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Dimension® EXL™ with LM Integrated Chemistry System Reagent Monitoring & Preparation Online Training

Perform reagent hydrations. Process samples using manual and automated dilutions and the HIL feature. Respond to STAT status, supply and sample alert key. This clinical laboratory training qualifies for continuing education units (CEU).

Add a third lot of reagent Add and remove reagents Identify options for Hydration and perform Pre-Hydration Identify the components of the Reagent System Respond to a Check Needs for reagent Respond to Supplies Alert Review reagent inventory Welcome to the Reagent Monitoring and Preparation online course for the Dimension® EXL™ with LM integrated chemistry system. In this course, you will learn how to: Select Next to continue. Blue image text (interactive image text) can be changed individually. You can use the mouse to adjust e.g. the slice thickness for the display types MPR Thick, MIP Thin and VRT Thin quickly. To adjust the values, point to the blue image text element ‘SL’ in the lower right corner of your image segment. With the left mouse button pressed, drag the mouse up or down to increase or decrease the values in small intervals With the left mouse button pressed, drag the mouse left or right to increase or decrease the values in large intervals OR Right-click on the same image text element and enter a slice thickness value in the upcoming properties dialog. In this section, you will learn how the reagent probes and pump panel work together to prepare and deliver reagents used during processing. Reagent Delivery Components Click START to learn about the Reagent Delivery Components Reagent Delivery Components Learn about the Reagent Delivery Components Slide NumberText BlocksCalloutsAudio ScriptImage File1 In this section, you will learn how the components of the reagent system prepare and deliver reagents during processing. 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 how the components of the reagent system function to prepare and deliver reagents during processing.2 Autoloader Flex® reagent cartridges may be loaded directly into the autoloader from any software screen at any time. Always load Flex® reagent cartridges with the narrow end forward and the barcode on the right side. Select Next to continue. Flex® reagent cartridges can be loaded at any time and from any software screen. Load the reagent cartridge with the narrow end forward and the barcode on the right side.3 R1 Probe Arm The R1 arm is stationary and is used to deliver reagents and sometimes water to the cuvette position directly below the probe. Ultrasonics in the probe mix reagents prior to delivery and also may mix reagents with additional water for some methods. Select Next to continue. The stationary R1 arm delivers reagent and sometimes water to the cuvette position directly below the probe. Ultrasonics in the probe mix reagents prior to delivery. For some methods, they also mix reagents with additional water.4 R1 Metering and Flush Pump Syringes The R1 metering syringe is a 500 µL syringe that is used to measure reagent. The R1 flush syringe is a 2500 µL syringe which is used to deliver water for testing or cleaning. The R1 metering and flush pump syringes are located in the lower right area of the Pump Panel. Select Next to continue. Select each number to review the corresponding text.CalloutsPump PanelR1 Metering syringeR1 Flush syringeThe 500µL R1 metering syringe measures reagents. The 2500µL R1 flush syringe delivers water for testing or cleaning.5 R2 Probe Arm The R2 probe arm moves to access various cuvette positions as well as HM reaction vessels. It hydrates most HM reagents. R2 also may be used to deliver reagents after hydration, for a quality check. Ultrasonics produced by the transducer in the probe mix reagents prior to delivery and also mix reagents with sample in the cuvette or reaction vessel. Select Next to continue. Select each number to review the corresponding text.CalloutsUltrasonics TransducerR2 Probe TipThe R2 prove arm moves to access various cuvette positions and HM reaction vessels. It also hydrates most HM reagents. Another function of the R2 is to deliver reagents after hydration for a quality check. Ultrasonics in the probe mix reagents prior to delivery and mix reagents with sample in the cuvette or reaction vessel.6 R2 Metering and Flush Pump Syringes The R2 metering syringe is a 500 µL syringe that is used to measure reagent.   