (if there are previously saved departments in the list, as Figure 7-9 shows). Figure 7-9 How to select department name from the pull-down list 7-13 Operating Your Analyzer Entering the names of the sender, tester and checker To enter the name of the person who sent the sample for analysis, ENTER the name into the “Sender” box or SELECT the desired name from the “Sender” pull-down list (if there are previously saved names in the list, as Figure 7-10 shows); to enter the name of the person who is to run (or has run) the sample, ENTER the name into the “Tester” box or SELECT the desired name from the “Tester” pull-down list (if there are previously saved names in the list) ; to enter the name of the person who is to check the sample results, ENTER the name into the “Checker” box, or SELECT the desired name from the “Checker” pull-down list (if there are previously saved names in the list). All the three pull-down lists are capable of saving 30 entered names. Figure 7-10 Entering names of the sender, tester and checker z To correct an erroneous entry, DELETE the wrong character and ENTER the correct one. z After entering all the desired information, you may press [F4] on the external keyboard to save the changes and exit to the “Count” screen. “Enter” button When you have finished entering all the desired sample information, CLICK the “Enter” button to save the changes and return to the “Count” screen. 7-14 Operating Your Analyzer “Cancel” button If you do not want to save the entered information, CLICK the “Cancel” button to return to the ”Count” screen without saving the changes. ID Only At the “Count” screen, press [ID] then the “Next sample” window will pop up, as Figure 7-11 shows. Figure 7-11 ID window ENTER the sample ID into the ID box and press [ENTER] to save the changes and close the window. If you have the bar-code scanner installed, you can simply scan the sample ID into the analyzer. z If you have entered 0 as the sample ID, the analyzer will start a background check when you press [ASPIRATE]. 7.7.2 Running the Samples z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Load the tube to the right tube position and double check the position before proceeding to the next step. 7-15 Operating Your Analyzer z Insert the tube bottom first into the holder. z Do not re-use disposable products. z In the whole blood mode, do not count the same sample more than 2 consecutive times. 1. Press [OPEN] to open the sample compartment door. 2. Rotate Position 1 or 3, depending on the size of the collection tube, to the aspirating position. 3. Load the mixed sample to the aspirating position and close the door. 4. Press [ASPIRATE]. The System Status area will display “Running” and the analyzer will start aspirating sample. The analysis progress will be displayed on the screen and the sample ID will automatically increase by 1. 5. When the analysis is finished, the result will be displayed on the screen. The sample compartment door will automatically open and the sample tube can be removed. 6. If the auto printing function is activated, the analysis result will be automatically printed out. If the auto transmission function is activated, the analyzer will automatically transmit the analysis result to the host. 7. Repeat the above steps on other samples. z If the analyzer detects WBC/RBC clogging or bubbles during the analysis, the corresponding error messages will be displayed in the upper left corner of the screen and the results of all the related parameters will be invalidated. See Chapter 12 Troubleshooting Your Analyzer for solutions. z If the ambient temperature is outside the specified range, the analyzer will alarm you to the abnormal ambient temperature and the analysis results may be unreliable. See Chapter 12 Troubleshooting Your Analyzer for solutions. 7-16 Operating Your Analyzer 7.7.3 Special Functions Automatic saving of analysis results This analyzer automatically saves a maximum of 35,000 sample results. When the maximum number has been reached, the newest result will overwrite the oldest. Parameter flags If the analysis result is followed by an ”H” or “L”, it means the analysis result has exceeded the upper or lower limit of the reference range. If the analysis result is followed by an “A”, it means that the histogram discriminator associated with the parameter has been manually adjusted. The value of this parameter might have been changed by the adjustment of discriminator. If you see *** as opposed to the result, it means the result is either unreliable or out of the operating range (see Chapter 4 Performance Specifications and Characteristics). If the WBC result is less than 0.5 × 103 /µL, this analyzer will not perform the differential count and all the related parameter values will be non-numeric (***). z The result of the background check will not be flagged. Histogram flags The system will flag abnormal histograms. Abnormal WBC histograms will be flagged by one of the following markings: R1, R2, R3, R4 and Rm. Figure 7-12 WBC Histogram As shown in Figure 7-12:, R1: indicates cells distribute abnormally around region 1. R2: indicates the proportion of cell distribution in region 2 is out of the setting. 7-17 Operating Your Analyzer R3: indicates the proportion of cell distribution in region 3 is out of the setting. R4: indicates the proportion of cells larger than discriminator 4 is out of the setting. Rm: indicates at least two R flags Abnormal PLT histograms will be flagged by one marking: Pm.. Pm: indicates blurred demarcation between the platelet and red blood cell area and possible presence of large platelet, platelet coagulation, small red blood cell, cell debris or fibrin. z When the PLT value is less than 100 × 103/µL, a manual count by the microscope is recommended. There will be a flag “A” over the discriminator after it is manually adjusted. Adjusting histograms manually If you are not satisfied with the obtained histograms, you can adjust them manually, provided you have the administrator password. See Chapter 8 Reviewing Sample Results for details. Screen saver This analyzer will enter the screen saver if it has been idle at the “Count” screen for 10 minutes. When it happens, the LCD will turn dark. You can press any key (except the [ASPIRATE] key and the [OPEN] key) to resume the display. 7-18 Operating Your Analyzer 7.8 Running Prediluted Samples z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] and SELECT ”Count” to enter the ”Count” screen, as Figure 7-13 shows. Figure 7-13 “Count” screen Check the “Count” screen. Be sure the System Status area displays “Ready“ and the Count Mode area displays “Predilute“. z Select a proper reference range as instructed in Chapter 6.5 before running the samples. Otherwise, the obtained results may be erroneously flagged. 7-19 Operating Your Analyzer 7.8.1 Entering Sample Information You can enter the sample information one of the two ways, ID or All Info., depending on the configuration of your analyzer (see Chapter 6.13.5 for how to select the entering mode). z If the analyzer is restarted, you will lose all the information of the samples that have not been analyzed yet. All Info. (external keyboard needed) At the “Count” screen, press [ID] to enter the edit window, as Figure 7-14 shows. Figure 7-14 Entering all sample information Entering sample ID ENTER the ID number in the “ID” box. If you have the bar-code scanner installed, you can simply scan the sample ID into the analyzer. Selecting patient gender SELECT the desired item from the “Gender” pull-down list, as Figure 7-15 shows. Note that you can select blank in case you are not aware of the patient gender. 7-20 Operating Your Analyzer Figure 7-15 How to select the patient gender Selecting the reference range SELECT the desired reference range from the “Range” pull-down list, as Figure 7-16 shows (see Chapter 6.5 for how to set the reference range). Figure 7-16 How to select the reference range Entering the patient name ENTER the patient name into the “Name” box. 7-21 Operating Your Analyzer Entering the patient age This analyzer provides three ways for you to enter the patient age – in years, in months and in days. The first way is designed for the patients no younger than one year; the second for the patients one month to one year; the third for the patients no older than one month. You can choose only one of the three ways to enter the patient age. To enter the patient age in years: ENTER the desired number, an integer from 0 to 200, into the “Years” box. To enter the patient age in months: ENTER the desired number, an integer from 0 to 12, into the “Months” box. To enter the patient age in days: ENTER the desired number, an integer from 0 to 31, into the “Days” box. Entering the chart number ENTER the number of the patient’s medical chart into the “Chart No.” box. Entering the bed number ENTER the number of the patient’s bed into the “Bed No.” box. Entering the department name You can either directly ENTER the name of the department, from which the sample came, into the “Depart.” box or SELECT the desired department from the “Department” pull-down list (if there are previously saved departments in the list, as Figure 7-17 shows). Figure 7-17 How to select department name from the pull-down list 7-22 Operating Your Analyzer Entering the names of the sender, tester and checker To enter the name of the person who sent the sample for analysis, ENTER the name into the “Sender” box or SELECT the desired name from the “Sender” pull-down list (if there are previously saved names in the list, as Figure 7-18 shows); to enter the name of the person who is to run (or has run) the sample, ENTER the name into the “Tester” box or SELECT the desired name from the “Tester” pull-down list (if there are previously saved names in the list) ; to enter the name of the person who is to check the sample results, ENTER the name into the “Checker” box, or SELECT the desired name from the “Checker” pull-down list (if there are previously saved names in the list). All the three pull-down lists are capable of saving 30 entered names. Figure 7-18 Entering names of the sender, tester and checker z To correct an erroneous entry, DELETE the wrong character and ENTER the correct one. z After entering all the desired information, you may press [F4] on the external keyboard to save the changes and exit to the “Count” screen. “Enter” button When you have finished entering all the desired sample information, CLICK the “Enter” button to save the changes and return to the “Count” screen. 7-23 Operating Your Analyzer “Cancel” button If you do not want to save the entered information, CLICK the “Cancel” button to return to the ”Count” screen without saving the changes. ID Only At the “Count” screen, press [ID] then the “Next sample” window will pop up, as Figure 7-19 shows. Figure 7-19 ID window ENTER the sample ID into the ID box and press [ENTER] to save the changes and close the window. z If you have entered 0 as the sample ID, the analyzer will start a background check when you press [ASPIRATE]. 7.8.2 Running Samples z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z The sample probe tip is sharp and may contain biohazardous materials. Exercise caution to avoid contact with the probe when working around it. z Do not re-use disposable products. z Load the tube to the right tube position and double check the position before proceeding to the next step. 7-24 Operating Your Analyzer 1. Press [OPEN] to open the sample compartment door. 2. Rotate Position 4 to the aspirating position. 3. Load the mixed sample (uncapped) to it and close the door. 4. At the “Count” screen, be sure the System Status area displays “Ready“ and the Count Mode area displays “Predilute“. 5. Press [ASPIRATE]. The System Status area will display “Running” and the analyzer will start aspirating sample. The analysis progress will be displayed on the screen and the sample ID will automatically increase by 1. 6. When the analysis is finished, the result will be displayed on the screen. The sample compartment door will automatically open and the sample tube can be removed. 7. If the auto printing function is activated, the analysis result will be automatically printed out. And if the auto transmission function is activated, the analyzer will automatically transmit the analysis result to the host. 8. Repeat the above steps on other samples. z If the analyzer detects WBC/RBC clogging or bubbles during the analysis, the corresponding error messages will be displayed in the upper left corner of the screen and the results of all the related parameters will be invalidated. See Chapter 12 Troubleshooting Your Analyzer for solutions. z If the ambient temperature is outside the specified operating range, the analyzer will alarm you for abnormal ambient temperature and the analysis results may be unreliable. See Chapter 12 Troubleshooting Your Analyzer for solutions. 7.8.3 Special Functions Automatic saving of analysis results This analyzer automatically saves a maximum of 35,000 sample results. When the maximum number has been reached, the newest result will overwrite the oldest. Parameter flags If the analysis result is followed by an ”H” or “L”, it means the analysis result has 7-25 Operating Your Analyzer exceeded the upper or lower limit of the reference range. If the analysis result is followed by an “A”, it means that the histogram discriminator associated with the parameter has been manually adjusted. The value of this parameter might have been changed by the adjustment of discriminator. If you see *** as opposed to the result, it means the result is either unreliable or out of the operating range. If the WBC result is less than 0.5 × 103 /µL, this analyzer will not perform the differential count and all the related parameter values will be non-numeric (***). z The result of the background check will not be flagged. Histogram flags The system will flag abnormal histograms. Abnormal WBC histograms will be flagged by one of the markings: R1, R2, R3, R4 and Rm. Figure 7-20 WBC Histogram As shown in Figure 7-12:, R1: indicates cells distribute abnormally around region 1. R2: indicates the proportion of cell distribution in region 2 is out of the setting. R3: indicates the proportion of cell distribution in region 3 is out of the setting. R4: indicates the proportion of cells larger than discriminator 4 is out of the setting. Rm: indicates at least two R flags Abnormal PLT histograms will be flagged by one marking: Pm. Pm: indicates blurred demarcation between the platelet and red blood cell area and possible presence of large platelet, platelet coagulation, small red blood cell, cell debris or fibrin. 7-26 Operating Your Analyzer z When the PLT value is less than 100 × 103/µL a manual count by the microscope is recommended. There will be a flag “A” over the discriminator after it is manually adjusted. Adjusting histograms manually If you are not satisfied with the obtained histograms, you can adjust them manually, provided you have the administrator password. See Chapter 8 Reviewing Sample Results for details. Screen saver This analyzer will enter the screen saver if it has been idle at the “Count” screen for 10 minutes. When it happens, the LCD will turn dark. You can press any key (except the [ASPIRATE] key and the [OPEN] key) to resume the display 7-27 Operating Your Analyzer 7.9 Shutdown z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Perform the “Shutdown” procedure to shut down the analyzer daily. z To ensure stable analyzer performance and accurate analysis results, perform the “Shutdown” procedure to shut down the analyzer after it has been running continuously for 24 hours. z Shut down the analyzer strictly as instructed below. 1. Press [MENU] to enter the system menu and SELECT ”Shutdown”, as Figure 7-21 shows. Figure 7-21 Selecting the Shutdown program 2. A message box will pop up to ask you to confirm the shutdown, as Figure 7-22 shows. 7-28 Operating Your Analyzer Figure 7-22 Shutdown message box 3. CLICK “Enter” to confirm. 4. Press [OPEN] to open the sample compartment door. z The sample probe tip is sharp and may contain biohazardous materials. Exercise caution to avoid contact with the probe when working around it. z The reagents are irritating to eyes, skin and diaphragm. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Load the tube to the right tube position and double check the position before proceeding to the next step. 5. Rotate the Position 1 to the aspirating position. 6. Load a clean collection tube holding 3 to 5mL E-Z cleanser to Position 1, make sure the collection tube is not capped and close the sample compartment door. 7. Press [ASPIRATE]. The analyzer will aspirate the E-Z cleanser and automatically clean the fluidic system. The cleaning progress will be displayed on the screen, as Figure 7-23 shows. Figure 7-23 Shutdown progress bar 8. When the cleaning is finished, the sample compartment door will open automatically. Remove the collection tube and close the door. 7-29 Operating Your Analyzer 9. Place the switch at the back of the analyzer to OFF (O) to turn off the analyzer. 10. Empty the waste container. z Dispose of reagents, waste, samples, consumables, etc. according to government regulations. 7-30 8 Reviewing Sample Results 8.1 Introduction The analyzer automatically saves analysis results. Totally 35,000 results can be saved. You can either browse all the saved sample results in general (see Browsing All Sample Results) or search for the results of a particular sample or samples (see Searching for Interested Sample Results). z Helena recommends you backing up the saved results regularly. 8-1 Reviewing Sample Results 8.2 Browsing All Sample Results To browse all the saved sample results, you can choose either of the following modes: The “Sample Table Review” mode. In this mode, the sample results are presented in a columnar fashion without histograms (namely you can only see the parameter values). One screen displays a maximum of 6 sample results. The “Sample Histogram Review” mode. In this mode, you can review both parameter values and histograms of the saved sample results. One screen displays one sample result. 