Dimension® EXL™ 200 Integrated Chemistry System Sample Processing Online Training
Process samples in barcoded and non-barcoded tubes. Monitor samples during run. Add samples during processing. Manage test reports through software interaction. Evaluate sample height. Follow guidelines for proper use of a sample cup vs small sample container (SSC). This clinical laboratory training qualifies for continuing education units (CEU).
Assess sample height and volumes for appropriate processing Identify sample containers and how segments and adapters are used Interpret printed test reports Process and monitor patient and QC samples Welcome to the Sample Processing course for the Dimension® EXL™ 200 Integrated Chemistry System. After completing this course, you will be able to: Select Next to continue. Use the Tube Fill Guide to assist you in determining adequate sample height in primary tubes before processing. To assess the sample height: Hold a primary tube against the area indicated on the Tube Fill Guide for the 5-mL, 7-mL, or 10-mL tube that you are assessing. Verify that the sample height falls within the sufficient height range (the area displayed in green) indicated on the Tube Fill Guide. Assessing Sample Volumes Learn about assessing sample height. If a barcoded primary tube has sufficient sample height, you can load it directly into a segment position for processing. Later, you will learn how to: Process a tube with insufficient height. Assess the volume to use the correct container. Process a non-barcoded tube. When complete, select the X in the upper-right corner to close the window and continue. Use only the following types of sample containers on the Dimension® System: Unstoppered 5-mL, 7-mL, and 10-mL primary sample tubes (barcoded or non-barcoded) Dimension® system Sample Cups with lids Dimension® system Small Sample Containers (SSCs) Select Next to continue. A Dimension® system Sample Cup holds 1.5 mL of sample, including a 30 µL dead volume. Use a sample cup to set up samples for processing in any of the following situations: If the sample height on a primary (barcoded or non-barcoded) tube is insufficient and the sample volume is less than 1 mL Sample in any type of container with less than 1 mL To transfer a sample to a sample cup: Pipette sample into the sample cup and firmly close the lid. Load the sample cup into a teal or beige adapter in a segment. Push the sample cup completely down into the adapter. Tip: Ensure there are no air bubbles when transferring samples to sample cups or SSCs. Select Next to continue. A Dimension® system SSC holds 1 mL of sample, including a 30 µL dead volume. Use an SSC to set up samples for processing if both of the following situations apply: The sample level height on a barcoded primary tube is insufficient. AND There is at least 1 mL of sample available. To process a sample in an SSC: Pipette 1.0 mL of sample into the SSC. Load the SSC into the top of the original barcoded tube. Load the barcoded tube into an SSC designated segment for processing with the barcode label visible through the segment opening. Select Next to continue. 10 position segments and color-coded adapters hold sample containers to facilitate the loading process. 10-mL tubes are loaded directly into a segment. 5-mL and 7-mL tubes, and sample cups, use specified adapters: Teal adapters hold 5-mL tubes or sample cups. Beige adapters hold 7-mL tubes or sample cups. Up to 6 segments can be loaded onto the sample wheel for processing. Grooves in the segments align over the black pins in the sample wheel. Select Next to continue. You can transfer a sample to an SSC, load it into the top of a primary tube, and allow the instrument to read the barcode information to process the sample. During installation, the Dimension® System is programmed for SSC use. A sample probe maximum depth alignment is performed for optimal sample aspiration. Designate a segment for SSC use by selecting an orange or yellow segment and configuring it in the system software. Designate a segment for SSC use from the Operating Menu by selecting: F6: SYSTEM CONFIG F4: COMPUTER Configuring SSC Segments Learn how to configure a segment for SSC use. Checklist TitleChecklist TypeChecklist ContentConfiguring SSC SegmentsHTML Select each checkbox to learn more about how to configure SSC Segments. SSC ID (mm) fieldHTML Move the cursor to the SSC ID (mm) field, and then type 8 (the inside diameter in millimeters of the SSC). SSC fieldHTML Move the cursor to the SSC field. F5: ADD SEGSHTML Select F5: ADD SEGS. A prompt will appear in the highlighted message area. Type the letter of the designated segment(s), and then select Enter. F7: STOREHTML Select F7: STORE to save the SSC designated segment. Select the X in the upper-right corner to close the window