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epoc® Blood Analysis System PEP to Go

PEP to Go is an education resource material designed to support competency mastery on-the-job.

SIEMENS Quality ID HOOD 05162002983065 Effective date: 03/06/2019 Healthineers Enter user ID and password. p User ID Password C Login epoc Host 3.24. epoc®Blood Analysis epoc.3 System PEP to Go Unrestricted © Siemens Healthcare GmbH, 2018 epoc®Blood Analysis System – SIEMENS Healthineers Table of Contents Hardware Overview 3 Software Overview 9 epoc Test Cards 38 Sample Processing 44 Performing Maintenance 48 Troubleshooting 54 QA 59 2 Unrestricted © Siemens Healthcare GmbH, 2018 epoc®Hardware Overview SIEMENS Healthineers Reader 1. Battery Powered  The reader operates on a rechargeable Lithium Ion battery located inside the reader housing  The reader can be operated while charging  The battery light will illuminate when the reader needs to be charged 2. Internal Barcode Scanner  Located within the card slot 1  Activated upon entry into the card insertion slot- a red light will be displayed 2 Do  Reads the test card for lot number, serial number, use-by date and card Oc type 3 3. Test Card Slot  The epoc reader has a card slot for inserting the test card  Test card must be inserted properly into the slot order for the reader to process a test  Thermal subsystem: two heating blocks at 37° C Hardware 3 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Hardware Overview SIEMENS Healthineers Reader (continued) 1. Battery Status Indicator  The battery status indicator will display an amber color when charged  When fully charged will process 50 test cards  Takes 4 hours to fully charge the battery 2. Test Status Indicator  The indicator light will display a green color when the system is ready to process a test, a flashing green color when the reader 1 is busy processing a test, or solid red when the test card needs 10000 3 2 G to be re-inserted 3. Power Indicator  When the power button is pressed, the Power Indicator turns solid green indicating that the reader is ON Hardware 4 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Hardware Overview SIEMENS Healthineers Reader 1. Docking Pivot  The epoc host is connected to the reader by inserting the host cradle blade into the docking pivot. The docking pivot also 2 provides a charging connection for the host battery 1 2. Power Jack/AC adapter  The epoc reader operates on a rechargeable battery located inside the reader. The reader can be operated on battery power only or while the battery is being charged using the AC adapter 000 o Dc provided with the reader. The power jack is located at the back of the reader Hardware 5 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Hardware Overview SIEMENS Healthineers Host 1. Rechargeable Battery  The epoc host contains a Lithium Ion rechargeable battery  Insert the host cradle blade into the docking pivot located on the reader to charge the host Enter user ID and passwor User ID Password 2. Touchscreen and Manual Keypad Login O  Keypad allows the operator to enter information 2 Host 3.24. manually into the host. Red power button is located on the bottom left of the keypad and CEEEEL epoc5- allows the operator to manually turn the host on or off 1  Touchscreen allows the operator to enter information into the host using the supplied stylus Hardware 6 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Hardware Overview SIEMENS Healthineers Host 1. Barcode Scanner 1  Located at the top of the host and activated by AA TIT the yellow barcode button on the manual 03-Mar-17 10:49 2 keypad epoc Host Enter user ID and password. e User ID  Allows the operator to scan text, such as patient 2 p 12345 Password ID, directly into the host O Login C 2. Scan Buttons  Two buttons located on the side of the host epoc Host 3.24.4 allow the operator to activate the barcode Login scanner 1 2 BKSP MINO 6 5 ENT TAB CHI O UV OO Hardware 7 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Hardware Overview SIEMENS Healthineers Care-Fill Capillary Tubes  epoc Care-Fill Capillary Tubes are used for the collection and dispensing of capillary blood samples with the epoc Test Cards  epoc Care-Fill Capillary tubes are Mylar™ wrapped glass capillary tubes. The capillary tubes feature a custom adapter specifically designed to perform with the epoc Test Card. Each capillary tube is marked with a single blue band and contains a white porous plug positioned at the 90µL mark  In the event of accidental breakage, the Mylar puncture-resistant wrapping minimizes risks associated with glass capillaries by containing both the glass and the blood sample Hardware 8 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Host Application User Interface 25-Jul-12  The epoc Host login screen appears when the operator epoc Host 10:24 Enter user ID and password. powers on the Host, after any Reset, or after the e operator logs out of the epoc Host Application p User ID  The epoc Host supports two types of users: Password Administrator and Operator. The Administrator has access to customizable features of the epoc Host C Login Application and is able to exit the program to change settings in the Host operating system, outside of the NICU 4 West Host Application. Operators have to ability to perform tests and view test results. Some operator options are epoc Host 3.13.2 limited by the Administrator settings Login  The epoc Host distinguishes between Operators and Administrators by their unique User ID and Password Software 9 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Host Application User Interface 25-Jul-12 The epoc Host Application has a simple, intuitive user epoc Host 10:28 3 × interface. Tabs within the software allow the user to enable fields for text input. Buttons perform actions and Pat ID 45231313164652165 enable fields for text input. 