8.2.1 Browsing in the “Sample Table Review” Mode z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Entering the “Sample Table Review” Screen Press [MENU] to enter the system menu. Figure 8-1 System menu SELECT “Review→ Sample Review→ Sample Table Review” (Figure 8-1) to enter the “Sample Table Review” screen (Figure 8-2). The sample results are sequentially displayed on the screen, the earliest on the utmost left. The “Location/Total” displayed in the lower right corner of the screen indicates the location 8-2 Reviewing Sample Results of the current sample result (the one whose “ID” is highlighted) and the total number of the saved sample results. Figure 8-2 “Sample Table” screen Browsing sample results Press [←] or [→] to browse the preceding or following sample result; press [PgUp] or [PgDn] to browse the preceding or following screen. Switching to the “Sample Histogram Review” mode If you are interested in reviewing the histograms of the current sample result, press [6] to switch to the ”Sample Histogram Review” mode. To switch back to the “Sample Table Review” mode, press [6] again. Jumping to a sample result with known location Press [1] to enter the “Goto” window, as Figure 8-3 shows. Figure 8-3 “Goto” window If you know the location of a sample in the total sample results, you can ENTER its location 8-3 Reviewing Sample Results number into the “Location” box and press [ENTER] to jump to the desired sample result. Jumping to a sample result with known sample ID Press [2] to enter the “Find” window, as Figure 8-4 shows. Figure 8-4 “Find” window If you know the ID of a sample, you can ENTER the sample ID into the “ID” box and press [↑] to search backward or [↓] to search forward. If the desired sample result is found, the analyzer will jump to it; if not, a message box will pop up, as Figure 8-5 shows. Press [ENTER] to close the message box. Figure 8-5 A “Result” message box Selecting/deselecting sample results You can select certain desired sample results for transmission or printing. Selecting/deselecting a sample result Press [←] or [→] to move the cursor to the desired sample result and press [ENTER] to select it. The selected sample result will be marked with a “*”, as sample “75” shown in Figure 8-6. 8-4 Reviewing Sample Results Figure 8-6 Selecting a sample result Press [ENTER] again to deselect the sample result. Once the sample is deselected, the “*” will disappear, as sample “75” in Figure 8-7 shows. Figure 8-7 Deselecting a sample result Selecting/deselecting multiple sample results Example1: To select the sample results of locations 1 – 5 (sample ID: 75, 77, 78, 84, 95 in Figure 8-8), follow the procedure below to do so: 1. Press [3] to enter the “Select” window, as Figure 8-8 shows. 8-5 Reviewing Sample Results Figure 8-8 Entering the “Select” window 2. ENTER “1” into the “Start” box. 3. ENTER “5” into the “End” box. 4. CLICK “Select” and the lower left corner of the “Select” window will display “Results selected”, as Figure 8-9 shows. Figure 8-9 Selecting sample results of locations 1- 5 5. CLICK “Quit” to return to the “Sample Table Review” screen. The selected sample results will be marked with “*”, as Figure 8-10 shows. 8-6 Reviewing Sample Results Figure 8-10 Reviewing the selected results Example2: To deselect the sample results of locations 1 – 5 (sample ID: 75, 77, 78, 84, 95 in Figure 8-10), follow the procedure below to do so: 1. Enter the start and end positions as instructed in steps 1 – 3 of Example1. 2. CLICK “Deselect” and the lower left corner of the “Select” window will display “Results deselected”, as Figure 8-11 shows. Figure 8-11 Deselecting the sample results of locations 1 – 5 3. CLICK “Quit” to return to the “Sample Table Review” screen. The “*” above those 8-7 Reviewing Sample Results sample results will disappear, as Figure 8-12 shows. Figure 8-12 Reviewing the deselected results Example3: To select the sample results of locations 1 to 3 and 5 to 6, follow the procedure below to do so: 1. Press [3] to enter the “Select” window. 2. ENTER “1” into the “Start” box. 3. ENTER “3” into the “End” box. 4. CLICK “Select”. 5. ENTER “5” into the “Start” box. 6. ENTER “6” into the “End” box. 7. CLICK “Select”. 8. CLICK “Quit” to return to the “Sample Table Review” screen. The selected sample results will be marked with “*”, as Figure 8-13 shows. 8-8 Reviewing Sample Results Figure 8-13 Reviewing the selected results Example4: To deselect the sample results of locations 1 to 5 and 7 to 8, follow the procedure below to do so: 1. Press [3] to enter the “Select” window. 2. ENTER “1” into the “Start” box. 3. ENTER “3” into the “End” box. 4. CLICK “Deselect”. 5. ENTER “5” into the “Start” box. 6. ENTER “6” into the “End” box. 7. CLICK “Deselect”. 8. CLICK “Quit” to return to the “Sample Table Review” screen. The “*” above those sample results will disappear, as Figure 8-14 shows. 8-9 Reviewing Sample Results Figure 8-14 Reviewing the deselected results Transmitting sample results to a host You can transmit the selected sample results to an external computer (a host). Press [4] to enter the “Transmit” window, as Figure 8-15 shows. Figure 8-15 “Transmit” window To transmit the selected sample results to a host, CLICK “Selected”. To stop transmitting the sample results, CLICK “Stop”. To return to the “Sample Table Review” screen, CLICK “Quit”. Deleting sample results (if configured and administrator password entered) Deleting some sample results Select the sample results you want to delete and press [DEL]. A message box will pop up to confirm the deletion, as Figure 8-16 shows. CLICK “Enter” to delete the selected results; 8-10 Reviewing Sample Results CLICK “Cancel” to abort the deletion. Figure 8-16 A message box to confirm the deletion Deleting all sample results Press [5] and a message box will pop up to ask you to confirm the deletion, as Figure 8-17 shows. Figure 8-17 A “Delete All” message box CLICK ”Enter” to delete all the sample results; CLICK “Cancel” to abort the deletion. Printing sample results Select the sample results you want to print and press [PRINT]. A message box will pop up to ask you to confirm the printing, as Figure 8-18 shows. CLICK “Enter” to print out all the selected results; CLICK “Cancel” to abort the printing. Figure 8-18 A Print message box Calculating reproducibility This analyzer provides three reproducibility indices Mean, SD(Standard Deviation) and CV%( Coefficient of Variation), 8-11 Reviewing Sample Results n ∑x Mean= i=1 n SD = ∑ (X CV% = i − Mean ) 2 i n −1 SD × 100 % Mean where n represents how many sample results are selected and Xi is the result of the ith analysis. To check the reproducibility of the selected sample results, select at least three sample results and press [7] to view the reproducibility. If any selected result contains invalid parameter value (s), the reproducibility indices of that parameter(s) will also be non-numeric (***). To print out the displayed indices, press [PRIINT]. To exit the “Reproducibility” screen, press [MENU] to exit the “Reproducibility” screen. 8.2.2 Browsing in the “Sample Histogram Review” Mode z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Entering the “Sample Histogram Review” screen Press [MENU] to enter the system menu. 8-12 Reviewing Sample Results Figure 8-19 System menu SELECT “Review → Sample Review → Sample Histogram Review” (Figure 8-19) to enter the “Sample Histogram Review” screen (Figure 8-20). Figure 8-20 “Sample Histogram Review” screen The sample information will be displayed at the upper part of the screen, followed by the parameter values and histograms. The “Location/Total” displayed in the upper right corner of the screen indicates the location of the current sample result and the total number of the saved sample results. Browsing sample results Press [←] or [→] to browse the preceding or following sample result; press [PgUp] or [PgDn] to jump 6 locations (e.g. from location 1 to location 7). 8-13 Reviewing Sample Results Switching to the “Sample Table Review” mode To switch to the “Sample Table Review” mode, press [6]; to switch back to the “Sample Histogram Review” mode, press [6] again. Jumping to a sample result with known location Press [1] to enter the “Goto” window will pop up, as Figure 8-21 shows. Figure 8-21 “Goto” window ENTER the location into the “Location” box and press [ENTER] to jump to the desired sample result. Editing sample information Press [F1] to edit the sample information, Figure 8-22 shows. Figure 8-22 Editing sample information ID You cannot edit the sample ID of an analyzed sample. Selecting patient gender SELECT the desired item from the “Gender” pull-down list. Note that you can select blank in case you are not aware of the patient gender. 8-14 Reviewing Sample Results Selecting the reference range SELECT the desired reference range from the “Range” pull-down list (see Chapter 6.5 for how to set the reference range). Entering the patient name ENTER the patient name into the “Name” box. Entering the patient age This analyzer provides three ways for you to enter the patient age – in years, in months and in days. The first way is designed for the patients no younger than one year; the second for the patients one month to one year; the third for the patients no older than one month. You can choose only one of the three ways to enter the patient age. To enter the patient age in years: ENTER the desired number, an integer from 0 to 200, into the “Years” box. To enter the patient age in months: ENTER the desired number, an integer from 0 to 12, into the “Months” box. To enter the patient age in days: ENTER the desired number, an integer from 0 to 31, into the “Days” box. Entering the chart number ENTER the number of the patient’s medical chart into the “Chart No.” box. Entering the bed number ENTER the number of the patient’s bed into the “Bed No.” box. Entering the department name You can either directly ENTER the name of the department, from which the sample came, into the “Depart.” box or SELECT the desired department from the “Depart.” pull-down list (if there are previously saved departments in the list. Entering the names of the sender, tester and checker To enter the name of the person who sent the sample for analysis, ENTER the name into the “Sender” box or SELECT the desired name from the “Sender” pull-down list (if there are previously saved names in the list) ; to enter the name of the person who ran the sample, ENTER the name into the “Tester” box or SELECT the desired name from the “Tester” pull-down list (if there are previously saved names in the list) ; to enter the name of the person who reviewed the sample results, ENTER the name into the “Checker” box, or SELECT the desired name from the “Checker” pull-down list (if there are previously saved 8-15 Reviewing Sample Results names in the list). All the three pull-down lists are capable of saving 30 entered names. “Enter” button When you have finished entering all the desired sample information, CLICK the “Enter” button (or press [F4] of the external keyboard) to save the changes and return to the “Sample Histogram Review” screen. “Cancel” button If you do not want to save the entered information, CLICK the “Cancel” button to return to the ”Sample Histogram Review” screen without saving the changes. Adjusting histograms If you are not satisfied with the obtained histograms, you can adjust them manually, provided you have the administrator password. The first three discriminators of the WBC histogram are adjustable. Note that if the WBC result is less than 0.5 or non-numeric (***), the WBC histogram is not adjustable. The first two discriminators of the RBC histogram are adjustable. Note that if the RBC result is less than 0.2 or non-numeric (***), the RBC histogram is not adjustable. The first two discriminators of the PLT histogram are adjustable. Note that if the PLT result is less than 10 or non-numeric (***), the PLT histogram is not adjustable. If a discriminator has been manually adjusted, all of the analysis results associated with this discriminator will be followed by an “A” immediately, and there will be a flag “A” over the discriminator after you switch to another discriminator or press [ENTER] to save this adjustment. Example 5: To move the second discriminator of the following WBC histogram, follow the procedure below to do so. 1. Press [ENTER] and the discriminator will become adjustable. See Figure 8-23. 8-16 Reviewing Sample Results Figure 8-23 WBC histogram with adjustable discriminators 2. Press [↑] or [↓] to select the WBC histogram. 3. Press [2] to select the second discriminator, as Figure 8-24. Figure 8-24 Adjusting discriminator (1) 4. Press [→] to move the second discriminator, as Figure 8-25 shows. 8-17 Reviewing Sample Results Figure 8-25 Adjusting discriminator (2) 5. Press [ENTER] and a message box will pop up, as Figure 8-26 shows. 6. CLICK “Enter” to save the changes and return to the “Sample Histogram Review” screen. CLICK ”Cancel” to abort the changes and return to the “Sample Histogram Review” screen. Figure 8-26 “Note” message box There will be a flag “A” over the corresponding discriminator if the adjustment is saved, as Figure 8-27 shows. 8-18 Reviewing Sample Results Figure 8-27 The screen after saving adjustment Printing sample results Press [PRINT] to print out the current sample result. 8-19 Reviewing Sample Results 8.3 Searching for Interested Sample Results z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 8.3.1 Starting a Search At the “Sample Table Review” screen, press [F1] of the external keyboard to enter the “Search” window, as Figure 8-28 shows. Figure 8-28 “Search” window To include a search condition, press [↑] or [↓] to move the cursor to the desired condition and press [ENTER] to tick the condition, as Figure 8-29 shows. Figure 8-29 All 7 search conditions are included 8-20 Reviewing Sample Results Entering the patient name ENTER the patient name into the “Name” box. Selecting patient gender SELECT the desired item from the “Gender” pull-down list. Note that you can select blank in case you are not aware of the patient gender. Entering the department name You can either directly ENTER the name of the department, from which the sample came, into the “Depart.” box or SELECT the desired department from the “Depart.” pull-down list (if there are previously saved departments in the list). Entering sample ID ENTER the ID number into the “ID” box. Entering bed number ENTER the number of the patient’s bed into the “Bed No.” box. Entering the chart number ENTER the number of the patient’s medical chart into the “Chart No.” box. Entering the start and end date ENTER the start date into the “Start” box; ENTER the end date into the “End” box. CLICK “Enter” to start the search. The analyzer will search the saved sample results for matches and report the conclusion, as Figure 8-30 shows. CLICK “Enter” to close the box. Figure 8-30 Reporting conclusion of the search 8-21 Reviewing Sample Results 8.3.2 Reviewing Search Result in the “Search Table Review” Mode z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z For every search, the analyzer can display a maximum of 500 matches. z The search result will be cleared if you have run another sample (including background check), or deleted a sample result, or restarted the analyzer after the search. Entering the “Search Table Review” screen Press [MENU] to enter the system menu. Figure 8-31 System menu SELECT “Review → Search Review → Search Table Review” (Figure 8-31), to enter the “Search Table Review” screen (Figure 8-32). 8-22 Reviewing Sample Results Figure 8-32 “Search Table Review” screen The sample results are sequentially displayed on the screen, the earliest on the utmost left. The “Location/Total” displayed in the lower right corner of the screen indicates the location of the current sample result (the one whose “ID” is highlighted) and the total number of the sample results matching the search conditions. Browsing sample results Press [←] or [→] to browse the preceding or following sample result; press [PgUp] or [PgDn] to browse the preceding or following screen. Switching to the “Search Histogram Review” mode If you are interested in reviewing the histograms of the current sample result, press [6] to switch to the ”Search Histogram Review” mode. To switch back to the “Search Table Review” mode, press [6] again. Jumping to a sample result with known location Press [1] to enter the “Goto” window, as Figure 8-33 shows. 8-23 Reviewing Sample Results Figure 8-33 “Goto” window ENTER the location into the “Location” box and press [ENTER] to jump to the desired sample result. Selecting/deselecting sample results You can select certain desired samples for transmission or printing. Selecting/deselecting a sample result Press [←] or [→] to move the cursor to the desired sample result and press [ENTER] to select it. The selected sample result will be marked with a “*”, as sample “75” in Figure 8-34 shows. Figure 8-34 Selecting a sample result Press [ENTER] again to deselect the sample result. Once the sample result is deselected, the “*” will disappear, as sample “75” shown in Figure 8-35. 8-24 Reviewing Sample Results Figure 8-35 Deselecting a patient result Selecting/deselecting multiple sample results Example 6:To select the sample results of locations 1 – 5 (sample ID: 75, 77, 78, 84, 95, 106 in Figure 8-36), follow the procedure below to do so: 1. Press [2] to enter the “Select” window, as Figure 8-36 shows. Figure 8-36 Entering the “Select” window 2. ENTER 1 into the “Start” box. 3. ENTER 5 into the “End” box. 8-25 Reviewing Sample Results 4. CLICK “Select” and the lower left corner of the “Select” window will display “Results selected”, as Figure 8-37 shows. Figure 8-37 Selecting sample results of locations 1- 5 5. CLICK “Quit” to return to the “Sample Table Review” screen. The selected sample results will be marked with “*”, as Figure 8-38 shows. Figure 8-38 Reviewing the selected results Example 7:To deselect the sample results of locations 1 – 5 (sample ID: 75, 77, 78, 84, 95, 106 in Figure 8-39), follow the procedure below to do so: 8-26 Reviewing Sample Results 1. Enter the start and end positions as instructed in steps 1 – 3 of Example 6. 2. CLICK “Deselect” and the lower left corner of the “Select” window will display “Results deselected”, as Figure 8-39 shows. Figure 8-39 Deselecting the sample results of locations 1 – 5 3. CLICK “Quit” to return to the “Search Table Review” screen. The “*” above those sample results will disappear, as Figure 8-40 shows. Figure 8-40 Reviewing the deselected results Example 8: To select the sample results of locations 1 to 3 and 5 to 6, follow the procedure below to do so: 8-27 Reviewing Sample Results 1. Press [2] to enter the “Select” window. 2. ENTER “1” into the “Start” box. 3. ENTER “3” into the “End” box. 4. CLICK “Select”. 5. ENTER “5” into the “Start” box. 6. ENTER “6” into the “End” box. 7. CLICK “Select”. 8. CLICK “Quit” to return to the “Sample Table Review” screen. The selected sample results will be marked with “*”, as Figure 8-41 shows. Figure 8-41 Reviewing the selected results Example 9: To deselect the sample results of locations 1 to 3 and5 to 6, follow the procedure below to do so: 1. Press [2] to enter the “Select” window. 2. ENTER “1” into the “Start” box. 3. ENTER “3” into the “End” box. 4. CLICK “Deselect”. 5. ENTER “5” into the “Start” box. 6. ENTER “6” into the “End” box. 7. CLICK “Deselect”. 