The R2 flush syringe is a 2500 µL syringe which is used to deliver water for hydration, testing or cleaning. The R2 metering and flush syringes are located in the top right area of the Pump Panel. Select Next to continue. Select each number to review the corresponding text.CalloutsPump panelR2 Metering syringeR2 Flush syringeThe 500µL R2 metering syringe measures reagents. The 2500µL syringe delivers water for hydration, testing or cleaning.7 Reagent Management System With an RMS, the R3 probe will perform most of the reagent hydrations. The RMS (R3) Pump Panel has a 2500 µL flush syringe which is used to deliver water for hydration and cleaning. Note: For additional information on the RMS, refer to the Reagent Management System course for the Dimension® EXL™ with LM integrated chemistry system. Select each number to review the corresponding text.CalloutsBarcode ReaderHydration StationR3 ProbeFlush syringeFor a Dimension® EXL™ which includes an RMS, the R3 probe performs the majority of reagent hydrations. The RMS (or R3) Pump Panel has a 2500µl flush syringe which delivers water for hydration and cleaning. For additional information on the RMS, refer to the Reagent Management System course for the Dimension® EXL™ with LM system.8 Congratulations. You now have learned how the components of the reagent system prepare and deliver reagents during processing.    When complete, select the X in the upper-right corner to close the window and continue. Congratulations. You now have learned how the components of the reagent system prepare and deliver reagents during processing. Le système d'automation utilise un support de tube unique, appelé puck, pour le transport de tubes de prélèvement sur le convoyeur. Les Pucks permettent de traiter chaque échantillon individuellement ce qui offre une plus grande efficacité et une meilleure cadence. Mais comment les échantillons sont-ils placés dans les pucks ? Les échantillons de types et de tailles variables sont tout d'abord chargés dans Portoir Echantillon code à barrés. Pour bien charger les échantillons dans un portoir échantillon, commencer par la position A1 et continuer le chargement des échantillons de gauche à droite. Une fois que la ligne A est remplie, passez à la position B1. Le Portoir Echantillon est chargé dans le Sample Manager. Le Robot du Sample Manager charge les tubes sur le convoyeur en prenant les tubes sur les portoirs échantillon et en plaçant chaque tube dans son propre puck individuel à l'Interface Gate du Sample Manager. In this section, you will learn how to check for reagent needs and also how the instrument performs checks to ensure sufficient inventory is available to process tests that are ordered.   First, we will look at how an operator can monitor the reagent inventory by reviewing the Reagent Cartridge Inventory screen and responding to the Supplies Alert.   To access the Reagent Cartridge Inventory screen:  From the Operating Menu, select F4:System Prep > F1: Inventory Or  Select Alt/I   Tip: The number of tests per Flex® reagent cartridge and well varies by method.     Monitoring Reagent Inventory Learn about the Reagent Inventory Screen. Base ImageHotspotsText BlocksImage File Tests left Indicates the number of tests remaining.  The Needs Check and Supplies Alert also notifies the operator of a reagent needed.  Method and Lot Displays the name of the reagent and the lot number that is onboard Calib. Exp. Date  Indicates when the current reagent cartridge calibration will expire. Calib Alert also provides a warning before calibration expiration.  System Exp. Date Each reagent cartridge has an onboard stability of at least 30 days, which is tracked by the software and noted in this column. Flex® reagent cartridges are removed automatically when the reagent expires.   Nous avons maintenant un aperçu de la façon dont un échantillon se déplace dans le système d'automation. Examinons le processus plus en détail. Cliquez sur DEMARRER pour voir le cheminement du tube. Each time the RUN key is selected, the system checks its needs for processing the requested tests. During this check, the yellow Needs Check icon appears on the screen.   If a reagent need exists, the system displays the red Check Needs icon and emits a short audible alarm.    To view the required need, select: Alt/N to display the System Needs screen F1: Reagent to display the method and lot needed to complete the ordered tests Select Next to continue. Non seulement le système ADVIA ® automation dirige et délivre les échantillons vers les analyseurs appropriés mais il contrôle également l'emplacement de chaque échantillon sur le système. L'écran Recherche d'Echantillon contient toutes les informations concernant les échantillons sur 7 jours et est utilisé pour la recherche d'un échantillon. Il peut indiquer si l'échantillon est sur le convoyeur, sur un instrument, dans lSample Manager, à la Chambre Froide ou si l'échantillon n'a jamais été chargé sur le système d'automation. The Supplies Alert feature provides a more proactive approach to reagent monitoring. When reagent levels drop below a defined limit, the Supply Alert key turns yellow. Select the yellow Supplies Alert key to view the cartridges that have test quantities below the Alert At limit. Select Next to continue. Quand une série d'analyse a été effectuée avec succès, les échantillons retournent au Sample Manager et sont souvent placés dans un portoir de déchargement. Cela signifie généralement que les échantillons sont prêts à être placés en chambre froide. Quand un portoir de déchargement est enlevé du Sample Manager, le LineMaster crée automatiquement une entrée en Chambre