25-Jul-12 10:28:20 Blood BGEM 1. The Toolbar at the bottom of the screen contains Time left to introduce sample 450s Menu Items and Toolbar buttons. The Text Input Button is located here Inject sample ... 2. Screen Tabs located near the bottom of the screen allow the operator to toggle between different screens of the software epoc Readers Rdr1702 (01702)| 2 3. Page Tabs are located across the upper left corner of 1 Tools View Help the screen Software 10 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Host Application User Interface The epoc Host Application has a simple, intuitive user epoc Host 25-Jul-12 10:28 1 × 2 interface. Tabs within the software allow the user to enable fields for text input. Buttons perform actions and Pat ID 45231313164652165 enable fields for text input: 25-Jul-12 10:28:20 Blood BGEM 1. The print and save buttons are located in the upper Time left to introduce sample 450s center of the screen which are unavailable for use when colored gray Inject sample ... 2. The × button allows the operator to exit out of the current screen epoc Readers Rdr1702 (01702) Tools View Help Software 11 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Operational Modes epoc Host 24-May-18 The following Operational Modes are available to the 11:43 operator by tapping the button: 1. Testing Mode (the Run Test option) Rdr1 Rdr17 Rdr18 #03411 #05613 #04456  Run and view tests in progress  Open multiple Reader Screens to view tests 1 Run Test on Readers concurrently 2 View Test 2. Viewing Tests Mode (the View Test option) View EQC  Review previous test results  View multiple tests in a list. Select tests to View Thermal QA view on separate screens epoc Readers Tools View Help Software 12 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Operational Modes epoc Host 24-May-18 The following Operational Modes are available to the 11:43 operator by tapping the button: 1. Viewing Electronic QC Mode(the View EQC option) Rdr1 Rdr17 Rdr18 #03411 #05613 #04456  Review latest electronic quality control record (since the last EDM synchronization) Run Test  View multiple electronic quality control records in View Test a List. Select records to view on separate screens 1 View EQC 2. Viewing Thermal QA mode(the View Thermal QA option) 2 View Thermal QA  Review latest thermal quality assurance records epoc Readers (since the last EDM synchronization) Tools View Help  View multiple thermal quality assurance records in a List. Select records to view on separate screens Software 13 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Testing Mode The following information is displayed when conducting a epoc Host X 24-May-18 11:59 test: X 1. Test Type  Blood Test Pat ID 24-May-18 11:44:12  QA Test 1 Blood 2. Reader Battery Level Calibration 3 2  Green indicates a sufficient charge  Red indicates a Low Battery Level Insert test card to begin test. 3. Progress Bar  Displays the progress of timed events during a test 4 4. Message Box  Displays text and error messages epoc Readers Rdr18 (04456) Tools View Help Software 14 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Main Reader Screen 1. Access the Main Reader Screen by pressing the epoc epoc Host X 24-May-18 14:27 Readers tab. The screen displays all Readers available 2 for use Rdr1. Reader# 0 ... Rdr17. Reader# 2. Locate Readers by pressing the Discovery button. Rdr18. Reader# During discovery mode, the Host searched for Readers in the vicinity. Blue waves imitating the radio signal are visible in the icon. The Discovery Mode is cancelled by pressing the Discovery button again. Discovery can be performed again to locate additional Readers, but not while a connection already exists between a Host and Reader, such as during a test 1 epoc Readers Rdr18 (04456) Tools View Help Software 15 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Main Reader Screen 1. Dedicated Readers are always listed and are indicated epoc Host 02-Nov-11 by the Lock icon Available readers are displayed on 15:15 . 3 the Main Reader Screen either as Icons or in a list. The BE test. Reader# 00263 serial number and name for each Reader are displayed 1 Rdr1686. Reacer# 01686 2 Rdr279. Reader# 00279 2. When a data manager is present, the EDM Rdr2320. Reacer# 02320 Rdr758. Reader# 00758 Synchronization button is used to exchange information between the epoc Host and EDM 3. Tap the Logout button to logout and display the Login screen again Ranges Icons epoc ¥ List Tools |View Help Software 16 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Main Reader Screen Gently press and hold stylus on Reader icon or List Item to epoc Host 02-Nov-11 open the Options Menu for each Reader. Select an activity 15:24 for the Reader to perform: 1. Run blood test- Connect reader to perform blood test test 2. Run QA test- Connect Reader to perform QA test. This #00263 1 Run blood test function is limited to operators who have administrator 2 Run QA test privileges Status 3 Rdr279 Rd #00279 Page 3. Status- Reader reports to Host with Reader status Run Thermal QA information epoc Readers Tools View Help *Procedure is continued on the next slide Software 17 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Main Reader Screen Gently press and hold stylus on Reader icon or List Item to epoc Host 02-Nov-11 open the Options Menu for each Reader. Select an activity 15:24 for the Reader to perform: 4. Page- Reader beeps 5 times. Reader Indicator illuminates to help locate reader test Rd #00263 Run blood test 5. Run thermal QA- Available for Operators authorized Run QA test to run QA tests. Thermal QA records may be saved for Status Rdr279 later viewing or printing. Saved Thermal QA records #00279 4 Page will be sent to your data manager during Run Thermal QA 5 synchronization, and can then be viewed and printed from