8-28 Reviewing Sample Results 8. CLICK “Quit” to return to the “Search Table Review” screen. The “*” above those sample results will disappear, as Figure 8-42 shows. Figure 8-42 Reviewing the deselected results Printing sample results Select the sample results you want to print and press [PRINT]. A message box will pop up to ask you to confirm the printing, as Figure 8-43 shows. CLICK “Enter” to print out all the selected results; CLICK “Cancel” to abort the printing. Figure 8-43 Print message box Calculating reproducibility This analyzer provides three reproducibility indices Mean, SD(Standard Deviation)and CV% ( Coefficient of Variation)., n ∑x Mean= i=1 n 8-29 i Reviewing Sample Results SD = ∑ (X − Mean ) 2 i n −1 CV% = SD × 100 % Mean where n represents how many sample results are selected and Xi is the result of the ith analysis. To check the reproducibility of the selected sample results, select at least three sample results and press [7] to view the reproducibility. If any selected result contains invalid parameter value (s), the reproducibility indices of that parameter(s) will also be invalid (***). To print out the displayed indices, press [PRIINT]; to exit the “Reproducibility” screen, press [MENU]. 8.3.3 Reviewing Search Result in the “Search Histogram Review” Mode z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z For every search, the analyzer can display a maximum of 500 matches. z The search result will be cleared if you have run another sample (including background check), or deleted a sample result, or restarted the analyzer after the search. Entering the “Search Histogram Review” screen Press [MENU] to enter the system menu. 8-30 Reviewing Sample Results Figure 8-44 System menu SELECT “Review → Search Review → Search Histogram Review” (Figure 8-44) to enter the “Search Histogram Review” screen (Figure 8-45). Figure 8-45 “Search Histogram Review” screen The sample information will be displayed at the upper part of the screen, followed by the parameter values and histograms. The “Location/Total” displayed in the upper right corner of the screen indicates the location of the current sample result and the total number of the saved sample results. Browsing sample results Press [←] or [→] to browse the preceding or following sample result; press [PgUp] or [PgDn] to jump 6 locations (e.g. jumping from location 1 to location 7). 8-31 Reviewing Sample Results Switching to the “Search Table Review” mode To switch to the “Search Table Review” mode, press [6]; to switch back to the “Search Histogram Review” mode, press [6] again. Jumping to a sample result with known location Press [1] to enter the “Goto” window, as Figure 8-46 shows. Figure 8-46 “Goto” window ENTER the location into the “Location” box and press [ENTER] to jump to the desired sample result. Editing sample information Press [F1] to edit the sample information, Figure 8-47 shows. Figure 8-47 Editing sample information ID You cannot edit the sample ID of an analyzed sample. 8-32 Reviewing Sample Results Selecting patient gender SELECT the desired item from the “Gender” pull-down list. Note that you can select blank in case you are not aware of the patient gender. Selecting the reference range SELECT the desired reference range from the “Range” pull-down list (see Chapter 6.5 for how to set the reference range). Entering the patient name ENTER the patient name into the “Name” box. Entering the patient age This analyzer provides three ways for you to enter the patient age – in years, in months and in days. The first way is designed for the patients no younger than one year; the second for the patients one month to one year; the third for the patients no older than one month. You can choose only one of the three ways to enter the patient age. To enter the patient age in years: ENTER the desired number, an integer from 0 to 200, into the “Years” box. To enter the patient age in months: ENTER the desired number, an integer from 0 to 12, into the “Months” box. To enter the patient age in days: ENTER the desired number, an integer from 0 to 31, into the “Days” box. Entering the chart number ENTER the number of the patient’s medical chart into the “Chart No.” box. Entering the bed number ENTER the number of the patient’s bed into the “Bed No.” box. Entering the department name You can either directly ENTER the name of the department, from which the sample came, into the “Depart.” box or SELECT the desired department from the “Depart.” pull-down list (if there are previously saved departments in the list). Entering the names of the sender, tester and checker To enter the name of the person who sent the sample for analysis, ENTER the name into the “Sender” box or SELECT the desired name from the “Sender” pull-down list (if there are previously saved names in the list) ; to enter the name of the person who ran the sample, ENTER the name into the “Tester” box or SELECT the desired name from the “Tester” 8-33 Reviewing Sample Results pull-down list (if there are previously saved names in the list) ; to enter the name of the person who reviewed the sample results, ENTER the name into the “Checker” box, or SELECT the desired name from the “Checker” pull-down list (if there are previously saved names in the list). All the three pull-down lists are capable of saving 30 entered names. “Enter” button When you have finished entering all the desired sample information, CLICK the “Enter” button (or press [F4] of the external keyboard) to save the changes and return to the “Search Histogram Review” screen. “Cancel” button If you do not want to save the entered information, CLICK the “Cancel” button to return to the ”Search Histogram Review” screen without saving the changes. Adjusting histograms If you are not satisfied with the obtained histograms, you can adjust them manually, provided you have the administrator password. The first three discriminators of the WBC histogram are adjustable. Note that if the WBC result is less than 0.5 or non-numeric (***), the WBC histogram is not adjustable. The first two discriminators of the RBC histogram are adjustable. Note that if the RBC result is less than 0.2 or non-numeric (***), the RBC histogram is not adjustable. The first two discriminators of the PLT histogram are adjustable. Note that if the PLT result is less than 10 or non-numeric (***), the PLT histogram is not adjustable. If a discriminator has been manually adjusted, all of the analysis results associated with this discriminator will be followed by an “A” immediately, and there will be a flag “A” over the discriminator after the operator switches to another discriminator or presses [ENTER] to save this adjustment. Example10: To move the second discriminator of the following WBC histogram to 100fL, follow the procedure below to do so. 1. Press [ENTER] and the discriminator will become adjustable. See Figure 8-48. 8-34 Reviewing Sample Results Figure 8-48 WBC histogram with adjustable discriminators 2. Press [↑] or [↓] to select the WBC histogram. 3. Press [2] to select the second discriminator, as Figure 8-49 shows. Figure 8-49 Adjusting discriminator (1) 4. Press [→] to move the second discriminator, as Figure 8-50 shows. 8-35 Reviewing Sample Results Figure 8-50 Adjusting discriminator (2) 5. Press [ENTER] and a message box will pop up, as Figure 8-51 shows. Figure 8-51 The message box to ask you to save the changes 6. CLICK “Enter” to save the changes and return to the “Search Histogram Review” screen. CLICK ”Cancel” to abort the changes and return to the “Search Histogram Review” screen. There will be a flag “A” over the corresponding discriminator if the adjustment is saved. 8-36 Reviewing Sample Results Figure 8-52 The screen after saving adjustment Printing sample results Press [PRINT] to print out the current sample result. 8-37 9 Using the QC Programs 9.1 Introduction Quality Control (QC) consists of strategies and procedures that measure the precision and stability of the analyzer. The results imply the reliability of the sample results. QC involves measuring materials with known, stable characteristics at frequent intervals. Helena recommends you run the QC program daily with low, normal and high level controls. A new lot of controls should be analyzed in parallel with the current lot prior to their expiration dates. This may be accomplished by running the new lot of controls twice a day for five days using any empty QC files. The QC files calculate the mean, standard deviation and coefficient of variation for each selected parameter. The instrument-calculated means of these ten runs should be within the expected ranges published by the manufacturer. The ICHOR II provides two QC programs: L-J Analysis and X-B Analysis. 9-1 Using the QC Programs 9.2 “L-J Analysis” Program Using the “L-J Analysis” program, you can provide quality control for 12 parameters. The analyzer provides 9 QC files for you to save QC settings and results. Every QC file can save the results of a maximum of 31 QC runs. When the saved QC results have reached the maximum number, the newest result will overwrite the oldest. The following introduction will use “File 1” as the example. 9.2.1 Editing L-J Settings z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Entering the “L-J Edit” screen Enter the administrator password as introduced in Chapter 6.4.1. Press [MENU] to enter the system menu. Figure 9-1 System menu SELECT “Quality Control→ L-J Analysis → L-J Edit → File 1” (Figure 9-1) to enter the “L-J Edit” screen (Figure 9-2). 9-2 Using the QC Programs Figure 9-2 “L-J Edit” screen If there are saved results and settings, you need to delete them first. Press [DEL] and a message box will pop up to confirm the deletion, as Figure 9-3 shows. Figure 9-3 A message box to confirm the deletion CLICK “Enter” to confirm the deletion; CLICK “Cancel” to abort the deletion. Entering lot number ENTER the lot number of the control to be used into the “Lot No.” box. Entering Exp. Date ENTER the expiration date of the control to be used into the “Exp. Date” box. Entering the expected results (mean) and limits (range) ENTER the expected results (mean) and limits (range) respectively into the “Mean” and “Range” boxes of the parameters to be included in the L-J analysis. 9-3 Using the QC Programs z Refer to the instructions for use of the control for information on the lot number, expiration date, open-vial stability days, expected results and limits. z The entered expiration date should be either the expiration date printed on the labeling or the open-vial expiration date, whichever is earlier. z The open-vial expiration date is calculated as follows: the date that vial is opened + the open-vial stability days. Deleting settings and results Press [DEL] to delete all the settings and results of the current file Printing settings Press [PRINT] to print out all the settings of current file. Exiting the “L-J Edit” screen Press [MENU] to exit to the system menu; press [MAIN] to exit to the “Count” screen. If you see the message box shown in Figure 9-4 or Figure 9-5, check the settings and make sure the expired dates are correct and all the selected parameters have valid expected results and limits(the expected results shall be greater than the limits) Figure 9-4 An “Invalid input” message box Figure 9-5 An “Invalid date” message box If all the entries are correct, a message box will pop up to remind you to save the changes, as 9-4 Using the QC Programs Figure 9-6 shows. CLICK “Enter” to save the changes and exit to the system menu (or the “Count” screen); CLICK “Cancel” to abort the changes and exit to the system menu (or the “Count” screen). Figure 9-6 A message box to confirm the changes 9.2.2 Running Controls z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z The sample probe tip is sharp and may contain biohazardous materials. Exercise caution to avoid contact with the probe when working around it. Entering the “L-J Count” screen Press [MENU] to enter the system menu. SELECT “Quality Control→L-J Analysis → L-J Count →File 1” to enter the “L-J Count” screen, as Figure 9-7 shows. 9-5 Using the QC Programs Figure 9-7 L-J Count screen (Whole blood) z Load the tube to the right tube position and double check the position before proceeding to the next step. z Use the Helena- specified controls. Using controls other than the specified will lead to misleading results. z Refer to the instructions for use of the controls for how to store and use them. z When switching from the Predilute mode to the Whole Blood mode, the analyzer will automatically flush the fluidic system. Running controls 1. Press [OPEN] to open the sample compartment door. 2. Rotate Position 1 or 2, depending on the size of the control vial, to the aspirating position. 3. Load a vial of mixed control (uncapped) to the aspirating position and close the door. 4. At the “L-J Count” screen, be sure the System Status area displays “Ready“. 5. Press [ASPIRATE]. The System Status area will display “Running” and the analyzer will 9-6 Using the QC Programs start aspirating control. The analysis progress will be displayed on the screen and the “NO./Total” in the upper left corner of the screen will automatically increase by 1. 6. When the analysis is finished, the result will be displayed on the screen. The sample compartment door will automatically open and the control can be removed. z If the analyzer detects WBC/RBC clogging or bubbles during the analysis, the corresponding error messages will be displayed in the upper left corner of the screen and the results of all the related parameters will be invalidated. See Chapter 12 Troubleshooting Your Analyzer for solutions. z If the ambient temperature is outside the specified range, the analyzer will alarm you for abnormal ambient temperature and the analysis results may be unreliable. See Chapter 12 Troubleshooting Your Analyzer for solutions. Browsing other L-J analysis results To browse the result of the preceding or following L-J analysis, press [PgUp] or [PgDn]. Deleting L-J results To delete the current result, enter the administrator password as introduced in Chapter 6.4.1 and press [DEL]. A message box will pop up, as Figure 9-8 shows. CLICK “Enter” to confirm the deletion; CLICK “Cancel” to abort the deletion. Figure 9-8 A message box to confirm the deletion Printing L-J results Press [PRINT] to print out the current L-J result by the printer. Exiting the “L-J Count” screen Press [MENU] to exit to the system menu, or press [MAIN] to exit to the “Count” screen. 9-7 Using the QC Programs 9.2.3 Reviewing L-J Analysis Results You can review the saved L-J results in either the “L-J Graph” mode or “L-J Table” mode. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. “L-J Graph” mode Entering the “L-J Graph” screen Press [MENU] to enter the system menu. Figure 9-9 System menu SELECT “Quality Control→ L-J Analysis→ L-J Graph→ File 1” (Figure 9-9) to enter the “L-J Graph” screen (Figure 9-10). 9-8 Using the QC Programs Figure 9-10 “L-J Graph” screen 1 The 12 parameters are displayed on three screens, 4 parameters on every screen, as Figure 9-10 to Figure 9-12 show. The saved L-J results are sequentially displayed in the L-J graph, the latest on the utmost right (No.1). The L-J graph can be interpreted as follows: The x-coordinate represents the number of the L-J analyses performed; the y-coordinate represents the results of the L-J analyses. For every parameter, its L-J graph can display a maximum of 31 points. For every parameter, the upper dash line represents the expected result + limit. For every parameter, the lower dash line represents the expected result – limit. For every parameter (e.g. WBC), the three numbers to the left of the graph are: 10.4 – the expected result + limit. 9.9 – the expected result. 9.4 – the expected result – limit. 9-9 Using the QC Programs Figure 9-11“L-J Graph” screen 2 Figure 9-12“L-J Graph” screen 3 For every parameter,the three numbers to the right of the L-J graph are defined and calculated as follows: Mean – the average of the saved L-J analyses. SD – Standard Deviation. CV% – Coefficient of Variation. 9-10 Using the QC Programs n ∑x Mean= i=1 n SD = ∑ (X CV% = i − Mean ) 2 i n −1 SD × 100 % Mean where, n is the number of the saved L-J analyses and Xi is the result of the ith L-J analysis. If the saved L-J analyses are less than 3, only the “Mean” will be displayed. For a parameter, if any of the saved results is non-numeric (*), the “Mean”, “SD” and “CV%” are all empty. The “■” and “□”points in the graphs can be interpreted as follows: The “■” points fallen between the upper and lower dash lines are within the expected ranges. The “■”points fallen outside the upper or lower dash lines are out of the expected ranges. The “□” points represent non-numeric parameter values (*), which can be caused by either errors during the run or values outside the operating range. If you see any points fallen outside the control range, do the following steps until the problem is solved. If all the steps have failed, contact Helena customer service department or your local distributor for assistance. 1. Check the upper left corner of the screen for error messages. Refer to Chapter 12Troubleshooting Your Analyzer for solutions to any displayed error messages. 2. Check the L-J settings for inappropriate entries. 3. Do the background check. In case of an abnormal background result, refer to Chapter 12 Troubleshooting Your Analyzer for solutions. 4. Re-run the control. 5. Run another vial of control. 6. Check if the analyzer needs to be calibrated. Browsing L-J analysis results Press [↑] or [↓] to review the preceding or following screen; press [←] or [→] to review the preceding or following result. The parameter value of the current point (the one the cursor is located at) is displayed below the parameter box. The location of the current point is displayed in the “No.” field. The analysis time is displayed in the “Time” field. Printing L-J graphs 9-11 Using the QC Programs Press [PRINT] to print out the displayed L-J graphs. Exiting the “L-J Graph” screen Press [MENU] to exit to the system menu, or press [MAIN] to exit to the “Count” screen. “L-J Table” mode Entering the “L-J Table” screen Press [MENU] to enter the system menu. Figure 9-13 System menu SELECT “Quality Control → L-J Analysis →L-J Table → File 1” (Figure 9-13) to enter the “L-J Table” screen (Figure 9-14). Every screen displays 5 results. The parameter values fallen outside the expected range will be flagged “H” (higher than the upper limit) or “L” (lower than the lower limit). Figure 9-14 “L-J Table” screen 9-12 Using the QC Programs Browsing L-J analysis results Press [PgUp] or [PgDn] to review the preceding or following screen. Deleting L-J analysis results Enter the administrator password as introduced in Chapter 6.4.1 and press [DEL]. A message box will pop up to ask you whether to delete all the L-J results saved in this file, as Figure 9-15 shows. CLICK “Enter” to confirm the deletion; CLICK “Cancel” to abort the deletion. Figure 9-15 A message box to confirm the deletion Transmitting L-J analysis results to a host If you want to transmit all the L-J analysis results to an external computer (a host), press [1] and a message box will pop up to confirm the transmission, as Figure 9-16 shows. CLICK “Enter” to confirm the transmission;CLICK “Cancel” to abort the transmission. Figure 9-16 A message box to confirm the transmission Printing L-J analysis results Press [PRINT] to print out all the L-J analysis results. Exiting the “L-J Table” screen Press [MENU] to exit to the system menu, or press [MAIN] to exit to the “Count” screen. 