froide pour ce portoir sur l'écran Chambre froide. Tout ce que nous devons faire, c'est mettre l'écran à jour avec l'emplacement spécifique du portoir après l'avoir placé dans la chambre froide ! Cliquez sur Démarrer pour assigner un portoir à la Chambre froide Reagents can be loaded through the autoloader or the RMS. In this section, you will learn about successful and unsuccessful loading of cartridges, adding a third reagent lot and unloading reagents. Select Next to continue. Après qu'un échantillon ait été placé en chambre froide le système d'automation garde la trace de son emplacement. Lorsque des tests supplémentaires sont demandés, le système d'automation tente de localiser l'ID échantillon. Si l'échantillon a été retiré du système d'automation, il place l'ID échantillon dans la Pick List. La Pick List fournit une liste des échantillons dont le système d'automation a besoin pour terminer les demandes de test en attente. Cliquez sur Démarrer pour localiser des échantillons sur la Pick List. In this section, you will learn about the different hydration options that are available on the Dimension® EXL™ with LM integrated chemistry system. Using the Inventory/Hydration screen, you can manage workload hydration requirements more effectively. There are three options for hydrating reagents: Automatically by the instrument Prehydration by specific lots Prehydration by a list of methods on a timed schedule Flex® reagent cartridges contain either liquid or tablet reagents. Tablets require hydration prior to use. Select Next to continue. Félicitations! Vous avez terminé le cours ADVIA ® Automation - Traitement des échantillons -. Dans cette formation en ligne, vous avez appris à charger des échantillons sur Sample Manager, suivre le déplacement d'un échantillon à travers le système ADVIA® Automation, utiliser la fonction de recherche, affecter des portoirs échantillons terminés à la chambre froide, et localiser des échantillons avec des demandes de test en attente. Congratulations. You have completed the Reagent Monitoring and Preparation course for the Dimension® EXL™ with LM 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. Once you have reviewed the content on this page, you may proceed to the assessment portion of the course. Reagent Delivery Components In this section, you identified the components of the Reagent Delivery System: Autoloader R1, R2, and R3 Probes R1, R2, and RMS (R3) Pump Panels Refer to each section within this course if you need to review the components and their functionality.   Monitoring Reagent Inventory The operator can access the Reagent Cartridge Inventory screen by selecting Alt/I which displays the Method and Lot, Tests Left and both Calibration and System Expiration Dates. Once loaded, unopened reagents have a minimum of 30 days stability, and each well also has an expiration time.    The instrument also checks for reagent needs every time RUN is pressed. If a Red Check Needs icon appears, Alt/N will display the System Needs and the F1: Reagent function key will become active to indicate the reagent need.  Supplies Alert provides a proactive warning to alert the operator when levels are below a preset limit that is defined by your laboratory.   Adding and Removing Reagents Flex® reagent cartridges can be loaded through the autoloader or the bulk loader on the RMS even while the system is processing.  When loading Flex® reagent cartridges into the autoloader, position the barcode on the right and the narrow end forward.  During loading, the red load light remains on.  If unsuccessful,  the loader light blinks and the reagent manager icon appears on the screen. Selecting Alt/R displays the reason for this icon. If the reason is due to a third lot of reagent, the Flex® reagent cartridge will be placed into HOLD status until the operator replaces an old lot with the new lot. Reagents will be removed automatically when expired or empty.  To remove a Flex® reagent cartridge manually from the Reagent Cartridge Inventory screen, press F3: Remove Reag. After removing the reagent, press F1: Confirm Remove to confirm the removal.   Hydration The Dimension system automatically hydrates Flex® reagent cartridges, as needed, to complete all requested tests. Use the Hydration By Lot screen to hydrate specific lots of Flex® reagent cartridges. To hydrate Flex® reagent cartridges by selecting specific test methods, select the methods and enter the number of tests to be hydrated.   Use the Inventory/Hydration screen to create or load a pre-programmed setup list of test methods that you want to hydrate. Pre-programming hydrations improves test turnaround times, maximizes instrument efficiency based on test volumes, and ensures that tableted Flex® reagent cartridges are ready to use during peak workloads. The system will hydrate up to the required number of tests based on this number. To hydrate Flex® reagent cartridges using a timed hydration schedule, load a setup and then set the hydration start day, time and frequency.  Turn the Activated option to ON.  