EDM epoc Readers Tools View Help Software 18 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Reader Screen A tabbed Reader Screen appears for the Reader once a test epoc Host 2 24-May-18 11:59 is started. Reader name and serial number are displayed on 1 × 3 the Reader Screen tab at the bottom of the screen. Three buttons may appear at the top right corner of the Reader Pat ID | 24-May-18 11:44:12 screen: Blood 1. The Print button appears only if there are printers Calibration configured. Tap the Print button to send test results to Insert test card to begin test. a printer connected to the Host. The print button is not enabled during a test 2. The Save button is enabled only after a test completed. Information entered during a test is epoc Readers Rdr18 (04456) automatically saved as the test completes. Information Tools View Help entered after the test completes must be saved by pressing the save button 3. Tap the Red X X button to cancel the test and close the Reader connection Software 19 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Reader Screen Pages There are 3 pages for each Reader Screen: 2 epoc h X 24-May-18 11:59 The Test Results page displays all information and 1 × 1. starts information in a test about a test in progress and Pat ID | 3 the results of a test once it is complete 24-May-18 11:44:12 Blood 2. The Test Information page allows for user input for Calibration optimal information for the test (some calculated or corrected results may not be available unless these Insert test card to begin test. data are completed) 3. The Test Selection page permits for the selection of analytes for testing epoc Readers Rdr18 (04456) Tools View Help Note: Test Date and Time are displayed on each page as well as Patient ID (Blood Test) or Lot Number Field (QA Test) Software 20 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Test Results Page 01-Jan-17 While a test is in progress: epoc Host 08:35 epoc Host 11-Jun-18 01:00  The Progress Bar displays the progress of timed events and X X their title. The color of the Progress Bar varies with each Pat ID |123 Pat ID zxcvvpoiuy event. The Message Box displays all instructions, errors, and 01-Jan-17 08:35:14 Blood 19-Oct-17 10:34:38 messages during the test @ Blood Gases+ Chem+ Meta+ Time left to introduce 260s PH > 8.000 T When a test is complete: pCO2 < 5.0 mmHg  The three tabs (Gases+, Chem+, Meta+) show test results. Inject sample ... pO2 181.3 mmHg pH(T) cnc Click on the tabs to display each set of results data. Results pCO2(T) cnc displayed depend on the Test Card type and tests selected pO2(T) 185.5 mmHg cHCO3- cnc BE(ecf) cnc cSO2 cnc epoc Readers Rdr3610 (03610) Tests |zxcvpoiuy Tools View Help Tools View Help Q Software 21 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Test Results Page Message Interpretation cnc Could not calculate. Component required for calculation was not available Failed iQC Failed internal quality control expired Card was expired. Test results not displayed Software 22 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Critical Values Actions  After completing a test, if one or more of the test results fall epoc Host 05-Jul-12 11:41 outside of its critical range and the Host has been configured X to flag critical results, the result will appear in bold red with Pat ID |12345 crea out-of-critical-range indicator and the Critical Actions button 05-Jul-12 11:40:22 displayed Gases + Chem+ Meta+  Tap the Doctor button to open the Critical Actions Window, pH 7.861 pCO2 7.1 mmHg where actions taken by the Operator may be entered p02 200.3 mmHg CHO03- 14.5 mmol/L BE(ecf) -9.3 mmol/L CS02 99.8 % epoc Readers Rdr775 (00775) Tools View Help Software 23 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Critical Actions Window epoc Host 03-Nov-11 1. Mandatory fields appear in red in the Critical Actions 12:17 Window. Action dropdown contains selections for Notify Save [x] Cancel [x] Action 1 physician, Notify RN, Repeated test, Sent to lab, Expected Notify RN values and Other Notify 2. Select Notify to enter text information such as the name of 2 Physician who was notified. If Action was selected, then a Read back Yes O NO 3 text entry is required for valid action Time Current Change 4 3. Select Yes or No to record action of reading back test results Date Current Change 4. The time and date of the action is automatically recorded using current time and date. Tape Change to edit the time Save and date epoc Readers test (00263) *Procedure is continued on the next slide Software 24 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Critical Actions Window 03-Nov-11 5. If the Host has been configured to allow additional epoc Host 12:17 documentation fields, a scrollbar will appear to the right , Save [x] Cancel [x] 7 providing access to additional fields. Consult the Additional Action Notify RN Documentation subsection for the list of fields Notify 6. Tap Save to keep all text entered. The window closes after selecting the save option Read back O Yes O No 7. Tap Cancel to close the window. No Critical Values action Time Current Change changes will be saved Date Current Change 6 Save epoc Readers test (00263) Software 25 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Test Information Page  Use the Optional fields on this page to enter test specific epoc Host 30-Mar-11 15:40 data. Enter Patient information at any time during the test. X Information entered prior to the end of the test is saved Pat ID automatically with test results when the test is completed. ID2 Save any information entered after the test completion Hemodilution? () Yes () No before the next test begins by tapping the Save button. Once Sample the test screen is closed, patient information can no longer be Temp entered |Reject test Comments  Use Pat ID 1 and ID 2 fields to enter sample