9-13 Using the QC Programs 9.3 “X-B Analysis” Program The X-B analysis is a weighted moving average analysis that uses values obtained from patient samples. It was proposed by Brian Bull, M.D. using the 3 red cell indices, MCV, MCH and MCHC to indicate the hematology instrument performance. Effective use of X-B requires randomization of samples and a normal cross section of patients to prevent skewing of indices. It is recommended the X-B analysis be activated when the sample volume of your laboratory is greater then 100 samples per day. 9.3.1 Editing X-B Settings z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Entering the “X-B Edit” screen Enter the administrator password as introduced in Chapter 6.4.1. Press [MENU] to enter the system menu. Figure 9-17 System menu SELECT “Quality Control → X-B Analysis → Limit” (Figure 9-17) to enter the “Limit” screen (Figure 9-18). 9-14 Using the QC Programs Figure 9-18 “Limit” screen If there are saved results and settings, you need to delete them first. Press [DEL], a message box will pop up to confirm the deletion, as Figure 9-19 shows. Figure 9-19 A message box to confirm the deletion CLICK “Enter” to confirm the deletion; CLICK “Cancel” to abort the deletion. Entering the expected results (mean) and limits (range) The expected results vary depending on laboratories. It is recommended they are obtained by calculating the averages of at least 500 random patient samples. The recommended limit is 3% - 5%. z Calibrate your analyzer before trying to establish the expected results by calculating the averages of random patient samples. 9-15 Using the QC Programs ENTER the expected results (mean) and limits (range) respectively into the “Mean” box and “Range” boxes of the parameters to be included in the QC run. Deleting settings and results of current file Press [DEL] to delete all the settings. Printing settings of current file Press [PRINT] to print out all the settings. Exiting the “Limit” screen Press [MENU] to exit to the system menu, or [MAIN] to exit to the “Count” screen. If you see the message box shown in Figure 9-20, check the settings and make sure the all selected parameters have valid expected results and limits(the expected results shall be greater than the limits) Figure 9-20 An “Invalid input” message box CLICK “Enter” to close the box and clear the erroneous entries. Re-enter the correct values before trying to exit the screen again. The settings can be saved only when both the expected result and limit are valid. If all the entries are correct, a message box will pop up to remind you to save the changes, as Figure 9-21 shows, CLICK “Enter” to save the changes and exit to the system menu (or the “Count” screen) . CLICK “Cancel” to abort the changes and exit to the system menu (or the “Count” screen). Figure 9-21 A message box to save the changes 9-16 Using the QC Programs 9.3.2 Setting Frequency of X-B Analysis The X-B analysis is performed on batches of certain number of patient samples. To determine how many samples are to be included in every batch, follow the steps below: z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Entering the “Samples/Batch” screen Enter the administrator password as introduced in Chapter 6.4.1. Press [MENU] to enter the system menu. Figure 9-22 System menu SELECT “Quality Control→ X-B Analysis → Samples/Batch” (Figure 9-22) to enter the “Samples/Batch” screen (Figure 9-23). 9-17 Using the QC Programs Figure 9-23 “Samples/Batch” screen Setting Samples/Batch ENTER the desired number, which should be 20 to 200. 20 is recommended. Exiting the “Sample/Batch” screen Press [MENU] to exit to the system menu; press [MAIN] to exit to the “Count” screen. 9.3.3 Activating/deactivating X-B Analysis z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Entering the “Start/Stop” screen Enter the administrator password as introduced in Chapter 6.4.1. Press [MENU] to enter the system menu. 9-18 Using the QC Programs Figure 9-24 System menu SELECT “Quality Control→ X-B Analysis→ Start/Stop” (Figure 9-24) to enter the “Start/Stop” screen (Figure 9-25). Figure 9-25 Activating/deactivating X-B analysis Random samples are required for the X-B analysis. In case of known samples of a particular type (oncology, neonatal and so forth) that will seriously interfere with the X-B results, deactivate the X-B analysis. Activating/deactivating X-B analysis Press [PgUp] or [PgDn] to activate/deactivate X-B analysis. Exiting the ”Start/Stop” screen 9-19 Using the QC Programs Press [MENU] to exit to the system menu, or [MAIN] to exit to the “Count” screen. A message box will pop up to remind you to save the changes, as Figure 9-26 shows. CLICK “Enter” to save the changes and exit to the system menu (or the “Count” screen); CLICK “Cancel” to abort the changes and exit to the system menu (or the “Count” screen). Figure 9-26 A message box to confirm the changes 9.3.4 Performing X-B Analysis Once activated, the X-B analysis will be performed on batches of patient samples of the defined number (20 - 200). The analysis results will be displayed on the X-B graph as well as the X-B table. 9.3.5 Reviewing X-B Analysis Results You can review the X-B analysis results in either the “X-B Graph” mode or “X-B Table” mode. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. “X-B Graph” mode Entering the “X-B Graph” screen Press [MENU] to enter the system menu. 9-20 Using the QC Programs Figure 9-27 System menu SELECT “Quality Control → X-B Analysis → X-B Graph” (Figure 9-27) to enter the “X-B Graph” screen (Figure 9-28). Figure 9-28 “X-B Graph” screen The saved X-B analysis results are sequentially displayed in the X-B graph, the latest on the utmost right (No.1). The X-B graph can be interpreted as follows: The x-coordinate represents the number of X-B analyses performed; the y-coordinate represents the results of the X-B analyses. For every parameter, its X-B graph can display a maximum of 500 points, 30 points per screen. 9-21 Using the QC Programs For every parameter, the upper dash line represents the expected result + limit. For every parameter, the lower dash line represents the expected result – limit. For every parameter (e.g. MCV), the three numbers to the left of the X-B Figure are defined as follows: 100 – expected result + limit. 90 – expected result. 80 – expected result – limit. The “■”points fallen between the upper and lower dash lines are within the expected ranges. The “■”points fallen outside the upper or lower dash lines are out of the expected ranges. If you see any points fallen outside the control range, do the following steps until the problem is solved. If all the steps have failed, contact Helena customer service department or your local distributor for assistance. 1. Check the upper left corner of the screen for error messages. Refer to Chapter 12 Troubleshooting Your Analyzer for solutions to any displayed error messages. 2. Check the X-B settings for inappropriate entries. 3. Do the background check. In case of an abnormal background result, refer to Chapter 12 Troubleshooting Your Analyzer for solutions. 4. Run the controls. 5. Check if the analyzer needs to be calibrated. Browsing X-B analysis results Press [↑] or [↓] to review the preceding or following screen; press [←] or [→] to review the preceding or following result. The parameter value of the current point (the one the cursor is located at) is displayed below the parameter. The location of the current point is displayed in the “No.” field. The analysis time is displayed in the “Time” field. Printing X-B graphs Press [PRINT] to print out the displayed X-B graphs. Exiting the “X-B Graph” screen Press [MENU] to exit to the system menu, or press [MAIN] to exit to the “Count” screen. “X-B Table” mode Entering the “X-B Table” mode Press [MENU] to enter the system menu. 9-22 Using the QC Programs Figure 9-29 System menu SELECT “Quality Control → X-B Analysis → X-B Table → File 1” (Figure 9-29) to enter the “X-B Table” screen (Figure 9-30). Every screen displays 5 results. The parameter value fallen outside the expected range will be flagged “H” (higher than the upper limit) or “L” (lower than the lower limit). Figure 9-30 “X-B Table” screen Browsing X-B analysis results Press [PgUp] or [PgDn] to review the preceding or following screen. Deleting X-B analysis results Enter the administrator password as introduced in Chapter 6.4.1. Press [DEL] and a message box will pop up to ask you whether to delete all the X-B analysis results saved in 9-23 Using the QC Programs this file, as Figure 9-31 shows. CLICK “Enter” to confirm the deletion; CLICK “Cancel” to abort the deletion. Figure 9-31 A message box to confirm the deletion Printing X-B analysis results Press [PRINT] to print out the displayed results by the printer. Exiting the “X-B Table” screen Press [MENU] to exit to the system menu; press [MAIN] to exit to the “Count” screen. 9-24 10 Using the Calibration Programs 10.1 Introduction The purpose of the calibration is to maintain system accuracy. Quality of the calibration depends on the calibration materials and reagents used. You should only use the calibrator and reagents specified by Helena for the calibration. Store and use the calibrator and reagents as directed by their instructions for use. 10-1 Using the Calibration Programs 10.2 When to Calibrate You should run the calibration program if: it is the first time the analyzer has been used. certain major component (s) of the analyzer has been changed. the quality control results indicate there may be a problem. z All of the measured parameters must be calibrated before readings of this analyzer can be used as valid analysis results. 10-2 Using the Calibration Programs 10.3 How to Calibrate The analyzer provides 2 calibration programs: manual calibration and auto calibration using commercial calibrator. 10.3.1 Preparing Your Analyzer z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Do the following pre-calibration procedures before calibration. If problems are detected during these checks, do not attempt to calibrate the analyzer. If necessary, call Helena customer service department or your local distributor for assistance. Check and make sure there are enough reagents for the calibration. Do the background check. If the analyzer alarms you to abnormal background results, see Chapter 12 Troubleshooting Your Analyzer for solutions. Enter the “Count” screen and run a vial of normal control 11 consecutive times. Enter the “Review” screen to check the reproducibility of the second to eleventh runs and make sure they meet the requirements in Table 10-1. z Use the Helena- specified controls. Using controls other than the specified will lead to misleading results. z Refer to the instructions for use of the controls for how to store and use them. 10-3 Using the Calibration Programs Table 10-1 Reproducibility Parameter Expected range 3 7.0 - 15.0 × 10 /µL WBC 6 CV% ≤ 3.0 RBC 3.50 - 6.00 × 10 /µL ≤ 2.5 HGB 11.0 – 18.0 g/dL ≤ 2.0 MCV 80.0 - 110.0 fL ≤ 2.0 3 200 - 400 × 10 /µL PLT ≤ 6.0 At the “Count” screen, run a vial of high control three consecutive times and then immediately run the diluent three consecutive times, calculate the carryover per the following equation. Carryover(%) = First low - level sample result-Third low - level sample result × 100% Third high - level sample result-Third low - level sample result The calculated carryovers shall meet the following requirements: WBC, RBC and HGB shall be no greater than 0.5 %; PLT shall be no greater than 1%. It is recommended that you create a log table for your analyzer. This log table should contain all necessary information that is pertinent to your analyzer. Suggested items that you may want to include in the log table are: calibration date supplier of calibrator lot number expected results result of background check. Enter the administrator password as instructed in Chapter 6.4.1 and then choose one or several parameters among WBC, RBC, HGB, MCV and PLT for calibration. 10-4 Using the Calibration Programs 10.3.2 Calibration Program with Calibrator z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z When switching from the Predilute mode to the Whole Blood mode, the analyzer will automatically wash the fluidic system. Entering Calibrator screen Press [MENU] to enter the system menu. Figure 10-1 System menu SELECT “Calibration → Calibrator” (Figure 10-1) to enter the “Calibrator” screen (Figure 10-2). 10-5 Using the Calibration Programs Figure 10-2 “Calibrator” screen Editing calibration settings Press [ENTER] to activate the edit boxes. Entering lot number ENTER the lot number of the calibrator to be used into the “Lot No.” box. Entering Exp. Date ENTER the expiration date of the calibrator to be used into the “Exp. Date” box. Entering the expected results (mean) ENTER the expected results (mean) into the “Mean” boxes of the parameters included in the calibration. z Refer to the instructions for use of the calibrator for information on the lot number, expiration date, open-vial stability days, and expected results. z The entered expiration date should be either the expiration date printed on the labeling or the open-vial expiration date, whichever is earlier. z The open-vial expiration date is calculated as follows: the date that vial is opened + the open-vial stability days. When you have finished editing the settings, press [ENTER] to deactivate the edit boxes. 10-6 Using the Calibration Programs Running calibrator z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z The sample probe tip is sharp and may contain biohazardous materials. Exercise caution to avoid contact with the probe when working around it. z Do not re-use disposable products. z Load the tube to the right tube position and double check the position before proceeding to the next step. z Use the Helena- specified calibrator. Using calibrator other than the specified will lead to misleading results. Do not use other calibrator. z Refer to the instructions for use of the calibrator for how to store and use the calibrator. 1. Press [OPEN] to open the sample compartment door. 2. Rotate Position 1 to the aspirating position. 3. Load a vial of mixed calibrator (uncapped) to it and close the door. 4. At the “Calibrator” screen, be sure the System Status area displays “Ready“ and the Count Mode area displays “Whole“. 5. Press [ASPIRATE]. The System Status area will display “Running” and the analyzer will start aspirating sample. The analysis progress will be displayed on the screen. 6. When the analysis is finished, the sample compartment door will automatically open and the control can be removed. The result will be displayed on the screen. 10-7 Using the Calibration Programs Saving the calibration results If non-numeric parameter values (“***”) are obtained, a message box will pop up to warn you, as Figure 10-3 shows. CLICK “Enter” to clear the results. Figure 10-3 A message box to warn you about the invalid results If all the parameter values obtained are numeric, a message box will pop up to confirm the validity of the results, as Figure 10-4 shows. Figure 10-4 A message box to confirm the validity CLICK “Enter” to save the results; CLICK “Cancel” to abort the result. The saved results will be displayed on the screen. Repeat the above steps to run the calibrator 4 to 11 times (11 is recommended) and the analyzer will automatically calculate the CVs and calibration factors, as Figure 10-5 shows. Be sure the CVs meet the requirements of Table 10-1. 10-8 Using the Calibration Programs Figure 10-5 Results of the auto calibration The calculated calibration factor should be within the 75% - 125%. Any calculated value that falls between 0% - 75% or 125% - 9999% will be flagged with a “*”. Other values will not be displayed. In case of an empty calibration factor, try to find out the reason and if necessary, contact Helena customer service department or your local distributor for assistance. Saving new factors and Exiting the “Auto Calibration” screen Press [MENU] to exit to the system menu or [MAIN] to exit to the “Count” screen. If you want to leave calibration program when less than 4 calibrators has been run, a message box will pop up to confirm your action, as Figure 10-6 shows. Figure 10-6 A message box to confirm CLICK “Enter” to discard the calibration data and leave calibration program; CLICK “Cancel” to continue running more calibrators. In other cases, a message box will pop up to confirm the new calibration factors, as Figure 9-13 shows. CLICK “Enter” to save the new factors and exit to the system menu or the “Count” screen; CLICK “Cancel” to abort the new factors and exit to the system menu or the “Count” screen. 10-9 Using the Calibration Programs Figure 10-7 A message box to confirm the new calibration factors Printing new calibration factors Press [PRINT] to print out the new calibration factors. Verifying new calibration factors At the “Count” screen, run the calibrator or a normal control at least 5 consecutive times and calculate the means of the results. The means should be within the expected ranges supplied by the manufacturer. If not, contact Helena customer service department or your local distributor for assistance. 10.3.3 Manual Calibration Program If needed, you may run the calibration material at the “Count” screen and calculate the calibration factors manually. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Selecting count mode Press [MENU] and SELECT “Sample Mode” to enter the “Sample Mode” screen. SELECT “Whole Blood” or “Predilute” from the “Sample Mode” pull-down list. z Once switching from the Predilute mode to the Whole Blood mode, the analyzer will automatically wash the fluidic system. 10-10 Using the Calibration Programs Entering Count screen Press [MENU] to enter the system menu. SELECT “Count” (Figure 10-9) to enter the “Count” screen (Figure 10-9). Figure 10-8 System menu Figure 10-9 “Count” screen Running the calibration material After you have selected the desired sample mode, refer to the sample handling and analysis procedures introduced in Chapter 7 Operating Your Analyzer and run the calibration material with known expected results 11 consecutive times. 10-11 Using the Calibration Programs Checking the reproducibility When you have finished running the calibration material, enter the “Sample Table Review” screen to check the Mean, SD and CV% of the 2nd to 11th runs. Press [MENU] to enter the system menu as Figure 10-10 shows. Figure 10-10 System menu SELECT “Review → Sample Review → Sample Table Review” to enter the “Sample Table Review” screen, as Figure 9-19 shows. Figure 10-11 “Sample Table Review” screen Check the reproducibility as instructed in Chapter 8.2.1. If the reproducibility meets the requirements listed in Table 10-1, record the Mean of the last 10 runs for calculating the new calibration factors. If the reproducibility of the calibrated parameter does not meet the requirements of Table 10-1, you must try to find out the reason and re-run the calibration materials after you have solved the problem. If necessary, contact Helena customer service department or your local distributor for assistance. 