and continue. Before a sample can be processed, the instrument requires specific information: Patient demographics Test specifics The instrument can retrieve the information in 1 of 3 ways: Directly from a barcoded tube Manual Query from host Manual Order Entry Manual Query can be used to enter sample information when the LIS is operational. An asterisk (*) in front of the sample number on the Enter Sample Data screen will trigger the instrument to query the host (LIS) to obtain patient and test information. If the system does not have an active LIS, the order must be entered manually into the Enter Sample Data screen. Manual Query Learn how to use Manual Query. To use Manual Query, begin at the Operating Menu and perform the following steps: Select F1: ENTER DATA. Enter segment position (example: A1). Move to Sample No. field. Enter "*" followed by the sample number (example: *123456). All fields will populate with patient and test information. When complete, select the X in the upper-right corner to close the window and continue. Manual Order Entry Learn how to use Manual Order Entry. To use Manual Order Entry, begin at the Operating Menu and perform the following steps: Select F1: ENTER DATA. Enter the segment position (example: A1). Enter the name in Patient Name field. Enter the sample number in Sample No. field. Enter the patient location in Location field. Select the appropriate Test or Panel keys Change the Mode (F7: NEXT MODE), Fluid (F8: NEXT FLUID) and Priority (F4: NEXT PRIORITY) using the appropriate Function Keys. Enter a dilution factor, if a manual dilution is required. Refer to the Instructions for Use for the proper diluent. Note that the dilution limit is 1 to 99. The instrument will calculate the final result automatically. When complete, select the X in the upper-right corner to close the window and continue. Store Sample Information Learn how to store sample information. After all patient and order fields are populated, press 1 of 3 keys to store the sample information: F1: NEW SAMPLE to store sample information and display the next available segment position F2: PROCESS SINGLE to store sample information and start processing a single sample F3: LOAD LIST to store sample information and view the group of samples ready to process. To start processing the group of samples, select F4: Run. Select the X in the upper-right corner to close the window and continue. Process QC using the following options: Manually in the Enter Sample Data screen QC Recall, a shortcut that eliminates reentry of QC sample information on the Enter Sample Data screen A defined QC Panel with an SSC in a barcoded tube Note: You will learn how to process QC in barcoded tubes in the QCC PowerPak® training course for the Dimension® EXL™ 200 Integrated Chemistry System. Manual Order Entry for QC and QC Recall Learn how to use Manual Order Entry for QC and QC Recall. To use Manual Order Entry for QC in sample cups, from the Operating Menu, perform the following steps: Press F1: ENTER DATA. Enter segment position (example: A1). Enter the QC name in Patient Name field. To use the QC Recall feature, enter a unique QC identifier in the Patient Name field beginning with the letters QC. Enter the lot number in the Sample No. field and select the appropriate Test keys. Change the mode (F7) to sample cup, priority (F4) to QC, and fluid (F8) to the correct QC fluid. Note: All fields will be populated with QC and test information automatically if using the QC Recall feature. QC Recall requires the data to be manually ordered at least once previously. When complete, select the X in the upper-right corner to close the window and continue. In this section, you will learn how the Dimension® EXL™ 200 Integrated Chemistry System processes samples. Processing Samples Learn how to process samples. Slide NumberText BlocksCalloutsAudio ScriptImage File1In this section, you will learn about processing samples. For additional information on the analyzer components, refer to the System Overview course for the Dimension® EXL™ 200 Integrated Chemistry System. Select Next to continue.Note: If audio does not automatically start, select the play arrow in the top left to begin.In this section, you will learn about processing samples. For additional information on the analyzer components, refer to the Dimension EXL® 200™ System Overview course. 