identifiers. Pat ID field can be accessed from any page. ID2 may be used to enter alternate sample identifiers such as an order number epoc Readers Rdr411 (00411) Tools View Help Note: The green arrows on either side of the screen must be pressed in order to advance to new options. Software 26 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Test Information Page  Use the Hemodilution field to select the hemodilution epoc Host 30-Mar-11 15:40 correction factor for Hematocrit. Selecting Yes corrects the X Hematocrit result for the amount of Hemodilution Pat ID  Select Sample Type to stamp the test record for identification ID2 purposes. Associated with each sample type are unique Hemodilution? () Yes () No reference and critical ranges that are applied to the test Sample results and are configured by the System Administrator Temp  Sample types include: |Reject test Comments Unknown Arterial Venous Mixed-venous epoc Readers Rdr411 (00411) Tools View Help (Umbilical) Cord (Umbilical) Cord Arterial (Umbilical) Cord Venous Capillary Software 27 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Age and Gender Screen epoc Host 05-Jul-12 10:14  Use the Green Arrows at the sides of the Test Information × Page for entry of Age and Gender of the patient Pat ID 12345 Age 18 years Gender emale epoc Readers Rdr775 (00775) Tools View Help Software 28 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Test Information Page  Use Temp to enter patients body temperature to obtain epoc Host 30-Mar-11 15:40 temperature corrected values for pH, pCO2 and pO2. X Temperature measuring units are set by the administrator to Pat ID Farhenheit or Celsius ID2  If allowed to reject tests, the user can do so by checking the Hemodilution? () Yes () No Reject Test box. The EDM will mark this test record as Sample rejected and not send it to the Lab Information System Temp  In the Comments box, enter test-related comments to save Reject test Comments with the test record epoc Readers | Rdr411 (00411) Tools View Help Software 29 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Test Selection Page  Use the check boxes to select the proper analytes for testing epoc Host 05-Jul-12 13:28  Use four quick buttons to make multiple selections as X described Pat ID 12345 crea A. Select All 05-Jul-12 13:27:50 B. Clear All Select tests to perform ... C. Gases pH Lac pCO2 Crea Select all D. Electrolytes pO2 Clear All  Healthcare Institution policy may require selection of Na+ K+ Gases analytes for testing. Policy is set in the Host Application by Ca++ Electrolytes the System Administrator Hct  When required, analytes must be selected before the end of Glu the test epoc Readers Rdr775 (00775) Tools View Help Note: New epoc Test Cards are available that include BUN/TCO2. Due to the addition of new analytes and options, this screen will be changing. Software 30 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Respiratory Therapy Parameters  Use the Green Arrows at the sides of the main Test epoc Host x 02-Nov-11 12:46 Information page for entry of Respiratory Therapy X parameters. Many of the fields contain drop down boxes with Pat ID 987654321 choices. Select the text and tap the backspace key on the Draw site | onscreen keyboard to delete text from these fields. The Allen's test values listed on the screen are recorded for reference Del. system purposes only. These values do not impact test results Mode Dropdown Box Choices: FIO2 % Draw site- Art line, R/L Radial, R/L Brach, R/L Fem, Central VT 1. RR Line, R/L Heel, R/L Finger, R/L Toe, PICC, PA, RA, RV, Swan RQ Ganz, UAC and UVC Allen’s test- Positive, Negative and N/A epoc Readers test (00263) 2. Tools View Help a * Procedure continued on next slide Software 31 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Respiratory Therapy Parameters Dropdown Box Choices: epoc Host x 02-Nov-11 12:46 3. Del. System- Adult Vent, Aeromask, AeroTX, AquinOx, X Bagging, BiPAP, Cannula, CPAP, ET Tube, FaceTent, HFJV, Pat ID 987654321 HFNC, HFOV, Incubator, Neo Vent, NRB, Optiflow, Oxy Hood, Draw site | Oxy Mask, Pedi Vent, PRB, Room Air, T Collar, T Tube, Allen's test Vapotherm, and Venti Mask Del. system 4. Mode- AC, BiLevel, CPAP/PS, PAV, PC, PC/PS, PRVC, PRVC/PS, Mode PS, SIMV, SIMV/PC, SIMV/PS, TC, VC, BiVent, NCPAP, NIV, FIO2 % SIMV(PC)+PS, SIMV(PRVC)+PS, SIMV(VC)+PS, VS. VT RR 5. Units (beside FiO2)- percentage and lpm RO 6. FiO2, VT, RR, RQ- require numeric data entry epoc Readers test (00263) Tools View Help Software 32 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Viewing Tests Mode epoc Host 10-Jun-18  Tap the Toolbar button at the bottom of the screen 22:18 epoc Host 10-Jun-18 22:20  Select View Test to display the list of Test Results  Fields viewed on the List page can be selected from the Filter by Filter by Pat ID/Lot # Pat ID/Lot # View menu on the Toolbar. Check or uncheck fields to display Advanced >> Operator Simple << on the List page Clear Card # Clear All  Narrow test results by using the Filter page. Enter Apply Reader SN Apply search parameters such as Operator and/or date range to Test Mode limit the results From 19-Oct-17  Toggle between Simple<< or Advanced >> filtering mode to To 10-Jun-18 Upload status limit/enhance the search parameters All  Tap Clear All to remove all entered text Tests| zxcvpoiuy Tests| zxcvpoiuy  Tap Apply to view filtered results directly Tools View Help Tools View Help Software 33 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Viewing Tests Mode Dropdown Box Choices: epoc Host 11-Jun-18 00:51 1. Hold the stylus on the desired test result row momentarily. A new menu opens 2 tests. Double-tap to view test. Pat Test Time Operator 2. Select View this test from the menu 15-Nov-17 12345 3. Go back to the list by tapping Tests at the bottom left corner 1 kcVvpoi 19-Oct-17 of the screen