10-12 Using the Calibration Programs Calculating the new calibration factors manually Use the following formula to calculate the new calibration factor. new factor = old factor × exp ected result recorded mean The calculated new calibration factor should be within 75%-125%. If not, try to find out the reason and if necessary, call Helena customer service department or your distributor for assistance. Entering the manually calculated factors Press [MENU] to enter the system menu. Figure 10-12 System menu SELECT “Calibration → Manual” (Figure 10-12) to enter the “Manual” screen (Figure 10-13). 10-13 Using the Calibration Programs Figure 10-13 “Manual Calibration” screen Press [ENTER] to activate the edit boxes as Figure 10-14 shows. Figure 10-14 Edit boxes activated ENTER the calculated calibration factors into the corresponding boxes. Saving new factor and Exiting the “Manual” screen Press [MENU] to exit to the system menu. If the new factors are within 75%-125%, a message box will pop up to confirm the new calibration factors, as Figure 10-15 shows. CLICK “Enter” to save the new factors and exit to the system menu; CLICK “Cancel” to abort 10-14 Using the Calibration Programs the new factors and exit to the system menu. Figure 10-15 A message box to confirm the new calibration factors If the new factors are not within 75%-125%, a message box will pop up to note the invalid factors, as Figure 10-16 shows. CLICK “Enter” to close the message box and the invalid factors can not be saved. Figure 10-16 A message box to note invalid factors Printing new calibration factors Press [PRINT] to print out the current calibration factors. Verifying new calibration factors Verify the new calibration as instructed in Chapter 10.3.2. 10-15 11 Maintaining Your Analyzer 11.1 Introduction Preventive and corrective maintenance procedures are required to keep the ICHOR II in a good operating condition. This analyzer provides multiple maintenance functions for this purpose. This chapter introduces how to use the provided functions to maintain and troubleshoot your analyzer. z Do not perform any maintenance procedures that are not described in this chapter. Performing unauthorized maintenance procedures can damage your analyzer. z In case of problems not specified in this manual, contact Helena customer service department or your local distributor for assistance. z Only Helena-supplied parts can be used for maintenance. For any questions, contact Helena customer service department or your local distributor. 11-1 Maintaining Your Analyzer 11.2 Using the “Maintenance” Program 11.2.1 Entering the “Maintenance” screen z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] to enter the system menu. SELECT “Service → Maintenance” (Figure 11-1) to enter the “Maintenance” screen (Figure 11-2). Figure 11-1 System menu 11-2 Maintaining Your Analyzer Figure 11-2 “Maintenance” screen 11.2.2 Diluent Prime z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Let the reagents stand for a while before using them. z After installing a new container of diluent, rinse or lyse, do a background check to ensure the background results are normal. You should perform the “Diluent Prime” procedure to prime the diluent tubing when you have installed a new container of diluent without shutting down the analyzer. SELECT “Diluent Prime” to prime the tubing with diluent, as Figure 11-3 shows. 11-3 Maintaining Your Analyzer Figure 11-3 Priming diluent When the priming is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11.2.3 Rinse Prime z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Let the reagents stand for a while before using them. z After installing a new container of diluent, rinse or lyse, do a background check to ensure the background results are normal. You should perform the “Rinse Prime” procedure to prime the rinse tubing when WBC/RBC bubbles are reported; or you have installed a new container of rinse without shutting down the analyzer. 11-4 Maintaining Your Analyzer SELECT “Rinse Prime” to prime the tubing with rinse, as Figure 11-4 shows. Figure 11-4 Priming rinse When the priming is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11.2.4 Lyse Prime z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Let the reagents stand for a while before using them. z After installing a new container of diluent, rinse or lyse, do a background check to ensure the background results are normal. You should perform the “Lyse Prime” procedure to prime the lyse tubing when you have installed a new container of lyse without shutting down the analyzer. 11-5 Maintaining Your Analyzer SELECT “Lyse Prime” to prime the tubing with lyse, as Figure 11-5 shows. Figure 11-5 Lyse priming When the priming is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11.2.5 Zap Apertures You can perform the “Zap Apertures” procedure to unclog the apertures or prevent clogging. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. SELECT “Zap Apertures” to zap the apertures, as Figure 11-6 shows. 11-6 Maintaining Your Analyzer Figure 11-6 Zapping apertures When the zapping is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11.2.6 Flush Apertures You should perform the “Flush Apertures” procedure to flush the apertures after you have zapped the apertures. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. SELECT “Flush Apertures” to flush the apertures, as Figure 11-7 shows. 11-7 Maintaining Your Analyzer Figure 11-7 Flushing apertures When the flushing is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11.2.7 Probe Cleanser Cleaning z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Do not re-use collection tube needed for probe cleanser cleaning over 5 times. Replace it periodically. You should perform the “Probe Cleanser Cleaning” procedure every week to clean the baths and fluidic lines with the probe cleanser. Follow the steps given below to do so: 1. Press the arrow keys ([←][→] [↑][↓]) as needed to move the cursor to “Probe Cleanser 11-8 Maintaining Your Analyzer Cleaning”. 2. Press [OPEN] to open the sample compartment door. 3. Rotate Position 1 to the aspirating position. 4. Pipette 4 to 5 mL probe cleanser to a clean collection tube, then load the tube to the aspirating position and close the sample compartment door. Make sure the collection tube is not capped. 5. Press [ENTER] to start the aspiration, as Figure 11-8 shows. 6. When the aspiration is done, the sample compartment door will open automatically. Take out the tube and close the sample compartment door. 7. Press [ENTER] to start the 15-minute cleaning process, as Figure 10-9 shows. Note that if you want to end the cleaning process before the time is due, you can press [ENTER]. However, a shortened cleaning process may not be as effective as a complete one. 8. When the cleaning is done, the analyzer will start the draining process, as Figure 11-10 shows. When the draining is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. Figure 11-8 Aspirating probe cleanser 11-9 Maintaining Your Analyzer Figure 11-9 Cleaning baths and fluidic lines Figure 11-10 draining process To make sure this analyzer functions normally, every time the analyzed samples add up to 1000, a message box will pop up to remind you to perform the “Probe cleanser cleaning” procedure, as Figure 11-11 shows. You may CLICK “Enter” to proceed with the cleaning, or CLICK “Cancel” to ignore the message. 11-10 Maintaining Your Analyzer Figure 11-11 A message box to confirm the cleaning 11.2.8 E-Z Cleanser Cleaning z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. If you have run your analyzer for 24 continuous hours, you need to perform the “E-Z Cleanser Cleaning” procedure to clean the fluidic lines and the baths. Follow the steps given below to do so: 1. Press the arrow keys ([←][→] [↑][↓]) as needed to move the cursor to “E-Z Cleanser Cleaning” . 2. Press the [OPEN] key to open the sample compartment door as the screen shows. 3. Rotate Position 1 to the aspirating position. 4. Pipette 3 to 5mL of E-Z cleanser to a clean collection tube, then load the tube to the aspirating position and close the sample compartment door. Make sure the collection tube is not capped. 5. Press [ENTER] to start the aspiration, as Figure 10-12 shows. 11-11 Maintaining Your Analyzer Figure 11-12 Aspirating E-Z cleanser 6. When the aspiration is done, the sample compartment door will open automatically. Take out the tube and close the sample compartment door. The analyzer will start the 8-hour cleaning process, as Figure 11-13 shows. Note that you can choose to end the cleaning process before the time is due by pressing [ENTER]. However, a shortened cleaning process may not be as effective as a complete one. Figure 11-13 E-Z cleanse cleaning 7. When the cleaning is done, the analyzer will start the draining process, as Figure 10-14 shows. 11-12 Maintaining Your Analyzer Figure 11-14 Draining the baths and fluidic lines 8. When the draining is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11.2.9 Cleaning Baths z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. SELECT “Clean Baths” to start the cleaning procedure, as Figure 11-15 shows. When the cleaning is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11-13 Maintaining Your Analyzer Figure 11-15 Cleaning the baths 11.2.10 Drain Tubing z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. z Do the “Empty Tubing” procedure and remove the tube from the sample compartment before relocating the analyzer. You can perform the “Drain Tubing” procedure to drain the fluidic system. Follow the steps given below to do so: 1. Press the appropriate arrow keys ([←][→] [↑][↓]) as needed to move the cursor to “Drain Tubing”. 2. Follow the displayed instructions to remove the diluent, rinse and lyse pickup tubes from this analyzer and then press [ENTER] to start the draining process.. 11-14 Maintaining Your Analyzer Figure 11-16 Draining the fluidic lines 3. When the draining is done, the screen will display “Turn off this analyzer” and you should turn off the power switch. 11.2.11 Reset Tubing z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. SELECT “Reset Tubing” to reset the fluidic system. 11-15 Maintaining Your Analyzer Figure 11-17 Resetting the fluidic system When the resetting is done, a message box will pop up to inform you so. CLICK “Enter” to close the message box. 11.2.12 Exit the “Maintenance” screen z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] to exit the “Maintenance” screen. 11-16 Maintaining Your Analyzer 11.3 Using the “System Status” Program The items displayed in the “System Status” screen reflect how the analyzer is functioning and contribute significantly to diagnosing analyzer errors. You may follow the instructions given below to check those items. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] to enter the system menu. SELECT “Service” → “System Status” (Figure 11-18) to enter the “System Status” screen (Figure 11-19). Figure 11-18 System menu 11-17 Maintaining Your Analyzer Figure 11-19 “System Status” screen At the “System Status” screen you can only view the displayed status information and reference ranges. Press [MENU] to exit to the system menu and the screen will display “Resetting” and the system menu will pop up later. 11-18 Maintaining Your Analyzer 11.4 Using the “Valve Test” Program Malfunctioning valves will lead to fluidic system malfunctions. Therefore, testing the valves is a major way to remove fluidic errors. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] to enter the system menu. SELECT “Service → Valve Test” (Figure 11-20) to enter the “Valve Test” screen (Figure 11-21). Figure 11-20 System menu 11-19 Maintaining Your Analyzer Figure 11-21 “Valve Test” screen SELECT the valve you want to check and press [ENTER] to test it. If the valve goes through the Off-On-Off sequence without making any abnormal sound, it passes the test. Otherwise, something may be wrong with the valve. Press [MENU] to exit to the system menu and the screen will display “Resetting” and the system menu will pop up later. z “V7” and “V17” cannot be tested when something is wrong with the vacuum chamber. 11-20 Maintaining Your Analyzer 11.5 Using the “System Test” Program Press [MENU] to enter the system menu. SELECT “Service → System Test” (Figure 11-22) to enter the “System Test” screen (Figure 11-23). z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. SELECT the desired item to perform the corresponding test. Figure 11-22 System test 11-21 Maintaining Your Analyzer Figure 11-23 System test screen Press [MENU] to exit to the system menu and the screen will display “Resetting” and the system menu will pop up later. 11-22 Maintaining Your Analyzer 11.6 Using the “Prepare to ship” Program You can use the “Prepare to ship” program to prepare your analyzer for a prolonged period of non-use or for shipping. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] to enter the system menu. SELECT “Service → Prepare to Ship” (Figure 11-24) to enter the “Prepare to Ship” screen (Figure 11-25). Figure 11-24 System menu 11-23 Maintaining Your Analyzer Figure 11-25 “Prepare to Ship” screen Follow the steps below to do so: 1. Remove the tube from the sample compartment. 2. Remove the diluent, rinse and lyse pickup tubes from their containers and press [ENTER]. A message box will pop up to confirm the operation, as Figure 11-26 shows. Figure 11-26 A message box to confirm the operation 3. CLICK “Enter” to proceed with the operation. 4. The analyzer starts to drain the tubing. 11-24 Maintaining Your Analyzer Figure 11-27 Draining fluidic lines 5. When the draining is done, place the diluent, rinse and lyse pickup tubes into a container filled with distilled water and press [ENTER], as the Figure 11-28 shows. Figure 11-28 Washing the analyzer 6. When the washing is done, remove the diluent, rinse and lyse pickup tubes from the distilled water and press [ENTER] to drain the fluidic lines. 7. When the draining is done and the screen displays “You can turn off the analyzer now!”, turn off the analyzer as instructed. 11-25 Maintaining Your Analyzer 8. Remove the diluent, rinse and lyse pickup tubes and all the cables and sensors from this analyzer. 9. Wipe the analyzer and the pickup tubes dry and pack it in its original box. 11-26 Maintaining Your Analyzer 11.7 Using the “Error Message” Program The analyzer can store a maximum of 1,000 latest error messages. When the maximum number has been reached, the latest overwrites the earliest. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Press [MENU] to enter the system menu. SELECT “Service → Error Message” (Figure 11-29) to enter the “Error Message” screen (Figure 11-30). Figure 11-29 System menu 11-27 Maintaining Your Analyzer Figure 11-30 “Error message” screen Press [↑] or [↓] to browse the error messages. Press [PRINT] to print out the displayed error messages. Press [MENU] to exit the “Error Message” screen. 11-28 Maintaining Your Analyzer 11.8 Replacing the Filter of the Vacuum Chamber You need to replace the filter of the vacuum chamber when there is an air filter error. Follow the steps below to do so: z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 1. Push the right door latch in the direction indicated in Figure 11-31. Figure 11-31 Push the right door latch 2. Find the filter shown in Figure 11-32. 11-29 Maintaining Your Analyzer Figure 11-32 Vacuum filter 3. Remove the filter and take a new one from the accessory kit and install it. 4. Close the right door. 11-30 12 Troubleshooting Your Analyzer 12.1 Introduction The ICHOR II continuously monitors the status of the system and displays pertinent information in the upper left corner of the “Count” screen (the Error Message area). If a problem is detected, the Error Message area displays the corresponding error message. This chapter contains information that is helpful in locating and correcting problems that may occur during operation of your analyzer. z Unless otherwise instructed, always turn off the power before trying to fix the error. z This chapter is not a complete service manual and is limited to problems that are readily diagnosed and/or corrected by the user of the analyzer. If the recommended solution fails to solve the problem, contact Helena customer service department or your local distributor. z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 12-1 Troubleshooting Your Analyzer 12.2 Errors without Error Messages z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Error Possible Cause(s) The analyzer cannot be turned on. 1. The power broken or Recommended Action cord not is well connected. 1. Check the power cord connection. 2. Check the fuse. 3. Check the power outlet. 2. The fuse is broken. 3. The power outlet has no electricity. Liquid drips from analyzer inside. Damaged pump hose or blocked filter. 1. Turn off the power and wipe the analyzer dry. 2. Call Helena customer service department or your local distributor for assistance. Recorder does not work. 1. Recorder paper is jammed. 1. Remove the jammed paper. 2. If the problem remains, turn off the 2. Something is wrong with the circuit. analyzer and turn it on again in 10 seconds. 12-2 Troubleshooting Your Analyzer 12.3 Errors Indicated by Error Messages See the tables below for the error messages and their probable causes and recommended action. If the problem still remains after you have tried the recommended solutions, contact Helena customer service department or your local distributor. 12.3.1 Pressure Errors z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Error Message Possible Cause(s) PC Pressure Low The pressure Recommended Action inside the 1. Enter the “Service → System Test” pressure chamber does not screen and test the “PC Pressure” reach the expected value as instructed in Chapter 11.5. The within the given time error will be removed if the test result is normal. 2. If the problem remains, contact Helena customer service department or your local distributor. Vacuum Low The vacuum degree does not 1. Check the tubes connected to the reach the expected value back of the analyzer and make sure within the given time. they are not pressed. 2. If the tubes are fine, enter the “Service → System Test” screen and test the “Vacuum” as instructed in Chapter 11.5. The error will be removed if the test result is normal. 3. If the problem remains, contact 12-3 Troubleshooting Your Analyzer Helena customer service department or your local distributor. VC Pressure Low The pressure inside the 1. Enter the “Service → System Test” vacuum chamber does not screen and do the “VC Pressure” reach the expected value procedure as instructed in Chapter within the given time. 11.5. The error will be removed if the test result is normal. 