At the scheduled time, date, and frequency, the system hydrates the required number of Flex® reagent cartridges to satisfy the total number requested.  The instrument provides 5 and 1 minute warnings before hydration and alerts the operator when hydration has begun.   Select Next to continue.   Place the Flex® reagent cartridge into the autoloader so that the narrow end goes into the instrument first and the barcode label is on the right side of the cartridge.  The barcode reader scans the barcode, and then the system moves the cartridge into the reagent tray. During the loading process, the red loader light will be lit. TIP: You can load reagents any time during processing or standby.  The Reagent Inventory screen does not need to be displayed to load reagents. Do not add any Flex® reagent cartridges that have been partially used.  Select Next to continue. Étudions de plus près le Sample Manager Le Sample Manager et le robot du Sample Manager sont responsables du chargement et du déchargement de divers types et tailles de tubes de prélèvement sur le convoyeur. Cliquez sur Démarrer pour regarder l'écran du Sample Manager pendant qu'il traite les tubes de prélèvement. If the autoloader will not insert the cartridge into the instrument, the loader light blinks, and a blinking reagent manager icon appears on the screen. If this occurs: Remove the Flex® reagent cartridge from the autoloader Press Alt/R to see why the cartridge could not be loaded and to remove the icon from the screen. Tip: Ctrl/Help provides an explanation of the Reagent Cartridge Status Icon options  Select Next to continue. The screen displays a blinking Reagent Manager icon when a third reagent lot is loaded onto the instrument. Selecting Alt/R provides the message:  A reagent cartridge has been added which will force calibration of a third lot. The cartridge has been stored as method “HOLD.”   A Flex® reagent cartridge designated as “HOLD” will not be used until it is confirmed for use. Reagent Cartridge Inventory Screens Learn how to add a third lot to Reagent Inventory. Checklist TitleChecklist TypeChecklist ContentAdding a Third Lot to Reagent InventoryHTMLSelect each checkbox to learn more about how to replace a currently calibrated lot or remove it from inventory. Access Reagent Cartridge Hold InventoryHTML From the Reagent Inventory Screen (Alt/I), Press F1:Show HoldAccess 3rd Lot ScreenHTML  From the Reagent Cartridge Hold Inventory screen, press F1:Show 3rd LotSelect LotHTML Highlight the method and press F1: Replace LotConfirm New LotHTML The system displays the message: “New lot would replace calibrated lot (Lot ID that will be replaced). Do you approve? (y/n).” Responding “yes” permanently removes a previous lot ID from instrument memory.Reagent Cartridge InventoryHTML The “HOLD” reagent cartridge no longer appears on the screen Select the X in the upper-right corner to close the window and continue.  When expired or empty, Flex® reagent cartridges are removed automatically through the autoloader or the RMS.  When reagent cartridges are removed through the autoloader, the red load light blinks until the cartridge is removed. To remove Flex® reagent cartridges manually: Alt/I Highlight the reagent to be removed F3: Remove Reagent Remove the cartridge from autoloader Press F1: Confirm Remove Select Next to continue.  In this section, you have the opportunity to think about these hydration FAQs.  When complete, select Next to continue. Hydration FAQ Answer During a timed hydration, if some tests are alrady hydrated, what will the instrument do? The instrument will hydrate only enough tests to meet the hydration request. What happens if I get a STAT while the instrument is pre-hydrating? The instrument will pause the hydration, process samples with a STAT priority, and then automatically continue the hydration. Can I cancel a reagent hydration? Yes.  You can cancel a hydration by doing the following: On the Hydration by Lot screen, press F5: DELETE. Select Y to confirm that you want to cancel hydrations. Hydrations in progress will be completed.  Hydrations not yet begun will be deleted. In what situation would I want to set up a timed hydration schedule? Suppose your facility receives the bulk of its workload from 6:00 - 8:30 A.M. daily and the average batch includes about 200 specimens.  Program a timed activated hydration to hydrate tests so that reagent is hydrated and available at 6 A.M. every day to process these samples. Can I load a setup list as many times as I want? Yes.  From the Inventory/Hydration screen, press F1 or F2 to recall either setup list and load it as many times as you need to hydrate the total number of tests required.  For example, if you press F1:LOAD SETUP twice to load the setup list for 200 BUN and 100 LDH tests, you would hydrate 400 BUN and 200 LDH tests.   