to select another test to view. Multiple tests View this test 2 open on separate tabs at the bottom of the screen to select Print this test another Test to view 4. Tap Tabs to move between multiple test results 3 Tests Tools View Help Q. Software 34 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Viewing Tests Mode epoc Host 11-Jun-18 To print a complete test result: 00:51 1. Hold the stylus on the desired test result row momentarily. A new menu opens 2 tests. Double-tap to view test. Pat Test Time Operator 2. Select Print this test from the menu, or print a test result by 15-Nov-17 12345 tapping the print icon while on the Test Result Tab 1 xcVvpoi 19-Oct-17 View this test Print this test 2 Tests Tools View Help Q. Software 35 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Viewing Tests Mode 2 Test results are available on four pages: epoc X 11-Jun-18 22:05 1 × 1. Test Results Page: Measured, calculated and corrected results Pat ID 3 oiuy 2. Test Information Page: Data as entered with the test and Blood 19-Oct-17 10:34:38 date/time of the last Electronic QC Gases+ Chem+ Meta+ Glu 53 mg/dl 3. Reference Ranges Page: Reference ranges for each analyte at Lac 2.17 mmol/L the time of the test Crea cnc eGFR cnc 4. Critical Ranges Page: Critical Ranges for each analyte at the time of the test Tests 00-17225-20 zxcvpoiuy Tools View Help Q Software 36 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Software Overview SIEMENS Healthineers Viewing Electronic QC Tap the Toolbar button at the bottom of the screen to open the epoc Host 11-Jun-18 22:18 epoc Host Hill X 11-Jun-18 22:23 menu with four options Select View EQC to display a list X 4 of Electronic QC records. To view an Elecrtonic QC record: Pat ID zxcvvpoiuy 10 Electronic QC records shown. Blood 19-Oct-17 10:34:38 Reader Date & Time Flag 1. Press and hold the stylus momentarily on the Row with the Gases+ Chem+ Meta+ 04456 |11-Jun-18 01:05:11 Passed desired record. A new menu window opens 04456 11- Glu 53 mg/dl 2. Select View this record from the menu Lac 2.17 04456 View this record 2 24- Ssed Crea Run Test cnc 04456 24- Print this record ssed 3. Go back to the list by tapping Electronic QC at the bottom eGFR cnc 1 4456 24- ssed left corner of the screen to select another record to view View Test 04456 24-May-18 10:09:06 Passed 4. Tap tabs to move between multiple Electronic QC record. View EQC 04456 22-May-18 10:41:55 Passed 04456 22-May-18 10:31:46 Passed Refresh the list by tapping the refresh button if View Thermal QA 04456 15-Nov-17 15:57:48 Passed required Tests 00-17225-ZU| zxCVVpoiuy] Electronic QC 3 Tools View Help Tools View Help 0 Software 37 Overview Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Test Cards SIEMENS Healthineers General Test Card Information  A test card is comprised of an array of sensors on a sensor module mounted in a credit card sized fluidic housing with a sample entry port and a sealed calibrator fluid reservoir epoc BLOOD ANALYSIS REF 10736515 PH Na+ Glu pCO2 K+ Lac pO2 Ca++ Crea TCO2 CI- BUN Hct 2016-12-12 LOT 88-88888-88 SN 888888 ®CE 86'F 15ºC Epocal Inc. Ottawa, ON Canada siemens.com/epoc 50012187-00 Test Cards 38 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Test Cards SIEMENS Healthineers General Test Card Information Front of Test Card characteristics: 1 1. Sensor module contact surface epoc 2. Test panel type BLOOD ANALYSIS 3. Barcode REF 10736515 4. Use-by date PH Na+ Glu 2 pCO2 K+ Lac pO2 Ca++ Crea 3 TCO2 CI- BUN Hct 4 2016-12-12 LOT 88-88888-88 SN 888888 CE Epocal Inc. Ottawa, ON Canada siemens.com/epoc 50012187-00 Note: The epoc Reader will reject any Test Card past the use by date on the Test Card. The use by date is based upon continuous storage of the Test Cards between 15° and 30°C Test Cards 39 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Test Cards SIEMENS Healthineers General Test Card Information Back of Test Card characteristics: 1 2 1. Measurement region 2. Sensor module sensor surface 3 3. Valve 4. Blood Waste Chamber 5. Sealed Calibrator Reservoir 5 6. Sample Entry Port 4 6 Test Cards 40 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Test Cards SIEMENS Healthineers Test Card Physical Characteristics Size L86mm x W54mm x H1.4mm Weight 6.3± 0.3 grams Materials Co-polyester body Polypropylene adhesive labels Polyethylene-coated aluminum foil Water-based calibration fluid Fiberglass-reinforced epoxy tape with an array of nickel-gold coated copper electrodes Test Cards 41 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Test Cards SIEMENS Healthineers Test Card Packaging Each single-use test card is packaged by the manufacturer into a card pouch which also contains one strip of desiccant. Twenty- five card pouches are packed into boxes of 25 cards. Quantities of 50 card boxes are packed into larger shipping cartons epoc BLOOD ANALYSIS REF 10736515 PH Na+ Glu pCO2 K+ Lac pO2 Ca++ Crea TCO2 CI- BUN Hct 2016-12-12 LOT 88-88888-88 SN 888888 CE Epocal Inc. Ottawa, ON Canada siemens.com/epoc 50012187-00 Note: The green epoc Test Card is packaged into a single card pouch. Fifty card pouches are packed into boxes of 50 cards. Quantities of 50 card boxes are packed into larger shipping cartons. Test Cards 42 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Test Cards SIEMENS Healthineers Test Card Shipping Controls  Test Card shipping cartons include two Temperature Monitors, which change color when the shipping temperature telatemp ColdSNAP Fullerton. CA Temperature Recorder WINDOW TURNS RED BRIEF WHEN EXPOSED TO 2ºC MODERATE RED INDICATES DESCENDING CT2C D 30'C / 86'F PROLONGED EXPOSURE ABOVE Time - Temp Tag is outside the specified range WarmMark  A low Temperature Monitor turns red below 2° C telatemp ColdSNAP Fullerton. CA Temperature Recorder WINDOW TURNS RED BRIEF WHEN EXPOSED TO 25C  A high Temperature