2. If the problem remains, contact Helena customer service department or your local distributor. Vacuum Filter Error The air inside the vacuum chamber is not extracted within the given time. 1. Enter the “Service → System Test” screen and test the “Vacuum” as instructed in Chapter 11.5. The error will be removed if the test result is normal. 2. If the problem remains, change a new filter. 3. If the problem remains, contact Helena customer service department or your local distributor. 12.3.2 Reagent Errors z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Error Message Possible Cause(s) Recommended Action Lyse Empty No lyse or a malfunctioning level transducer. 12-4 1. Check if the lyse has run out and if Troubleshooting Your Analyzer so. 2. Change a new container of lyse as instructed in Chapter 5.4.2. 3. If the problem remains, contact Helena customer service department or your local distributor. Diluent Empty No diluent or a malfunctioning level transducer. 1. Check if the diluent has run out, and if so. 2. Change a new container of diluent as instructed by Chapter 5.4.2. 3. If the problem remains, contact Helena customer service department or your local distributor. Rinse Empty No rinse or a malfunctioning level transducer. 1. Check if the rinse has run out, and if so, 2. Change a new container of rinse as instructed by Chapter 5.4.2. 3. If the problem remains, contact Helena customer service department or your local distributor. Rinse Expiry Expired rinse or wrong expiration setting. 1. Check if the rinse has expired. If so, change a new container of rinse as instructed by Chapter 5.4.2. 2. If not, reset the expiration date as instructed in Chapter 6.10.2. Diluent Expiry Expired diluent or wrong expiration setting. 1. Check if the diluent has expired. If so, change a new container of diluent as instructed by Chapter 5.4.2. 2. If not, reset the expiration date as instructed in Chapter 6.10.2. 12-5 Troubleshooting Your Analyzer Lyse Expiry Expired lyse or wrong expiration setting 1. Check if the lyse has expired. If so, change a new container of lyse as instructed by Chapter 5.4.2. 2. If not, reset the expiration date as instructed in Chapter 6.10.2. 12.3.3 Hardware Errors z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Error Message Real-time Clock Error Possible Cause(s) Recommended Action 1. Someone tempered with 1. Enter “Setup → Date & Time” the on-board battery off screen and reset the time as the board. instructed by Chapter 6.7. Restart Something is wrong with the analyzer after the adjustment the and the time should be correct. 2. on-battery contact, dead (poor battery, etc.). 2. If the problem remains, contact Helena 3. Damaged real-clock chip. department customer or your service local distributor. 10mL Syringe Motor Error 1. Pressed or blocked tubes. 1. Check if the tubes at the back of the 2. Poor contact of the signal analyzer is pressed or blocked. line. 2. If not, enter the “Service → System Test” screen and check 3. Damaged motor. 4. Poor connection between the drive board and the CPU board. the motor as instructed in Chapter 11.5. The error will be removed if the test result is normal. 3. If the problem remains, contact 12-6 Troubleshooting Your Analyzer 5. Malfunctioning photo coupler. Helena department customer or service your local distributor. 2.5mL Syringe & 50uL Motor Error .1. Poor contact of the signal line. Test” screen and check the motor 2. Damaged motor. as instructed in Chapter 11.5. The 3. Poor connection between the drive board and the CPU 4. Malfunctioning photo coupler. Motor Error result is normal. Helena department customer or service your local distributor. 1. Jammed sample probe. 2. Poor contact of the signal line. 1. Open the front panel and check if the sample probe is jammed. 2. Enter the “Service → System Test” screen and check the motor 3. Damaged motor. 4. Poor connection between the drive board and the CPU board. 5. Malfunctioning error will be removed if the test 2. If the problem remains, contact board. Elevator 1. Enter the “Service → System photo coupler. as instructed in Chapter 11.5. The error will be removed if the test result is normal. 3. If the problem remains, contact Helena department customer or service your local distributor. Rotation Error Motor 1. Jammed sample probe. 2. Poor contact of the signal line. Test” screen and check the motor Damaged motor. 4. Poor connection between the drive board and the CUP board. Malfunctioning the sample probe is jammed. 2. Enter the “Service → System 3. 5. 1. Open the front panel and check if photo 12-7 as instructed in Chapter 11.5. The error will be removed if the test result is normal. 3. If the problem remains, contact Helena customer service Troubleshooting Your Analyzer coupler. department or your local distributor. WBC Interrupt Error Something is wrong with the A/D part of the CPU board. 1. Enter the “Service → System Test” screen and check the WBC A/D interrupt as instructed in Chapter 11.5. 2. The error will be removed if the test result is normal. 3. If the problem remains, contact Helena customer department or your service local distributor. RBC Interrupt Error Something is wrong with the A/D part of the CPU board. 1. Enter the “Service → System Test” screen and check the RBC A/D interrupt as instructed in Chapter 11.5. 2. The error will be removed if the test result is normal. 3. If the problem remains, contact Helena customer department or your service local distributor. PLT Interrupt Error Something is wrong with the A/D part of the CPU board. 1. Enter the “Service → System Test” screen and check the PLT A/D interrupt as instructed in Chapter 11.5. 2. The error will be removed if the test result is normal. 3. If the problem remains, contact Helena customer service department or your local distributor. Deviated Tube The tube position where a 12-8 1. Open the sample compartment Troubleshooting Your Analyzer Position sampling shall run deviates door and readjust the sample from sample position. position. 2. The error will be removed if the adjustment is successful. Or, readjust again. 3. If the problem remains, contact Helena customer service department or your local distributor. Sample Comp. Door Open Sample compartment door is 1. at open status. Close the sample compartment door. 2. If the problem remains, enter the “Service → System Test” screen and check compartment the door sample status as instructed in Chapter 11.5. 3. The error will be removed if the test result is “OFF”. Or, contact Helena customer service department or your local distributor. Sample Sample compartment Compartment cannot open. door 1. Enter the “Service → System Test” Error screen and check the sample compartment door status as instructed in Chapter 11.5. 2. The error will be removed, if the test result is normal and the sample compartment door can open. Or, contact Helena customer service department or your local distributor. Front Cover Open The front door is at open 1. Close the front door. status. 2. If the problem remains, enter the “Service → System Test” screen and check the front cover status as 12-9 Troubleshooting Your Analyzer instructed in Chapter 11.5. 3. The error will be removed if the test result is “OFF”. Or, contact Helena customer service department or your local distributor. 12.3.4 Power Supply Errors z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Error Message Possible Cause(s) DC Something is wrong with the 12V Power Error Recommended Action internal DC power supplies. 1. Enter the “Service” → “System Status” screen and record the “DC 12V” and “DC -12V” values. 2. Shut down the analyzer and contact Helena customer service department or your local distributor. 5V Power Error Something is wrong with the 1. Enter the “Service → System power board. Status” screen and record the “5V” voltage. 2. Shut down the analyzer and contact Helena customer service department or your local distributor. 3.3V Power Error Something is wrong with the 5V power supply. 1. Enter the “Service → System Status” screen and record the “3.3V” voltage. 2. Shut down the analyzer and contact Helena customer service 12-10 Troubleshooting Your Analyzer department or your local distributor. 56V Power Error Something is wrong with the 1. Enter the “Service → System power board. Status” screen and record the “56V” voltage. 2. Shut down the analyzer and contact Helena customer service department or your local distributor. 12.3.5 Measurement Errors Error Message Background Abnormal Possible Cause(s) 1. Contaminated Recommended Action diluent, 1. diluent lines or bath (s). 2. Expired diluent. or expired. 2. Check if the tubes connected at the back of the analyzer are pressed. 3. The tubes at the back of the analyzer are pressed. Check if the diluent is contaminated 3. Enter the “Count” screen and press [STARTUP] (or [F3] of the external keyboard) to do the startup procedure. 4. If the problem remains, enter the “Service → Maintenance” screen and do the probe cleanser cleaning procedure as instructed in Chapter 11.2.7 When the procedure is finished, return to the “Count” screen and do the background check again. 5. If the problem remains, contact Helena customer service department or your local distributor. HGB Error HGB blank voltage within 0 V - 3.2 V or 4.9 V - 5 V. 1. Do the “Probe Cleanser Cleaning” procedure as instructed in Chapter 11.2.7. 12-11 Troubleshooting Your Analyzer 2. If the problem remains, adjust the HGB gain as instructed by Chapter 6.8.4 to set the voltage within 3.4 4.8V, preferably 4.5V. 3. If the problem remains, shut down your analyzer and contact Helena customer service department or you local distributor. HGB Adjust HGB blank voltage within 3.2 V - 3.4 V or 4.8 V – 4.9 V. 1. Do the “Probe Cleanser Cleaning” procedure as instructed in Chapter 11.2.7. 2. If the problem remains, adjust the HGB gain as instructed by Chapter 6.8.4 to set the voltage within 3.4 4.8V, preferably 4.5V. 3. If the problem remains, shut down your analyzer and contact Helena customer service department or you local distributor. WBC Clog 1. Clogged WBC aperture. 1. Do “Zap Apertures” and “Flush Apertures” 2. Inappropriate WBC count procedures as instructed by Chapter 11.2.5 and time setting. 10.2.6. 3. Solenoid valve error. 2. Enter the “Setup → Count Time” screen and record the WBC count time. Then enter the “Service → System Test” screen and test the actual WBC count time as instructed by Chapter 11.5. 3. If the difference between the reference WBC count time and the actual WBC count time is less than 2 seconds, the error has been 12-12 Troubleshooting Your Analyzer removed. 4. If not, enter the “Service → Maintenance” screen and do the probe cleanser cleaning procedure as instructed by Chapter 11.2.7. 5. Enter the “Setup → Count Time” screen and record the WBC count time. Then enter the “Service → System Test” screen and test the actual WBC count time as instructed by Chapter 11.5. 6. If the difference between the reference WBC count time and the actual WBC count time is less than 2 seconds, the error has been removed. 7. If the difference is still greater than 2 seconds but consistent, enter the “Setup → Count Time” and reset the WBC count time. Then enter the “Service → System Test” screen and test the actual WBC count time Chapter as 11.5 to instructed by confirm the difference is less than 2 seconds. 8. If the problem remains, contact Helena customer service department or your local distributor. WBC Bubbles 1. Diluent or rinse running out. 1. Check if the diluent or rinse has run out. If so, change a new container 2. Loose tube connections. 3. Inappropriate WBC count of diluent or rinse as instructed in Chapter 5.4.2. 2. Check the connection of the diluent time setting. 12-13 Troubleshooting Your Analyzer and rinse pickup tube. If necessary, reconnect and tighten them as instructed by Chapter 5.4.2. 3. If the problem remains, adjust the WBC count time as instructed by Chapter 6.3. 4. If the problem remains, contact Helena customer service department or your local distributor. RBC Clog 1. Clogged RBC aperture. 2. Inappropriate 1. Enter the “Service → Maintenance” screen. Zap and RBC flush the apertures as instructed by count time setting. Chapter 11.2.5 and 11.2.6. . 3. Solenoid valve error. 2. Enter the “Setup → Count Time” screen and record the RBC count time. Then enter the “Service → System Test” screen and test the actual RBC count time as instructed by Chapter 11.5. 3. If the difference between the reference RBC count time and the actual RBC count time is less than 2 seconds, the error has been removed. 4. If not, enter the “Service → Maintenance” screen and do the probe cleanser cleaning procedure as instructed by Chapter 11.2.7. 5. Enter the “Setup → Count Time” screen and record the RBC count time. Then enter the “Service → System Test” screen and test the actual 12-14 RBC count time as Troubleshooting Your Analyzer instructed by Chapter 11.5. . 6. If the difference between the reference RBC count time and the actual RBC count time is less than 2 seconds, the error has been removed. 7. If the difference is still greater than 2 seconds but consistent, enter the “Setup → Count Time” and reset the RBC count time. Then enter the “Service → System Test” screen and test the actual RBC count time as instructed by Chapter 11.5 to confirm the difference is less than 2 seconds. 8. If the problem remains, contact Helena customer service department or your local distributor. RBC Bubbles 1. Diluent or rinse running out. 1. Check if the diluent or rinse has run out. If so, change a new container 2. Loose tube connections. 3. Inappropriate RBC count time setting. of diluent or rinse as instructed in Chapter 5.4.2. 2. Check the connection of the diluent and rinse pickup tube. If necessary, reconnect and tighten them as instructed by Chapter 5.4.2. 3. If the problem remains, adjust the RBC count time as instructed by Chapter 6.3. 4. If the problem remains, contact Helena customer service department or your local distributor. 12-15 Troubleshooting Your Analyzer 12.3.6 External Connection Errors z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Error Message Com Error Possible Cause(s) Recommended Action 1. Communication cable not 1. Check if the communication cable is well connected. well connected. 2. Inappropriate 2. Check the transmission settings as transmission settings. instructed by Chapter 6.6 and make sure they are the same with the host. Barcode Com Error Poor connection between the scanner and the analyzer. 1. Check if the scanner is well connected to the analyzer. 2. If the problem remains, contact Helena customer service department or your local distributor. Barcode Error 1. Poor connection between the scanner and the analyzer. 1. Check if the analyzer is well connected to the analyzer. 2. Check if the bar-code is valid. 2. Invalid bar-code. 3. If the problem remains, contact Helena customer service department or your local distributor. Printer Offline Recorder Error Com Poor connection between the Check if the printer is well connected to printer and the analyzer. the analyzer. 1. Poor connection between the recorder and the analyzer. 12-16 Shut down the analyzer and contact Helena customer service department. Troubleshooting Your Analyzer 2. Damaged recorder. Printer Printer paper running out or out of Paper not properly installed. 1. Check if there is printer paper. 2. Check if the printer paper is well installed. Recorder out of Paper Recorder paper running out or not properly installed. 1. Check if the recorder paper has run out. If so, install the paper as instructed by Chapter 5.4.3. 2. Check if the recorder paper is properly installed. If not, re-install the paper as instructed by Chapter 5.4.3. 3. If the problem remains, contact Helena customer service department or your local distributor. Recorder too Hot Recorder head too hot. Stop using the recorder. If the problem repeats, contact Helena customer service department. Press Bar Up Tension lever not replaced. 1. Press the tension lever as instructed in Chapter 5.4.3. 2. If the problem remains, contact Helena customer service department or your local distributor. 12-17 Troubleshooting Your Analyzer 12.3.7 Ambient Temperature Error z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. Error Message Possible Cause(s) Ambient Abnormal Abnormal Temp. Recommended Action ambient 1. Enter the “Service → System temperature or temperature Status” transducer error. ambient temperature. screen to check the 2. If the actual ambient temperature exceeds the pre-defined ambient temperature, adjust the temperature. Otherwise, the analysis results may be unreliable. 3. If the actual temperature is within the pre-defined range and the problem remains, contact Helena customer service department or your distributor. 12.3.8 Other Errors z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. 