The Dimension® EXL™ integrated chemistry system hydrates reagents as needed to satisfy the test requests. Select Next to continue. Specific cartridge lots can be requested to hydrate by using the Hydration By Lot screen. For each Flex® reagent cartridge lot on the instrument, the Hydration By Lot screen shows the number of available tests of reagent that are hydrated, unhydrated, and to be hydrated. To access the Hydration by Lot screen and perform hydration, from the Operating Menu, select: F4: System Prep F2: Reagent Prep Use test keys or cursor keys to select a method to hydrate Enter number of tests to hydrate in the No.Tests to be Hydrated column Enter Select additional methods to hydrate if necessary F4: Hydrate to begin hydration Select Next to continue. Bienvenue dans le cours Traitement des échantillons sur ADVIA Automation. Le système ADVIA ® Automation gère chaque tube échantillon séparément, en reconnaissant précisément l'endroit où le tube de prélèvement doit se rendre, puis en l'acheminant pour une efficacité optimale. Ce système de transport de l'échantillon est capable de charger et de décharger des échantillons sur un convoyeur qui amène chaque échantillon à l'analyseur approprié. Quand une série d'analyse a été effectuée avec succès, les échantillons retournent au gestionnaire d'échantillon (Sample Manager) et sont souvent placés dans un portoir de déchargement. Cliquez sur le bouton suivant pour visualiser les objectifs du cours. Before hydrating using a timed schedule, it is necessary to define and load a setup list and then activate the timed hydration. Pre-programming hydrations improves test turnaround times and maximizes instrument efficiency based on test volumes. Safety Tip: If your instrument is not currently processing samples when hydration begins, components will begin to move. The warning alerts you to keep your hands out of the instrument. Define a hydration setup list Learn how to define a hydration setup list Checklist TitleChecklist TypeChecklist ContentDisplay the Inventory/Hydration screenHTML Select each checkbox to learn more about defining a hydration setup list. From the Operating Menu screen, select F4: System Prep > F2: Reagent Prep > F6: Reagent SetupDefine SetupsHTML  From the Inventory/Hydration screen, select F5: Define Setups..Select methodsHTML You can have 2 preprogrammed setup lists. Selecting F1: Next Setup toggles between the two setups. In this example, we will define Setup 1 to hydrate BUN and LDH. You need to know the total number of these reagent tests required for a 24 hour time interval: BUN is 200 and LDH is 100. (BUN has 40 tests per well and LDH has 20 tests per well) Highlight BUN and enter 200. Highlight LDH and enter 100.Store SetupHTML Select F3: Store Setup. Remember to Coordinate Supply Alert At volumes with hydration needs to ensure reagents are available for hydration. Now that you have a Setup List defined, you need to load it on the Inventory/Hydration Screen. Select the X in the upper-right corner to close the window and continue.  Loading a pre-programmed setup list Learn how to load a pre-programmed setup list Checklist TitleChecklist TypeChecklist ContentSelect SetupHTMLSelect each checkbox to learn more about loading a pre-programmed setup list. From the Inventory/Hydration screen, select F1: Load Setup 1Load SetupHTML  The tests 200 BUN and 100 LDH appear on the Inventory/Hydration screenSelect Hydrate NowHTML  Now that you have defined and loaded a setup list, select F4: Hydrate Now or set up a timed hydration. Select the X in the upper-right corner to close the window and continue.  Setting Up a Timed Hydration Learn how to set up a Timed Hydration Checklist TitleChecklist TypeChecklist ContentSelect Start TimeHTMLSelect each checkbox to learn more about setting up a Timed Hydration. On the Inventory/Hydration screen, select the start day and time. In this example, Mon to Fri, 0300 is selected. Note: Timed hydrations should be scheduled during non-peak times.Select FrequencyHTML Use the enter key to toggle between Only and Weekly. In this example, Weekly is selected so that hydration is performed Monday through Friday of each week.ActivateHTML Move the cursor to the Activated field. Select the Enter key to change the Activated field to ON. The timer countdown indicates the time until the hydration will occur.  Total Tests to Hydrate indicates how many tests will be hydrated. Select the X in the upper-right corner to close the window and continue.  Hydration Warnings Learn more about Hydration Warnings Checklist TitleChecklist TypeChecklist Content5 minute WarningHTMLSelect each checkbox to learn more about 5 minute warnings. The instrument provides 5 and 1 minute warnings before hydration and alerts the operator when hydration has begun.1 minute WarningHTML This message displays at the one minute warning.Now WarningHTML When this message appears, hydration will begin within ten seconds. Follow the onscreen safety warnings. Select the X in the upper-right corner to close the window and continue.  Vous venez d'apprendre comment les tubes échantillon cheminent à travers le système d'automation. Dans cet exercice pratique, voyons si vous pouvez identifier la séquence des événements qui se produit pendant le cheminement d'un tube qui est programmé pour des dosages sur l'ADVIA Centaur® XP.