2 Technologies The Dimension® EXL™ 200 Integrated Chemistry System provides chemistry analyses by using: IMT HM Photometric and turbidimetric testing LOCI® Module Select Next to continue. The Dimension® EXL™ 200 system provides chemistry analysis by using the Integrated Multisensor Technology (IMT), the Heterogeneous Immunoassay Module (HM) and photometric and turbidimetric testing. The added benefit of the system is the LOCI® module, which processes high sensitivity assays quickly.3 Sample Containers The Dimension® EXL™ 200 Integrated Chemistry System accepts samples in various types of sample containers, such as sample cups, primary tubes, and SSCs. Select Next to continue. The Dimension EXL 200 system accepts samples in various types of sample containers, such as sample cups, primary tubes, and SSCs.4 Loading Samples 5-, 7-, and 10-mL tubes are in the segment. Select Next to continue. Remember: When loading segments, make sure the grooves in the segment fit over the black pins in the sample area.When loading segments, make sure the segment is completed seated in position and that the grooves fit over the pins in the sample area.5 Processing Samples Select the RUN key on the touchscreen to begin processing. You also may use the RUN key on the keyboard. Select Next to continue. Once samples are loaded, select the RUN key to begin processing.6 Scanning Segments and Barcoded Tubes The sample area wheel scans the segment and barcoded tubes. Select Next to continue. The sample area wheel scans the segment and barcoded tubes.7 Checking for System Needs The NEEDS CHECK icon turns yellow while the instrument ensures there is sufficient inventory and that calibration, QC, and certain consumables are current. Select Next to continue. The yellow NEEDS CHECK icon informs the operator the system is checking the onboard inventory to ensure there are sufficient reagents to complete the ordered tests. Also, the system checks to ensure all calibration, QC, and other supplies are current.8Checking for System Needs If the icon turns to a red Check Needs, select Alt/N to display the needs that are required.Select Next to continue. If the icon turns to a red Check Needs, select Alt/N to display what needs are required. 9 Checking for System Needs Since the icon has disappeared, everything the instrument needs is present and the instrument can begin processing. Select Next to continue. At this time, the analyzer has the necessary supplies. Since the icon has disappeared, everything the instrument needs is present and the instrument can begin processing.10 Segment Status Area The barcode information read from the loaded segment will appear on the touchscreen in the Segment Status area. The red color indicates the analyzer is currently processing samples from that segment. Select Next to continue. The barcode information read from the loaded segment will appear on the touchscreen, in the segment status area. The red color alerts the operator that the analyzer is currently processing samples in that segment.11Level Sensing After level sensing is performed by the photometric sample probe, sample processing begins. Select Next to continue. Next, the Dimension® EXL™ 200 System will level sense the sample and begin to process.12 Technologies Used Tests ordered determine the technology used to process the samples: IMT HM Photometric/turbidimetric in cuvettes LOCI® Module Select Next to continue. Select each number to review the corresponding text.CalloutsIMTHM Photometric/turbidimetric in cuvettesLOCI® ModuleBased on the tests ordered, the samples will be processed using the Integrated Multisensor Technology (IMT), Heterogeneous Immunoassay Module (HM), photometric, turbidimetric, and/or LOCI® testing.13 Sample Status Screen As samples are processed, individual method results are available immediately by accessing F8: TEST RESULTS on the Sample Status screen. Select Next to continue. As samples are processed, individual method results are immediately available by accessing F8: TEST RESULTS on the Sample Status screen.14 STAT Status Key Selecting the STAT Status key displays the remaining time for completion of STAT sample testing. Select Next to continue. Selecting the STAT Status key displays the remaining time for completion of STAT sample testing.15 Sample Alert Key The Sample Alert key displays the reason for rerunning and completion time to result. Samples can be running for: Panic auto rerun Reflex testing Auto dilution Process error Select Next to continue. If the analyzer needs to re-run a sample, the Sample Alert key provides the reason for re-running and completion time to result. Samples can be running for panic auto rerun, reflex testing, auto dilution and process error.16 QC and Calib Alert Key QC and Calib Alerts indicate when QC and calibrations need to be run or rerun. Select Next to continue. QC and Calibration Alerts indicate when QC and calibrations need to be run or re-run.17 HELP Key Screen information can be accessed by selecting the HELP key on the touch screen. You also can use the HELP key on the keyboard. Select Next to continue. Select the HELP key to access information about a screen. 