12-18 Troubleshooting Your Analyzer Error Message Possible Cause(s) Recommended Action File Error Something is wrong with the Shut down the analyzer and contact file system. Helena customer service department or your local distributor. Dynamic Memory Something is wrong with the Shut down the analyzer and contact Error system memory. Helena customer service department or your local distributor. Waste Full The waste container is full. 12-19 Empty waste container 13 Appendices A Index analyzer dilution, 3-3 intended use, 2-2 dimensions, B-4 name, 2-1 display, B-3 aperture error flush, 11-7 10mL Syringe Motor Error, 12-6 bath 2.5mL & 50uL Syringe Motor Error, clean, 11-13 12-7 baud rate, 6-17 3.3V Power Error, 12-10 blank photocurrent, 3-7 56V Power Error, 12-11 bubbles 5V Power Error, 12-10 RBC, 12-15 ambient temp abnormal, 12-18 WBC, 12-13 Background Abnormal, 12-11 calibration Barcode Com Error, 12-16 calibration with calibrator, 10-5 Barcode Error, 12-16 conditions, 10-2 Com Error, 12-16 count mode, 10-10 DC 12V Power Error, 12-10 factors, 10-10, 10-15 deviated tube position, 12-9 manual, 10-10 Diluent Empty, 12-5 calibrator, 2-18 Diluent Expiry, 12-5 clog Dynamic Memory Error, 12-19 RBC, 12-14 Elevator Motor Error, 12-7 WBC, 12-12 File Error, 12-19 control, 2-18 Front Cover Open, 12-9 Coulter method, 3-6, 3-10 HGB Adjust, 12-12 count HGB Error, 12-11 principle, 3-6, 3-10 Liquid drips from analyzer inside, 12-2 procedure, 7-10 Lyse Empty, 12-4 CV Lyse Expiry, 12-6 definition, 8-11, 8-29 PC Pressure Low, 12-3 formula, 8-12, 8-30 PLT Interrupt Error, 12-8 diluent Press Bar Up, 12-17 connection, 5-11 Printer Offline, 12-16 definition, 2-17 Printer out of Paper, 12-17 empty tubing, 11-14 RBC Bubbles, 12-15 prime, 11-3 RBC Clog, 12-14 A-1 Appendices RBC Interrupt Error, 12-8 procedure, 5-6 Real-time Clock Error, 12-6 requirements, 5-2 Recorder Com Error, 12-16 LCD, 2-10 Recorder does not work, 12-2 leukocyte Recorder out of Paper, 12-17 granulocyte, 2-3 Recorder too Hot, 12-17 lymphocyte, 2-3 Rinse Empty, 12-5 mid-sized cell, 2-3 Rinse Expiry, 12-5 Lymph# Rotation Motor Error, 12-7 definition, 2-3 Sample Comp. Door Open, 12-9 formula, 3-8 Sample Compartment Error, 12-9 Lymph% The analyzer cannot be turned on, definition, 2-3 12-2 formula, 3-7 Vacuum Filter Error, 12-4 lyse Vacuum Low, 12-3 connection, 5-9 VC Pressure Llow, 12-4 definition, 2-18 WBC Bubbles, 12-13 prime, 11-5 WBC Clog, 12-12 maintenance, 11-1 WBC Interrupt Error, 12-8 MCH E-Z cleanser definition, 2-3 definition, 2-18 formula, 3-11 use, 7-29, 11-11 MCHC gain definition, 2-3 set HGB channel gain, 6-27 formula, 3-11 set the RBC gain, 6-26 MCV set WBC channel gain, 6-24 definition, 2-3, 3-11 Gran# reproducibility, 4-3 definition, 2-3, 3-8 Mid# formula, 3-8 definition, 2-3 Gran% formula, 3-8 definition, 2-3, 3-7 Mid% formula, 3-7 definition, 2-3 HCT formula, 3-7 definition, 2-3 MPV formula, 3-11 definition, 2-3, 3-11 HGB NRBC, 3-7 definition, 2-3 parameter formula, 3-7 Gran%, 2-3 measurement, 3-6 HCT, 2-3 reproducibility, 4-3 HGB, 2-3 histogram MCH, 2-3 adjust histograms, 7-18, 7-27 MCHC, 2-3 humidity, B-4 MCV, 2-3 installation MPV, 2-3 A-2 Appendices PLT, 2-3 auto clean time, 6-29 RBC, 2-3 count time, 6-7 RDW, 2-3 date & time, 6-20 parity, 6-18 gain, 6-23 password, 6-9 other, 6-41 performance specification, 4-2 parameter units, 6-37 PLT password, 6-9 definition, 2-3, 3-11 print, 6-2 reproducibility, 4-3 ref. range, 6-12 power supply, B-4 report title, 6-34 predilute transmission, 6-16 samples collection and handling, 7-8 specifications, B-1 prepare to ship, 11-23 table printer sample table review, 8-2 device, 6-3 search table review, 8-22 format, 6-4 temperature mode, 6-5 ambient temperature, B-4 probe cleanser operating temperature, B-4 definition, 2-18 throughput, B-3 use, 11-8 transmission quality control at count screen, D-15 L-J analysis, 9-2 at L-J table screen, D-15 X-B analysis, 9-14 at review screen, D-15 RBC troubleshooting, 12-1 definition, 2-3, 3-10 unpacking, 5-4 reproducibility, 4-3 valve RDW valve test, 11-19 definition, 2-3, 3-11 volumetric metering, 3-5 reagent, 2-17 WBC recorder, 2-11 definition, 2-3, 3-7 install paper, 5-13 formula, 3-7 rinse reproducibility, 4-3 connection, 5-11 weight, B-5 definition, 2-18 X-B analysis prime, 11-4 activate/deactivate, 9-18 sample perform, 9-20 run, 7-10 review results, 9-20 sample compartment, 2-11 set frequency, 9-17 setup A-3 B Technical Specifications B.1 Reagents Diluent M-30D DILUENT Rinse M-30R RINSE Lyse M-30CFL LYSE E-Z Cleanser M-30E E-Z CLEANSER Probe Cleanser M-30P PROBE CLEANSER B.2 Controls BC-3D HEMATOLOGY CONTROL (Low, Normal and High) B.3 Calibrator SC-CAL PLUS HEMATOLOGY CALIBRATOR B.4 Tube Sizes Tube Dimensions Fill Volume Collection tube φ13×75(mm) 5 mL φ12×75(mm) 3 mL φ15×45(mm) / φ11×40(mm) 1.5 mL Centrifugal tube B.5 Parameters Directly measured parameters and histograms Parameter Abbreviation Default Unit White Blood Cell or leukocyte WBC 103 /µL Red Blood Cell or erythrocyte RBC 106 /µL Hemoglobin Concentration HGB g/dL Platelet PLT 103 /µL WBC histogram WBC Histogram / RBC histogram RBC Histogram / PLT histogram PLT Histogram / B-1 Appendices Parameters derived from histograms Parameter Abbreviation Default Unit Lymphocyte percentage Lymph% % Mid-sized cell percentage Mid% % Granulocyte percentage Gran% % Mean Corpuscular Volume MCV fL Red Blood Cell Distribution Width RDW % Mean Platelet Volume MPV fL Calculated parameters Parameter Abbreviation Default Unit Lymphocyte Lymph# 103 /µL Mid-sized cell Mid# 103 /µL Granulocyte Gran# 103 /µL Hematocrit HCT % Mean Cell Hemoglobin MCH pg Mean Cell Hemoglobin Concentration MCHC g/dL B.6 Sampling Features B.6.1 Sample volumes required for each analysis Whole Blood Mode (vein blood) 13 µL Predilute Mode (capillary blood) 20 µL B.6.2 Lyse used for every analysis Whole blood 0.5 mL Prediluted 0.36 mL B.6.3 Dilution rate WBC/HGB RBC/PLT Whole blood 1:308 1:44872 Prediluted 1:546 1:45827 B.6.4 Apertures size Diameter Length WBC 100 µm 70 µm RBC 70 µm 65 µm B-2 Appendices B.6.5 Throughput 1 minute / analysis B.7 Input/output Devices z Use the specified devices only. B.7.1 Display Color LCD, 10.2″, 800×600. B.7.2 Keypad 23-key keypad. B.7.3 Keyboard PS/2 keyboard. B.7.4 Bar-code scanner(optional) TYSSO CCD-82 scanner. B.7.5 Recorder Built-in thermal recorder can support eight printing formats. B.7.6 Printer(optional) EPSON LX-300+. B.7.7 Interfaces A keyboard interface. Two RS-232 interfaces. A parallel port (for printer or floppy disk drive). A power supply for the floppy disk drive(only to be used with the power cord supplied by Helena). B-3 Appendices B.8 Power supply Voltage: 100-240 VAC. Frequency: 50/60 Hz Input power: 180 VA. Fuse: AC 250 V T4 A. z B.9 Use the fuse of the specified type and rating. EMC Description The product is subject to the EMC test as required by IEC61326:2002. B.10 Sound Maximal sound: 77 dB. B.11 Operating Environment Optimal operating temperature: 15 ℃ - 30 ℃ (59 ℉ - 86℉). Relative humidity: 30 % - 85 %. Atmospheric pressure: 70.0 kPa - 106.0 kPa. B.12 Storage Environment Ambient temperature: -10 ℃ - 40 ℃ (14 ℉ - 104℉) Relative humidity: 10 % - 93 % Atmospheric pressure: 70.0 kPa - 106.0 kPa B.13 Dimensions Width Depth Height 391mm 425mm 457mm B-4 Appendices B.14 Weight 25 kg B.15 Contraindications None. B-5 C Precautions, Limitations and Hazards C.1 Introduction You will find the following symbols in this manual. When you see… Then… read the statement below the symbol. The statement is alerting you to an operating hazard that can cause personnel injury. read the statement below the symbol. The statement is alerting you to a possibility of analyzer damage or unreliable analysis results. read the statement below the symbol. The statement is alerting you to information that requires your attention. read the statement below the symbol. The statement is alerting you to a potentially biohazardous condition. C.1.1 Installation Requirements All the space, power and environmental requirements listed in Chapter 5 and Appendix B must be met. Establishing and maintaining proper grounding cannot be overemphasized. C.1.2 Limitations Whenever the results are outside the normal limits, it is recommended that the laboratory following whatever written protocol is in place for validating results. If an error occurs, the analyzer displays the corresponding error message In case of errors related to the fluidic system (such as clogging or bubbles), it is recommended that you re-run the sample after removing the error. If the PLT value is less than 100 × 103/µL, it is recommended the result be verified by a microscope. C.1.3 Maintenance The maintenance instructions in Chapter 11 describe corrective and preventive procedures that must be followed to ensure proper operation and performance of your analyzer. C-1 Appendices C.2 Warnings z It is important for the hospital or organization that employs this equipment to carry out a reasonable service/maintenance plan. Neglect of this may result in machine breakdown or injury to human health. z Make sure the analyzer is properly grounded. z Before turning on the analyzer, make sure the input voltage meets the above requirements. z When moving the analyzer, face the front of the analyzer and carry it from the bottom with hands! z Do not place the analyzer in a flammable or explosive environment. z Dispose of reagents, waste, samples, consumables, etc. according to government regulations. z Avoid direct contact with patient samples. z The sample probe tip is sharp and may contain biohazardous materials. Exercise caution to avoid contact with the probe when working around it. z To avoid personal injury, keep your clothes, hair and hands away from such moving parts as the sample probe. z Only install a fuse of the specified type and rating. C-2 Appendices C.3 Cautions z Installation by personnel not authorized or trained by Helena may damage your analyzer. Do not install your analyzer without the presence of Helena-authorized personnel. z Liquid ingression may damage the analyzer. Do not place any bottles on the analyzer. z Do not connect or disconnect the printer, bar-code scanner or keyboard when the analyzer is on. z Improper installation of recorder paper may jam the paper and/or result in blank printouts. z Do not re-use disposable products. z The recommended limits are provided for your reference only. To avoid misleading parameter flags, set the patient limits according to the characteristics of your local population. z Do not perform any maintenance procedures that are not described in this chapter. Performing unauthorized maintenance procedures can damage your analyzer. z In case of problems not specified in this manual, contact Helena customer service department or your local distributor for assistance. z Only Helena-supplied parts can be used for maintenance. For any questions, contact Helena customer service department or your local distributor. C-3 Appendices C.4 Notes z This equipment must be operated by skilled/trained medical professionals. z Operate the analyzer strictly as instructed in this manual. z This analyzer adopts a fixed decimal point. You can enter the digits without bothering to look for the [.] on the external keyboard. z The purpose of this analyzer is to identify the normal patient, with all normal system-generated parameters, and to flag or identify patient results that require additional studies. z Store and use the reagents as directed by instructions for use of the reagents z When you have changed the diluent, rinse or lyse, run a background to ensure that the system is primed immediately prior to running any samples. z Pay attention to and record the expiration date and open-container stability of all the reagents. Be sure not to use expired reagents z Let the reagents stand for a while before using them. z Be sure the analyzer is off before switching on the power. z Retain the shipping carton and all the packing materials, as they can be used for packaging if analyzer must be reshipped. z Place the analyzer on a countertop. z Use the manufacturer-specified reagents, controls and calibrator only. z After connecting the reagents, tighten the cap to prevent contamination. z Pay attention to and record the expiration dates and open-container stability days of all the reagents. Be sure not to use expired reagents z For any reagent, the entered expiration date should be either the expiration date printed on the labeling or the open-container expiration date, whichever is earlier. The open-container expiration date is calculated as follows: the date that container is opened + the open-container stability days. z Whole-blood samples to be run for WBC differential or PLT count should be stored at room temperature and run within 8 hours of collection. z Use clean K2EDTA anticoagulant collection tubes, plastic centrifugal tubes and 20µL borosilicate glass capillary tubes. z If you do not need the PLT, MCV and WBC differential results, you can store the samples in a refrigerator (2℃ - 8℃(35.6 ℉ - 46.6℉)) for 24 hours. You C-4 Appendices need to warm the refrigerated samples at room temperature for at least 30 minutes before running them. z Mix any sample that has been prepared for a while before running it. z Keep dust from the prepared diluent. z After mixing the capillary sample with the diluent, wait 3 minutes before running the sample. Run the prediluted samples within 30 minutes after the mixing. z Evaluate predilute stability based on your laboratory’s sample population and sample collection techniques or methods. z Select proper reference range as instructed in Chapter 6.4.3 before running the samples. Otherwise, the obtained results may be erroneously flagged. z When switching from the Predilute mode to the Whole Blood mode, the analyzer will automatically clean the fluidic system. z After entering all the desired information, you may press [F4] on the external keyboard to save the changes and exit to the “Count” screen. z If you intend to do the background check instead of a patient sample, ENTER “0” into the “ID” box. z If the analyzer detects WBC/RBC clogging or bubbles during the analysis, the corresponding error messages will be displayed in the upper left corner of the screen and the results of all the related parameters will be invalidated. See Chapter 12 Troubleshooting Your Analyzer for solutions. z If the ambient temperature is outside the specified operating range, the analyzer will alarm you for abnormal ambient temperature and the analysis results may be unreliable. See Chapter 12 Troubleshooting Your Analyzer for solutions. z The result of the background check will not be flagged. z If the PLT value is less than 100 × 103/µL, it is recommended the result be verified by a microscope. z To ensure the stability of the analyzer and the accuracy of the results, do the “Shutdown” procedure if your analyzer has been working for 24 consecutive hours. z After entering all the desired information, you may press [F4] on the external keyboard to save the changes and exit to the “Sample (or Search) Histogram Review” screen. z Refer to the instructions for use of the control for information on the lot number, expiration date, open-vial stability days, expected results and limits. z The entered expiration date should be either the expiration date printed on the labeling or the open-vial expiration date, whichever is earlier. The C-5 Appendices open-vial expiration date is calculated as follows: the date that vial is opened + the open-vial stability days. z Use the manufacturer-specified controls. Using controls other than the specified will lead to misleading results. z Refer to the instructions for use of the controls for how to store and use the controls. z Calibrate your analyzer before trying to establish the expected results by calculating the averages of random patient samples. z All of the measured parameters must be calibrated before readings of this analyzer can be used as valid analysis results. z Refer to the instructions for use of the calibrator for information on the lot number, expiration date, open-vial stability days, expected results and limits. z Enter the lot number, expiration date, the mean and range of WBC, RBC, PLT, HGB and MCV before running the L-J analysis. If not, a message box will pop up to remind you to enter the required information first. z The entered expiration date should be either the expiration date printed on the labeling or the open-vial expiration date, whichever is earlier. The open-vial expiration date is calculated as follows: the date that vial is opened + the open-vial stability days. z Use the manufacturer-specified calibrator. Using calibrator other than the specified will lead to misleading results. z Refer to the instructions for use of the calibrator for how to store and use the calibrator. z After mixing the calibrator with the diluent, wait 3 minutes before running it. Run the prediluted calibrator within 30 minutes after the mixing. z Mix any prediluted calibrator that has been prepared for a while before running it. z Spills are possible during the soaking process. Keep a minimum 30cm distance from the analyzer. z Before moving the analyzer, do the “Drain Tubing” procedure and remove the tube from the sample compartment. z Running sample with the background abnormal error present will lead to unreliable results. z The troubleshooting chapter is not a complete service manual and is limited to problems that are readily diagnosed and/or corrected by the user of the analyzer. If the recommended solution fails to solve the problem, contact Helena customer service department or your local distributor. z Unless otherwise instructed, always turn off the power before trying to fix C-6 Appendices the error. z Use the printer and/or scanner of the specified model only. z “V7” and “V17” cannot be tested when error occurs to the vacuum chamber. z Refer to the printer’s operation manual for its installation. z Refer to the bar-code scanner’s operation manual for its installation. z If the analyzer is restarted, you will lose all the information of the samples that have not been analyzed yet. C.5 Biohazard z Samples, controls, calibrator, reagents and waste, as well as the area these materials may come into contact with, are potentially infectious. Wear proper personal protective equipment (e.g. gloves, lab coat, etc.) and follow safe laboratory procedures when handling them in the laboratory. C-7 Appendices C.6 Abnormal Results For your reference only. C.6.1 Abnormal Sample Analysis Results Parameter flags If the analysis result is followed by an ”H” or “L”, it means the analysis result has exceeded the upper or lower limit of the reference range. If the analysis result is followed by an “A”, it means that the histogram discriminator associated with the parameter has been manually adjusted. The value of this parameter might have been changed by the adjustment of discriminator or not. If you see *** as opposed to the result, it means the result is either unreliable or out of the operating range. If the WBC result is less than 0.5 × 103 /µL, this analyzer will not perform the differential analysis and all the related parameter values will be non-numeric (***). Histogram flags The system will flag abnormal histograms. Abnormal WBC histograms will be flagged by one of the markings: R1,R2,R3,R4 and Rm. Figure C-1 WBC histogram As shown in the Figure C-1: R1: indicates cells distribute abnormally around region 1. R2: indicates the proportion of cell distribution in region 2 is out of the setting. R3: indicates the proportion of cell distribution in region 3 is out of the setting. R4: indicates the proportion of cells larger than discriminator 4 is out of the setting. Rm: indicates at least two R flags Abnormal PLT histograms will be flagged by one of the markings: Pm. C-8 Appendices Pm: indicates blur demarcation between the platelet and red blood cell area and possible presence of large platelet, platelet coagulation, small red blood cell, cell debris or fibrin. There will be a flag “A” over the discriminator after it is manually adjusted. C-9 Appendices C.7 Abnormal QC Results In case of any abnormal QC results, do the following steps until the problem is solved. If all the steps have failed, contact Helena customer service department or your local distributor for assistance. Check the upper left corner of the screen for error messages. Refer to Chapter 12 Troubleshooting Your Analyzer for solutions to any displayed error messages. Check the L-J settings for inappropriate entries. Do the background check. In case of an abnormal background result, refer to Chapter 12 Troubleshooting Your Analyzer for solutions. Re-run the control. Run another vial of control. Check if the analyzer needs to be calibrated. C-10 D Communication D.1 Introduction The ICHOR II can transmit the sample data and QC data to an external computer (a host) through its RS-232 port. The transmission