Monitor turns red above 30°C DESCENDING CT2C D RED INDICATES MODERATE 30'C / 86"F PROLONGED EXPOSURE ABOVE Time - Temp Tag Warm Mark  Temperature monitors must be checked when Test Cards are received to verify that the temperature limits were not exceeded during shipment. If one or both of the temperature monitors indicate any RED, place the card shipment on hold and isolate from possible use  Never use Test Cards shipped outside the specified temperature limits. Never subject Test Cards to excessive shock (dropping, throwing, shaking) during shipping and handling Test Cards 43 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Sample Processing SIEMENS Healthineers Timing of Sample Introduction  After about 165 seconds of calibration the Test Status epoc Host 25-Jul-12 10:28 Indicator stops flashing green indicating that the Test Card is × ready to receive a test sample Pat ID 45231313164652165  The epoc Host displays the message: “Inject sample” 25-Jul-12 10:28:20  The screen has a bar indicating the time remaining to Blood BGEM Time left to introduce sample 450s introduce a sample. The blood sample must be introduced into the Test Card during this 450-second (or 7.5-minute) Inject sample ... period epoc Readers Rdr1702 (01702) Tools View Help Note: Introducing the sample too soon or too late will cause an error and abort the test. A new Test Card must be inserted and the test procedure started again Sample 44 Processing Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Sample Processing SIEMENS Healthineers Sample Introduction Using A Syringe 1. Hold the syringe barrel vertically between fingertips and thumb 4 2. Using slight downward pressure, secure the syringe’s luer tip into the center recess of the Test Cards blood sample entry port. Rotate the syringe up to ¼ turn to ensure a good seal. 1 3. The operator should feel the syringe tip engage with the rubber seal of the Test Card entry port. Press the syringe 2000 3 with enough downward force to engage the syringe tip with DO the blue rubber seal 2 4. While maintaining downward pressure, use the index finger of the other hand to steadily depress the syringe plunger with a single, smooth, continuous motion until prompted to stop. The Reader provides an audible beep and the Test Status Indicator flashes green indicating enough sample for analysis was received. The Host also displays sample acceptance Sample 45 Processing Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Sample Processing SIEMENS Healthineers Sample Introduction Using A Care-Fill™ Capillary Tube 1. Hold the cap tube by the large end of the adapter and insert into the Test Card sample port rotating up to ¼ turn to ensure a good fit 2. Using fingers of the free hand, push plunger down completely with one, smooth motion 2 3. Wait for the Reader to beep before removing 1 Sample 46 Processing Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Sample Processing SIEMENS Healthineers Test Completion  Once the analysis is complete, the epoc Host displays the test results from the reader screen. Display the results by tapping the tab epoc Host 05-Jul-12 11:41 on the left of the screen X  The Patient ID must be entered before the test results are displayed. Pat ID 12345 crea Once saved, the Patient ID textbox and Save button are disabled 05-Jul-12 11:40:22 again Gases+ Chem+ Meta+  When the Reader has completed a test, the Test Status Indicator on PH 7.463 T pC02 20.2 mmHg the Reader will flash green, indicating the Test Card can be removed. pO2 224.3 mmHg The motorized mechanism is heard briefly as the calibration fluid CHCO3- 14.5 mmol/L BE(ecf) -9.3 mmol/L plungers are disengaged CS02 99.8 % +  Remove the card from the Reader and dispose of it using appropriate biohazard precautions epoc Readers Rdr775 (00775) Note: Never re-use a test card. Test Cards are for single Tools View Help use only. After removing the used Test Card, the Reader’s Test Status Indicator will turn solid green, indicating that the Reader is ready to perform another test Sample 47 Processing Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Maintenance SIEMENS Healthineers Care of the epoc System The epoc Blood Analysis System requires a minimum of care and maintenance. The following general practices are recommended: Turn of the epoc Reader and Host when not in use in order to conserve the battery D 900 Store the epoc Reader and Host in a secure, dry location when not in use Periodically check the condition of the wires and cables of the AC adapter to check for wear and ensure integrity of electrical connections Note: Keep the epoc System Manual available to both operator and administrator Maintenance 48 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Maintenance SIEMENS Healthineers Cleaning the epoc System Wipe epoc Reader and epoc Host using a damp soft cloth or gauze pad with one of the following:  Mild detergent or non-abrasive cleanser  Alcohol D 900  Soap and Water  10% household bleach solution Note: Never submerse the epoc Reader and epoc Host into any liquid. Never allow fluids to pool in Pivot or Membrane Switch areas Maintenance 49 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Maintenance SIEMENS Healthineers Decontaminating the epoc System Decontaminate the epoc Reader or epoc Host when blood is spilled on them to prevent exposure to any blood-borne pathogens. Wear appropriate gloves to perform the following procedure: 1. Prepare 70% alcohol (three parts tap water with seven parts isopropyl alcohol). It is recommended that the solution be prepared D 900 fresh daily 2. Soak several gauze pads in the bleach solution. When removing a pad from the solution, squeeze excess liquid so that the pad does not drip 3. Gently rub any areas of dried blood with one or more moist pads until they are soft enough to wipe clean 4. After removing