18 Congratulations You have learned how to process samples on the Dimension® EXL™ 200 Integrated Chemistry System. When complete, select the X in the upper-right corner to close the window and continue.Congratulations. You now have learned how to process samples on the Dimension® EXL™ 200 system. There are several ways to determine the status of samples and segments for monitoring sample processing, and the length of time to finish processing the loaded samples. Segments and samples are monitored while processing, using the following screens: F2: SAMPLE STATUS F5: PROCESS CONTROL for “Estimated Process Time” F8: SEGMENT STATUS or Alt/S to view the Segment Status screen Sample Alert key STAT Status key Sample and Segment Monitoring Keys Learn about the Sample Monitoring keys and their functions. Tab TitleTextF2F2: Sample Status Use this screen when trying to locate a patient that has already been processed, or when you want to edit a sample already processing but not completed. Results can be viewed from this screen.F5F5: Process Control Displays the Estimated Process Time to complete all samples.F8 or Alt/SF8: Segment Status or Alt/S Displays the status of segments and what is being processed, or has been processed, in each segment position. Use this screen to verify that all tube barcodes have been read. Different colored lettering of each sample represents the status of that sample.Help Screen for F8 F8: Segment Status or Alt/S Help Screen The Help screen displays a list of Sample Status letters and colors. B Begun (yellow) D Done (pink) E Entered (white) N No Data (red) R Ready (green) r Reported (light blue) P Printed (blue) Sample AlertSample Alert Displays the rerun status of sample requests that encountered exceptions while processing.STAT StatusSTAT Status Displays the STAT requests that are in process and the time remaining until the result will be available. It also displays completed STATs and STATs requested that have not run. When complete, select the X in the upper-right corner to close the window and continue. The Instrument, Operating Conditions, and Segment Status areas of the Operating Menu provide information while processing samples. Selecting CTRL/Help accesses information about these screens. Monitoring Sample Processing Learn about monitoring the instrument during sample processing Checklist TitleChecklist TypeChecklist ContentMonitoring Sample ProcessingHTML Select each checkbox to learn how to monitor sample processing.Identify Processing Status BoxHTML Select Ctrl+Help to display the information box describing the meaning of the processing status icons.Identify Photometric Sampler Status BoxHTML Select Ctrl+Help to display the information box describing the meaning of the photometric sampler status icons.Identify Segment Status Area BoxesHTML The boxes in the Segment Status area indicate the status of each of the 6 segment positions of the segment wheel the last time the wheel was scanned.Identify Operating Conditions Status Area IconsHTML This area of the screen displays icons that depict instrument operating conditions. Select Ctrl+Help to display the meaning of the icon or refer to the Operator's Guide. When complete, select the X in the upper-right corner to close the window and continue. Aptio Automation will transform your customer's lab with One Unified Solution. You know this, and you want your customers to also know this. They'll be looking for the benefits of your solution. Siemens' automation messaging will help you present this information in a meaningful, consistent, and concise manner. So what are the sustainable benefits? Select the tabs below to learn more. Congratulations. You have completed the Sample Processing training course for the Dimension® EXL™ 200 Integrated Chemistry System. Listed below are the key points that have been presented. Take time to review the material before you proceed to the final quiz. In this course, you have learned how to: Assess sample height and volumes for appropriate processing Use the Tube Fill Guide to assess sample volumes in 5-, 7-, and 10-mL primary tubes. Load all tubes with sufficient sample volume directly into a segment. Use an adapter, as applicable. Use SSCs to process barcoded tubes with insufficient sample height and more than 1 mL of sample. Use sample cups to process all tubes with insufficient sample volume less than 1 mL. Identify sample containers and how segments and adapters are used Load 10-mL primary tubes directly into a segment. Use teal adapters for 5-mL primary tubes, and beige adapters for 7-mL primary tubes. Sample cups fit inside teal or beige adapters. Load an SSC into the top of the original barcoded primary tube. This sample may be loaded into a designated SSC segment. To process samples, load segments into the sample wheel, which can hold up to 6 segments. Configure a segment to use Small