can be conducted either automatically or through the command of the operator after the completion of the sample analysis. This section gives detailed discussion about the setup of transmission parameter, RS-232 port and the data transmission format, therefore, providing detailed information for the software engineers to program and for the user to conveniently perform transmission. z When the transmission symbol in the upper right corner of the screen appears animated, it indicates the transmission is in process. D-1 Appendices D.2 Connection The ICHOR II can be connected with an external computer through a DB9 connector. The pins of the DB9 connector are shown in Figure D-1. Figure D-1 DB9 connector Pin description: DCD: Carrier Detect RXD: Receive Data TXD: Transmit Data DTR: Data Terminal Ready GND: Signal Ground DSR: Data Set Ready RTS: Request to Send CTS: Clear to Send RI: Ring Indicator The ICHOR II communicates with a host through serial port 2, using Pin2, Pin 3 and Pin 5. The maximum transmission distance is 12 meters. D-2 Appendices D.3 Programming Methods 1. ASCII characters are used for transmission. Every value of the histogram is transmitted by using 3 bytes of ASCII characters. That is, the character data is transmitted by using the corresponding ASCII character of each bit, and the numerical value data is transmitted by using the corresponding ASCII character of each bit in decimal. For the 256-channel data in each histogram, the channel data is transmitted by using the corresponding ASCII characters of 3 bits in decimal. If the channel data are less than 3 bits, “0” will be added to the left of the data. For example, suppose that the sample ID is 0605230001, the string “0605230001” in ASCII characters will be transmitted as the ID; suppose that the WBC result is 5.2, the string “5.2” in ASCII characters will be transmitted as the result; suppose that data of a channel of the RBC histogram is 78, the string “078” will be transmitted as the channel data. 2. Each field transmitted consists of three parts orderly: the field ID, component field and the field contents. A comma is used to separate the field ID and the field contents (see table 2). A semicolon is used to separate the adjacent fields (see table 2). In the case of field contents being strings or numerical values, the use of these delimiters ensures that the protocol will still be compatible if the field contents’ length changes. For example, if the field ID of WBC is “0201” and the result of WBC is “5.2 x 109/L”, the data package received will include the string “0201,5.2;”. If the unit is transmitted, the package will also include the string “0201,10(9)/L;”. For the histogram field contents, each field is 256 channel data, and each channel corresponds to 3 characters. Therefore, in each field, there are 768 consecutive characters. When the field is transmitted, every 3 characters are encoded and no delimiter appears between different channel data. If the data of a channel are less than 3 characters, “0”(s) will be added to the left of the data. Some parameter units may contain indices. In such case, a pair of parentheses (0x28,0x29) are used for the index. For example, the “10(9)/L” will be transmitted as the “109/L”. 3. For the convenience of data analysis, some fields are combined into groups. All fields between a start character and an end character are called a group. A group is not allowed to nest other groups. The field contents of the group are the number of bytes (located between the group start character and end character, but the fields of the group start character and end character are excluded) in the group. For examples, all parameter results can be combined into a group to be transmitted, and all parameter reference range can be divided into the upper limit group and lower limit group to be transmitted respectively. 4. To avoid repeating the control field, the escape delimiter is used. D-3 Appendices If there is character less than 0x20 in the field, it should be transmitted by adding the “\x” in front of the 2 characters in hexadecimal, adding a “0” in the front if the character is less than 2 characters. For example, to transmit the character encoded 0x1a, transmit the “\x1a”. z When analyze the data package, you should make full use of the field ID and not rely on the field order and quantity. Since the field order and quantity may be changed if the instrument software is upgraded. z If there is field ID unneeded or unknown, reject the corresponding data. Especially for the field ID of unknown group (block), reject all the contents in the group (block) according to the number of bytes indicated by the field contents. D.4 D.4.1 Data Package Field ID Table D-1 Definition of Field ID Field ID 0001 Field name Description Start character of the sample The field contents are the number of bytes in the block data block data (excluding the start field and end field). The field contents descriptions of the block (group) start character below are the same with that of the sample block data. Thus, start characters below will not be described in details. 0002 End character of the sample The field contents are the corresponding ASCII block data characters of the checksum of the bytes in the block data. Bytes in the block data exclude the start field and end field. The checksum is obtained by accumulating BYTE reversely. The ASCII characters here are in decimal. The field contents descriptions of block (group) end character below are the same with that of the sample block data. Thus, end characters below will not be described in details. 0003 Start character of the L-J analysis standard block data 0004 End character of the L-J analysis standard block data 0005 Start character of the L-J D-4 Appendices analysis running block data 0006 End character of the L-J analysis running block data 0007 RESERVE Reserve … … … 0100 RESERVE Reserve 0101 Start character of the parameter result group 0102 End character of that of the block start character. the parameter result group 0103 Start character of The field contents description is the same with The field contents description is the same with that of the block end character. the reference range lower limit group 0104 End character of the reference range lower limit group 0105 Start character of the reference range upper limit group 0106 End character of the reference range upper limit group 0107 Start character of the L-J analysis expected result group 0108 End character of the L-J analysis expected result group 0109 Start character of the L-J analysis limit group 0110 End character of the L-J analysis limit group 0111 Start character of the of the parameter unit group 0112 End character parameter unit group 0113 Start character of the histogram data group 0114 End character of the histogram data group 0115 RESERVE Reserve … … … 0200 RESERVE Reserve D-5 Appendices 0201 WBC White Blood Cell or leukocyte The field contents are the parameter value or unit. If it is a value, it may indicate: the parameter result, L-J analysis expected result or the limit, or the upper or lower limit of the reference range. The field contents descriptions of the following parameters are the same with that of the WBC. Thus, parameters below will not be described in details. 0202 Lymph# Lymphocyte 0203 Mid# Mid-sized cell 0204 Gran# Granulocyte 0205 Lymph% Lymphocyte percentage 0206 Mid% Mid-sized cell percentage 0207 Gran% Granulocyte percentage 0208 HGB Hemoglobin Concentration 0209 RBC Red Blood Cell or erythrocyte 0210 HCT Hematocrit 0211 MCV Mean Corpuscular (erythrocyte) Volume 0212 MCH Mean Cell (erythrocyte) Hemoglobin 0213 MCHC Mean Cell (erythrocyte) Hemoglobin Concentration 0214 RDW Red Blood Cell (erythrocyte) Distribution Width Coefficient of Variation 0216 PLT Platelet 0217 MPV Mean Platelet Volume 0220 RESERVE1 Reserve parameter 1 0221 RESERVE2 Reserve parameter 2 0222 RESERVE3 Reserve parameter 3 0223 RESERVE4 Reserve parameter 4 0224 RESERVE5 Reserve parameter 5 0250 RESERVE Reserve 0251 Sample ID 0252 Analysis mode 0253 Analysis date (month) Used in the sample data and L-J analysis running data. 0254 Analysis date (day) Used in the sample data and L-J analysis running data. 0255 Analysis date (year) Used in the sample data and L-J analysis running data. 0256 Analysis time (hour) Used in the sample data and L-J analysis running data. 0257 Analysis time (minute) Used in the sample data and L-J analysis D-6 Appendices running data. 0258 Analysis time (second) Used in the sample data and L-J analysis running data. 0272 RESERVE Reserve … … 0300 RESERVE Reserve 0301 L1 Region The LymphLeft line of the WBC histogram. 0302 L2 Region The LymphMid line of the WBC histogram. 0303 L3 Region The MidGran line of the WBC histogram. 0304 L4 Region The GranRight line of the WBC histogram. 0305 L5 Region The Left line of the RBC histogram. 0306 L6 Region The Right line of the RBC histogram. 0307 L7 Region The Left line of the PLT histogram. 0308 L8 Region The Right line of the PLT histogram. 0309 WBC Histo (256 channels) Totally 768 characters, every 3 characters for a channel value (“0”(s) will be added to the left if the value has less than 3 characters). 0310 RBC Histo (256 channels) Totally 768 characters, every 3 characters for a channel value (“0”(s) will be added to the left if the value has less than 3 characters). 0311 PLT Histo (256 channels) Totally 768 characters, every 3 characters for a channel value (“0”(s) will be added to the left if the value has less than 3 characters). 0312 RESERVE Reserve … … … 0350 RESERVE Reserve 0351 3-part differential mark If “0” appears, there are peaks of Lymphocyte and Granulocyte and 3-part differential is conducted. If “1” appears, there is only peak of Lymphocyte. If “2” appears, there is only peak of Granulocyte. If “3” appears, the peak is in the middle and WBC is not differential. 0352 Histogram manual adjusted Using 8 binary bits to mark whether the 8 mark discriminators have been adjusted. If “1” appears, the corresponding discriminator has been adjusted. If “0” appears, the corresponding discriminator has not been adjusted. Bits of [0], [1], [2], [3], …, and [7] indicate orderly the LymphLeft, LymphMid, MidGran and GranRight lines of the WBC histogram, the left and right lines of the RBC histogram and the left and right lines of the PLT histogram. 0353 Rm If “1” appears, flag exists. If “0” appears, no flag. D-7 Appendices 0354 R1 Same 0355 R2 Same 0356 R3 Same 0357 R4 Same 0358 Pm Same 0361 Parameter flag shielded mark If “1” appears, the flag is shielded (no flag). If “0” appears, the flag is not shielded. 0362 WBC clog If “1” appears, an error is reported. If “0” appears, no error is reported. 0363 RBC clog Same 0364 WBC bubble Same 0365 RBC bubble Same 0366 Abnormal ambient Same temperature 0367 Control expiry Same 0368 Diluent expiry Same 0369 Rinse expiry Same 0370 Lyse expiry Same 0371 RESERVE Reserve … … … 0400 RESERVE Reserve 0401 L-J analysis file No. 0402 L-J control lot No. 0403 L-J control expiration date (month) 0404 L-J control expiration date (day) 0405 L-J control expiration date (year) 0406 RESERVE Reserve … … … 0450 RESERVE Reserve 0451 Transmission protocol version No. 0452 Instrument product No. 0453 Instrument serial No. 0454 Software version No. 0455 Fluidic sequence version No. 0456 RESERVE Reserve … … … 9999 RESERVE Reserve D-8 Appendices D.4.2 Special character Table D-2 Special character Character Component Coding 0x2c delimiter “,” Field Description A delimiter separating the field ID and the contents or a delimiter separating multiple components in the contents. 0x3b A delimiter separating the two adjacent fields. 0x28 A character before the index of the parameter unit, marking the delimiter “;” “(” index. “)” 0x29 A character after the index of the parameter unit, marking the index. Escape 0x5c delimiter “\” A character changing delimiters (including the escape delimiter itself). For example, if a delimiter appears in the field contents, the escape delimiter should be added to mark. “\x” A mark character before the hexadecimal values. Small letter x should be used (the corresponding ASCII code is 0x78). If a “,” appears in the field contents, a “\,” will be transmitted. If a “;” appears in the field contents, a “\;” will be transmitted. If a “\” appears in the field contents, a “\\” will be transmitted. If there is character less than 0x20 in the field, it should be transmitted by adding the “\x” in front of the 2 characters in hexadecimal, adding a “0” in the front if the character is less than 2 characters. For example, to transmit the character encoded 0x1a, transmit the “\x1a”. D.4.3 Field contents The field contents of the group (block) start character and end character is the number of bytes in the group (block) data, excluding the start character field (field ID, delimiter, field contents and field delimiter) and the end character field (field ID, delimiter, field contents and field delimiter). For the parameter results, if the result is invalid, the “*” will be transmitted (the number of “*” and whether there is a decimal depend on the unit). For the reserved fields, empty content will be transmitted. D-9 Appendices D.5 Transmission ICHOR II will communicate with the external computer in following procedures: 1. ICHOR II sends an ENQ (05 Hex), then waits up to 4 seconds for the external computer to respond. If the external computer does not respond, then one more ENQ (05 Hex) is tried. If it fails again, the analyzer aborts the transmission and reports a transmission error. 2. The external computer must respond by sending an ACK (06 Hex). If any other response is received, another ENQ (05 Hex) will be sent by the analyzer (maximum two ENQ [05 Hex] will be sent) . 3. The analyzer then sends: Body of text EOT (04 Hex) ETX (03 Hex) 4. Disconnection. ICHOR II sends an ETX (03 Hex), then waits 4 seconds for the external computer to respond. If no response is received, one more ETX (03 Hex) is sent, ICHOR II waits 4 seconds before giving up and gives alarm of communication error. If the external compute responds ACK, the transmission is done successfully. If the external computer responds NACK(15 Hex), the analyzer repeat the transmission from step 3. If the received response from the computer is neither ACK(06 Hex)nor NACK(15 Hex), the analyzer sends ETX(03 Hex) again. TableD-3 Character coding Table Character Coding [ENQ] 0x05 When handshake on, handshake request signal by the analyzer. [STX] 0x02 When handshake off, text transmission start signal by the analyzer. [EOT] 0x04 When handshake on, text transmission end signal by the analyzer. [EOF] 0x1A When handshake off, text transmission end signal by the analyzer. [ETX] 0x03 When handshake on, acknowledge request signal by the analyzer, confirming whether the transmission is correct. [ACK] 0x06 Acknowledge reply signal by the PC, indicating correct transmission. [NACK] 0x15 Non-acknowledge reply transmission. D-10 signal by the PC, indicating wrong Appendices D.6 Sample Data Protocol Field name Description Start character of the sample block data Transmission protocol version No. “A” Sample ID Analysis mode Parameter flag shielded mark WBC bubble WBC clog RBC bubble RBC clog Analysis date (month) Analysis date (day) Analysis date (year) Analysis time (hour) Analysis time (minute) Start character of the parameter result group WBC Lymph# Mid# Gran# Lymph% Mid% Gran% RBC HGB MCHC MCV MCH RDW HCT PLT MPV End character of the parameter result group Start character of the reference range upper limit group … The upper limit of the parameter. The order and quantity of fields in the group are the same with those in the parameter result group. D-11 Appendices End character of the reference range upper limit group Start character of the reference range lower limit group … The lower limit of the parameter. The order and quantity of fields in the group are the same with those in the parameter result group. End character of the reference range lower limit group Start character of the parameter unit group … The unit of the parameter. The order and quantity of fields in the group are the same with those in the parameter result group. End character of the parameter unit group Rm R1 R2 R3 R4 Pm L1 Region L2 Region L3 Region L4 Region L5 Region L6 Region L7 Region L8 Region 3-part differential mark Histogram manual adjusted mark WBC Histo (256 channels) RBC Histo (256 channels) PLT Histo (256 channels) End character of the sample block data D-12 Appendices D.7 L-J Analysis Standard Data Protocol Field Description Start of the L-J analysis standard block data Transmission protocol version No. “A” L-J analysis file No. L-J control lot No. L-J control expiration date (month) L-J control expiration date (day) L-J control expiration date (year) Start character of the L-J analysis expected result group WBC RBC HGB PLT Lymph# Lymph% Gran# Gran% HCT MCV MCH MCHC End character of the L-J analysis expected result group Start character of the L-J analysis limit group … The limit of the parameter. The order and quantity of fields in the group are the same with those in the L-J analysis expected result group. End character of the L-J analysis limit group Start character of the parameter unit group … The unit of the parameter. The order and quantity of fields in the group are the same with those in the L-J analysis expected result group. End character of the parameter unit group End of the L-J analysis standard block data D-13 Appendices D.8 L-J Analysis Running Data Protocol Field Description Start of the L-J analysis running block data Transmission protocol version No. “A” Analysis date (month) Analysis date (day) Analysis date (year) Analysis time (hour) Analysis time (minute) Start character of parameter result group WBC RBC HGB PLT Lymph# Lymph% Gran# Gran% HCT MCV MCH MCHC End character of parameter result group Start character of the parameter unit group … The unit of the parameter. The order and quantity of fields in the group are the same with those in the parameter result group. End character of the parameter unit group End of the L-J analysis running block data D-14 Appendices D.9 Transmission D.9.1 Defining transmission settings The data format is fixed for the transmission so that every byte to be transmitted has 7 data bits and 1 stop bit. Enter ”Setup → Transmission” screen and edit the transmission settings as instructed by Chapter 6.6. D.9.2 Transmission at count screen If the auto transmission function is on, once the analysis is done, the analyzer will automatically transmit the results to the external computer. If the auto transmission function is off, you can only transmit the results manually at the “Review” screen. D.9.3 Transmission at review screen Select the results you want to transmit and transmit them to the external computer as instructed by Chapter 8.2.1. . D.9.4 Transmission at L-J QC table screen Transmit the results as instructed by Chapter 9.2.3. D-15 P/N: H-3006-20-74817 (V1.0)