any stained areas, clean all surfaces twice with fresh pads soaked in the bleach solution. Ensure that the bleach solution Note: Never submerse the epoc Reader and epoc Host into is in contact with the surface for three minutes before wiping it off any liquid. Never allow fluids to pool in Pivot or Membrane Switch areas * Procedure is continued on next slide Maintenance 50 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Maintenance SIEMENS Healthineers Decontaminating the epoc System 5. Soak fresh pads in warm tap water and squeeze excess fluid. Wipe all surfaces and allow them to dry before turning any of the epoc System components on 6. Dispose of the used gauze pads in a biohazard disposal receptacle D 900 Note: Never submerse the epoc Reader and epoc Host into any liquid. Never allow fluids to pool in Pivot or Membrane Switch areas Maintenance 51 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Maintenance SIEMENS Healthineers Changing the epoc Reader Battery 1. Remove the screw that connects the battery door to the Reader using a Philips #0 or 3/16” slotted screwdriver 2. Lift the battery door from the reader 3. Carefully remove the battery from its compartment to allow access to its cable connection to the Reader 4. Gently unplug the battery from the Reader. Tweezers may be useful in order to pull the connector out 5. Connect the new battery connector to the epoc Reader. The connector orientation tab should be visible as seen in the picture 6. Place the new battery into its compartment. Place its wires in the small area to the right of the connection to protect the wires. Ensure that the battery is lying flat without wires underneath or on top * Procedure is continued on next slide Maintenance 52 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Maintenance SIEMENS Healthineers Changing the epoc Reader Battery 7. Install the battery door by inserting its hinge at an approximate 30˚ angle behind the battery. Pressure needs to be applied to the edge of the door in order for its hinges to snap into place. The battery door can then be closed into place 8. Secure the door by fastening with the screw removed, using a Philips #0 or 3/16” slotted screwdriver. Do not over-tighten the screw to avoid damaging the plastic Maintenance 53 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Troubleshooting SIEMENS Healthineers Out-of-range results on the Test Card for QA and Calibration From the epoc Host, disconnect from the Reader, then reconnect. If the wireless connection is successful and Electronic QC passes, verify the following and then repeat the test: 1. Use of correct control or Calibration Verification Value Assignment Datasheet 2. Use by Date of Controls has not been exceeded 3. The Controls have been handled correctly: see Instructions for Use 4. Test Cards and Controls have been stored correctly  If the repeat results are in range, the cards are acceptable for use. If the results are still out of range despite meeting the above criteria, repeat the test using a new box of control solutions and/or Test Cards. Contact Technical Services if Controls or Test Cards continue to fall outside of specified ranges Troubleshooting 54 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Troubleshooting SIEMENS Healthineers Failed Thermal QA  Perform Reader Thermal QA only after Reader has remained in same location and temperature with no airflow for a minimum of two hours  Reader must remain OFF for at least 30 minutes prior to Thermal QA because heating from circuits inside Reader will cause temperature variations C  If a Reader fails Thermal QA, this may indicate that three Temperature Sensors Ja inside the Reader are not at the same temperature. This can occur if the 900 O Reader is not fully equilibrated to the environment after being turned OFF  Turn the Reader ON. Repeat Thermal QA once. The Reader is acceptable for use if Thermal QA passes on the second attempt  If Thermal QA fails when repeated, contact Siemens Customer Services Troubleshooting 55 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Troubleshooting SIEMENS Healthineers Failed Reader Electronic QC  If a Reader fails electronic QC, first confirm the failure.  Close the Reader Screen, turn the Reader OFF and ON, and then try to connect to the Reader again.  If Reader connects successfully, and therefore passes electronic QC, it is C acceptable for use. If the problem is not resolved, contact Technical Services Ja 900 O Troubleshooting 56 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Performing QA SIEMENS Healthineers How To Run A QA Test Using An eVAD File 1. Start a QA test by selecting the Run QA Test option or switch to QA test while running a blood test epoc Host X 15-Jul-15 epoc Host 13-Jul-15 19:18 14:05 2. Scan QA information: X| X A. Find the fluid you want to run in the printed VAD Pat ID _V1:183-1-8428 B. Lot # 2 Scan the appropriate VAD barcode into the Lot # field. The 15-Jul-15 19:17:54 Test type Quality control screen will automatically switch to the middle tab where the Blood Fluid twne: Quality control QA Fluid information will be shown Reader configuration 55 Fluid 3 Calibration verification Fluid Proficiency 3. Select a test from the drop down menu Other A. Quality Control Configuring Reader ... B. Calibration Verification C. Proficiency Switch to QA test 1 D. Other Run Thermal QA Status (03610) epoc Readers Rdr3610JH (03610) Tools View Help Tools View Help * Procedure continues on next slide QA 57 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Performing QA SIEMENS Healthineers How To Run A QA Test Using An eVAD File 4. Select the desired analytes for the QA test. Depending on the fluid type, all applicable analytes will be selected automatically epoc Host 13-Jul-15 epoc Host x 11-Jun-15 14:06 16:31 as soon as the barcode is scanned. You