Sample Containers (SSCs) To designate a segment for SSC use, select an orange or yellow segment and then use the Sample ID/Computer Menu screen to configure it in the system software. The instrument will process all samples loaded in the dedicated segment as SSCs. The operator does not have to manually enter the sample mode for each SSC sample. Enter Patient and QC data If processing samples in barcoded tubes, the barcode readers will read the barcode and the host is queried to obtain patient data. If processing non-barcoded tubes, the operator can manually query patient data from the LIS. Use the Enter Data screen to manually enter patient and QC data or use defined QC panels in barcoded tubes. Manually download patient information from an LIS using Manual Query When processing non-barcoded samples or unreadable barcodes, patient order information can be downloaded using the Manual Query feature in the Enter Sample Data screen, if the instrument is configured to an LIS. Enter an asterisk followed by the sample ID in the Sample No. field. The fields on the Enter Data screen automatically fill in with the patient data from the LIS. Respond to System Needs If the red CHECK NEEDS icon appears in the Operating Conditions Status area, System Needs are required. To respond to System Needs, press Alt/N to view the System Needs screen. Monitor Segment and Sample Status Monitor the status of segments and samples and the time for processing using: STAT Status Sample Alert F2: SAMPLE STATUS F5: PROCESS CONTROL F8: SEGMENT STATUS (same as Alt/S) Monitor Sample Processing To monitor the instrument while processing samples use the following: Processing Status box Photometric Sampler Status box Segment Status area Operating Conditions Status area icons Interpret printed test reports A test result on the printed test report may appear with a test report message and/or a reference range indicator. Depending on the specific test report message, the test results may or may not be reportable. Reference the Appendix in the Operator’s Guide for further details on understanding the test report messages and reference range indicators. Clot check in action The instrument will perform an automatic clot check error recovery when a clot is detected. The remaining sample will be dispensed in drain port located in the back of the IMT sample port. The system will verify that the clot has been cleared, perform a bleach wash sequence, rinse, and then return to sampling. Select Next to continue. The clot check system utilizes the clot check pressure transducer board to check for clots. This action occurs during sample aspiration. The instrument performs an automatic clot check error recovery when a clot is detected. The remaining sample is dispensed into the drain port located in the back of the IMT sample port. The system verifies that the clot has been cleared, performs a bleach and wash sequence, rinse, and then returns to sampling. Clot Check in Action See the clot check in action. The sample is dispensed into the clot check drain when the clot check system detects a clot. If the media does not automatically start, select the play arrow to begin. When complete, select the X in the upper-right corner to close this window and continue. Clot Check Test Report Messages Learn about clot check test report messages. Clot Check Test Reports: A test result with a "ClotCheckErr" test report message will not include a numerical result. Any successfully completed test results from the same sample cup will be displayed. Any tests that have not yet aspirated sample from the same sample cup will be aborted, and have an "Aborted Test" message associated with them. TEST ------- RESULT ------------- REF. INTERVAL ---------------------- UNITS --------- MG 21.4 HI assay range mg/dl CA ClotCheck Err BUN Aborted Test GLUC Aborted Test When complete, select the X in the upper-right corner to close this window and continue. Clot Check Error Message Learn about clot check error messages. The instrument displays the error Clot Check Error - sample aborted. When complete, select the X in the upper-right corner to close this window and continue. A test result could contain a reference range indicator next to the result. Results with reference range indicators are reportable. There are 4 reference range indicators: HI, LO, lp (low panic) and hp (high panic). Test results with a test report message in the Reference Range column may be reportable or non-reportable. Note: Refer to the Appendix of the Operator's Guide for an explanation of the Reference Range Indicators and Test Report Messages. Interpreting Test Reports Learn about interpreting test reports. Base ImageHotspotsText BlocksImage FileTest ResultsPatient InformationReference Range IndicatorsTest Report MessageTest Report Message