may also adjust the list X × by unchecking the boxes for the analytes you do not wish to Lot # HPX:16301512 report Lot # Cv1:183-1-b428 13-Jul-15 14:05:01 11-Jun-15 16:29:14 5. View the test results. When the QA test is completed, the Select tests to perform ... Fluid type: CV1 screen will display Pass or Fail. Tap on the green bar to see the v p02 Fluid ref: 183.000.005 complete results Select all Fluid expiry: 31-Jul-15 Clear All 4 Gases Pass 5 Electrolytes epoc Readers Rdr3610JH (03610) epoc Readers Rdr3610JH (03610) Tools View Help Tools View Help QA 58 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Performing QA SIEMENS Healthineers How To Run A QA Test Using An eVAD File  Value Assignments are lot and software (sensor configuration) epoc® System Value Assignment Datasheet LOT 183-B742 SIEMENS specific, and appropriate Value Assignment Datasheets (VADs) Sensor Configuration 31.n (epoc18172.eVAD) REF 183.000.005 Eurotrol™ Calibration Verification Fluids, n = 1 Healthineers 2018-10-31 must be used. Value Assignment Datasheets contain target values and acceptable ranges for Aqueous Control and CV1:183-1-B738 CV2:183-2-B738 CV3:183-3-B738 CV4:183-4-B738 CV5:183-5-B738 X R, n = 1 X R, n = 1 X R, n = 1 X R, n = 1 X R, n = 1 PH 6.973 6.913 7.033 7.335 7.275 - 7.395 7.572 7.512 - 7.632 6.641 6.581 6.701 7.887 7.827 7.947 Calibration Verification Fluids specific to the epoc® System pCO2 mmHg 77.7 68.4 87.0 41.3 33.8 48.8 24.0 16.5 31.5 138.7 113.7 163.7 15.5 8.0 - 23.0 kPa 10.36 9.12 11.60 5.51 4.51 6.51 3.20 2.20 - 4.20 18.49 15.16 21.82 2.07 1.07 3.07  Download the current Value Assignment Datasheets at: pO2 mmHg 62.0 46.2 77.8 101.0 85.2 116.8 195.0 165.7 224.3 29.4 13.6 45.2 615.6 492.5 - 738.7 kPa 8.26 6.15 10.37 13.47 11.36 15.58 26.00 22.10 29.90 3.92 1.81 6.03 32.06 65.65 98.47 Na+ mmol/L 111 105 117 141 135 147 167 160 174 80 74 86 191 184 198 www.healthcare.siemens.com/blood-gas/blood-gas- mEq/L K+ mmol/L mEq/L 2.1 1.7 2.5 4.0 3.6 4.4 6.1 5.5 6.7 7.9 7.3 8.5 12.5 11.8 13.2 mmol/L 1.56 1.44 1.68 1.19 1.10 1.28 0.67 0.60 0.74 3.92 3.48 4.36 0.30 0.23 0.37 systems/epoc-blood-analysis-system (Customer Resource Ca++ mg/dL 6.2 5.7 6.7 4.8 4.4 5.2 2.7 2.4 3.0 15.7 13.9 17.5 1.2 0.9 1.5 mEq/L 3.1 2.9 3.3 24 2.2 2.6 1.3 1.2 14 7.8 6.9 8.7 0.6 0.5 0.7 mmol/L Center) CI- mEq/L 78 73 99 92 106 124 116 132 59 55 138 124 152 mg/dL 30 21 39 102 87 117 257 200 314 15 6 24 682 532 832 Glucose mmol/L 1.6 1.1 2.1 5.6 4.8 6.4 14.1 11.0 17.2 0.8 0.3 1.3 37.5 29.3 45.7  Never use Target Values or Ranges from the package insert g/L 0.30 0.21 0.39 1.02 0.87 1.17 2.57 2.00 3.14 0.15 0.06 0.24 6.82 5.32 8.32 mmol/L 0.79 0.49 1.09 2.67 2.07 3.27 6.01 4.66 7.36 0.45 0.15 0.75 17.77 11.91 23.63 Lactate mg/dL 7.1 4.4 - 9.8 18.6 29.4 54.2 42.0 66.4 4.1 160.1 107.3 included with Control Fluids 1.4 6.8 212.9 g/L 0.07 0.04 0.10 0.24 0.19 0.29 0.54 0.42 0.66 0.04 0.01 0.07 1.60 1.07 2.13 Creatinine mg/dL 0.91 0.46 1.36 2.19 1.70 2.68 4.37 3.40 5.34 0.43 0.00 - 0.88 14.65 9.81 19.49 umol/L 80 40 120 194 151 237 386 300 472 38 78 1295 868 1722 O QA 59 Unrestricted © Siemens Healthcare GmbH, 2018 epoc® Performing QA SIEMENS Healthineers How To Run A QA Test Using An eVAD File  Each Value Assignment Datasheet is identified by the: LOT 183-B742 A. Fluid Name, Level, Lot Number, and epoc System Sensor epoc® System Value Assignment Datasheet Sensor Configuration 31.n (epoc18172.eVAD) B SIEMENS REF 183.000.005 Eurotrol™ Calibration Verification Fluids, n = 1 Healthineers 2018-10-31 B. Configuration Version A C. VADs change with sensor configuration changes and changes CV1:183-1-B738 CV2:183-2-B738 CV3:183-3-B738 CV4:183-4-B738 CV5:183-5-B738 X R, n = 1 X R, n = 1 X R, n = 1 X R, n = 1 X R, n = 1 to control fluid lot numbers. Assure all information is correct PH 6.973 6.913 7.033 7.335 7.275 7.395 7.572 7.512 7.632 6.641 6.581 6.701 7.887 7.827 - 7.947 pCO2 mmHg 77.7 68.4 87.0 41.3 33.8 48.8 24.0 16.5 31.5 138.7 113.7 163.7 15.5 8.0 23.0 kPa 10.36 9.12 11.60 5.51 4.51 6.51 3.20 2.20 4.20 18.49 15.16 21.82 2.07 1.07 3.07 when using a VAD to determine acceptability of your results. pO2 mmHg 62.0 46.2 77.8 101.0 85.2 116.8 195.0 165.7 - 224.3 29.4 13.6 45.2 615.6 492.5 - 738.7 kPa 8.26 6.15 10.37 13.47 11.36 15.58 26.00 22.10 29.90 3.92 1.81 6.03 82.06 65.65 98.47 Na+ mmol/L mEg/L 111 105 117 141 135 147 167 160 174 80 74 86 191 184 198 The epoc System Sensor Configuration version is located in K + mmol/L mEq/L 2.1 1.7 2.5 4.0 3.6 4.4 6.1 5.5 6.7 7.9 7.3 8.5 12.5 11.8 13.2 mmol/L 1.56 1.44 1.68 1.19 1.10 1.28 0.67 0.60 0.74 3.92 3.48 4.36 0.30 0.23 0.37 the epoc Host’s Help About Menu. Ca++ mg/dL 6.2 5.7 6.7 4.8 4.4 5.2 2.1 2.4 3.0 15.7 13.9 17.5 1.2 0.9 1.5 mEq/L 3.1 3.3 2.4 2.6 1.4 6.9 8.7 0.5 0.7 CI- mmol/L mEq/L 78 73 83 99 92 106 124 116 132 59 55 63 138 124 152 mg/dL 30 21 39 102 87 117 257 200 314 15 24 682 532 832 Glucose mmol/L 1.6 1.1 2.1 5.6 4.8 6.4 14.1 11.0 17.2 0.8 0.3 1.3 37.5 29.3 45.7 g/L 0.30 0.21 0.39 1.02 0.87 1.17 2.57 2.00 3.14 0.15 0.06 0.24 6.82 5.32 8.32 mmol/L 0.79 0.49 1.09 2.67 2.07 3.27 6.01 4.66 7.36 0.45 0.15 0.75 17.77 11.91 23.63 Lactate mg/dl 7.1 4.4 9.8 24.0 18.6 29.4 54.2 42.0 66.4 4.1 1.4 6.8 160.1 107.3 212.9 g/L 0.07 0.04 0.10 0.24 0.19 0.29 0.54 0.42 0.66 0.04 0.01 0.07 1.60 1.07 2.13 Creatinine mg/dl 0.91 0.46 1.36 2.19 1.70 2.68 4.37 3.40 5.34 0.43 0.00 0.88 14.65 9.81 19.49 umol/L 80 40 120 194 151 237 386 300 472 38 78 1295 868 1722 O QA 60 Unrestricted © Siemens Healthcare GmbH, 2018 Quality ID HOOD 05162002983065 SIEMENS Effective date: 03/06/2019 Healthineers Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2019 Global Siemens Healthineers Headquarters Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84 0 siemens.com/healthineers 61 Unrestricted © Siemens Healthcare GmbH, 2018

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