IMMULITE® 1000 Immunoassay System Daily Maintenance Online Training

You learned about the pathophysiology of arrhythmias in this chapter, and followed Ms. Martens' case.  You know that cardiac arrhythmias are irregularities of the normal rhythmic beating of the heart caused by a disorder in the cardiac pacemaker and/or conduction system. You can differentiate between bradycardias and tachycardias. In addition, you are familiar with the most common causes and symptoms of cardiac arrhythmias and you know that the basic diagnostic procedures include taking a medical history, physical examination, laboratory diagnostics, as well as ECG and echocardiography. An EP study is reserved for more difficult cases, and, with ablation, offers a therapeutic alternative.  Drug therapy is the basic treatment used for many arrhythmias. Pacemaker and AICD implantation is performed for specific indications. You also know that any existing underlying diseases should always be treated first. Теперь проверьте вновь полученные знания с помощью следующего контрольного теста. Then we’ll move on to Heart failure (also called cardiac insufficiency) in the next chapter.   Welcome to the IMMULITE® 1000 Immunoassay System Daily Maintenance Online Training course.  Performing the maintenance procedures routinely and properly helps to keep your system running efficiently.  This course introduces you to the daily maintenance procedures:   Logging off and restarting the computer Performing daily probe cleaning Initializing the software Checking the consumables and waste Priming the syringes, water probe, and substrate probe Select Next to continue. Describe how to perform each of the startup tasks Describe how to perform log off and restart List the steps to perform daily probe cleaning Upon successful completion of this course, you will be able to: Select Next to continue. Warfarin is a commonly prescribed oral anticoagulant used for long term anticoagulant therapy.  It is often referred to by one of its brand names: Coumadin, Marfarin, or Jantoven.  Warfarin works by inhibiting formation of fully functional Vitamin K dependent factors:  II, VII, IX, X, as well as Protein C and Protein S.   Warfarin is used for the prophylaxis or treatment of venous thrombosis, pulmonary embolism and thromboembolic complications associated with atrial fibrillation and or cardiac valve replacement.  It also plays a role in reducing the risk of death, recurrent MI and thrombotic strokes. Between 20-30 million warfarin prescriptions are written annually in the United States making it one of the most commonly prescribed drugs.  Warfarin therapy can have serious adverse events which include bleeding. Monitoring is essential in order to prevent thromboembolic complications and minimize bleeding episodes. It is monitored using the prothrombin time reported as INR. The recommended therapeutic range for warfarin is an INR between 2.0 and 3.0. A higher range (2.5-3.5) is recommended for certain clinical conditions such as a mechanical heart valve replacement.   Congratulations. You have completed the IMMULITE 1000 Immunoassay System Daily Maintenance Online Training course.    Listed below are the key points that have been presented.    Take time to review the material before you proceed to the final quiz.    Key Points:   Describe how to perform log off and restart Logging off the software:  Select the Log Off button on the Home Screen.  Putting the system in IDLE: If the system is in Run mode, select the Pause button on the Display Panel three times to put the system in IDLE mode. If the Display Panel states "IMMULITE Press GO to start", select the Alarm Mute and Go buttons on the Display Panel simultaneously to put the system in IDLE mode. Restarting the computer: Select the Shutdown button on the Startup screen and then select Yes. On the Windows desktop, select the Start button on the lower left-hand corner of the screen and select Shut Down. When the shut down window appears, select Restart followed by the OK button.  Press the Enter key at the Log on Information window to return to the Windows desktop.  List the steps to perform daily probe cleaning Load the probe cleaning wedge with 2 mL of probe cleaning solution in position 1 on the reagent carousel. Initialize the daily probe cleaning diagnostic by selecting PRBCLEAN and then Run on the Diagnostics screen. Press Go on display panel to start the cleaning procedure. Check the probe dispense angle. Close the diagnostics screen. Describe how to perform each of the startup tasks Initialize the software by selecting Run IMMULITE or Run Turbo on the Startup screen.  When initialization is complete, the Home screen will appear on the screen and the display panel will display the message "Press Go to start". Select Go on the Display Panel to initiate the startup task prompts. When prompted, check the consumables: water, probe wash, substrate, solid waste, and liquid waste. When prompted, prime the syringes, water probe, and substrate probe.   Select Next to continue.   Since heparin provides immediate anticoagulation, it is useful in the prevention of fibrin clots in such instances as deep vein thrombosis, pulmonary embolism, unstable angina, and acute myocardial infarction. It is also used in open heart surgery and dialysis to keep the patient’s blood from clotting while circulating through extracorporeal systems.  Additionally, it is useful in treating both acute and chronic disseminated intravascular coagulation.   Logging off and restarting the computer are performed to optimize the performance of the system and operating software.  The log off and computer restart procedures include: Logging off the software Putting the system in IDLE Restarting the computer After completing the log off and restart tasks, update the Daily Maintenance Record to keep track that the maintenance was complete.     Logoff and Restart Learn about logging off and restarting the system. Tab TitleTextLogging Off the Software To log off the software, select the Log Off button on the Home screen.  A window will appear indicating that a system backup is occurring. When the log off is complete, the Startup screen will display.   Putting the System in IDLE The system should be put in IDLE mode anytime the software is logged off. If the system is in Run mode, select the Pause button on the display panel three times to put the system in IDLE mode. If the display panel message is "IMMULITE Press GO to start", select the Alarm Mute and Go buttons on the display panel simultaneously to put the system in IDLE mode.  Restarting the Computer To restart the computer, select the Shutdown button on the Startup screen and then select Yes. On the Windows desktop, select the Start button on the lower left-hand corner of the screen and select Shut Down. When the shut down window appears, select Restart followed by the OK button.  Press the Enter key at the Log On Information window to return to the Windows desktop.  A password is not required. When complete, select the X in the upper-right corner to close the window and continue.   The Clauss method is the most commonly used assay to determine fibrinogen levels.  This method uses a standard amount of thrombin added to diluted plasma and the time to clot is measured. Clotting time is inversely proportional to the fibrinogen concentration. This result is then read off  a standard curve which is prepared with a known concentration of fibrinogen. The result is reported in mg/dL.   Performing daily probe cleaning: Keeps the pipetting probe free of contamination and build up Checks the probe dispense angle After completing the daily probe cleaning task, update the Daily Maintenance Record to keep track that the maintenance was complete. Daily Probe Cleaning Learn about how to perform daily probe cleaning. Checklist TitleChecklist TypeChecklist ContentLoad Probe Cleaning WedgeHTML   Select the play arrow to begin video.  Select each checkbox to learn more about performing daily probe cleaning.  Initialize Daily Probe Cleaning DiagnosticSimulationInstructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90005452/sim_IM1_InitializeDailyProbeCleaning_9/sim_IM1_InitializeDailyProbeCleaning_9.swfHTML5 File:/content/generator/Course_90005452/sim_IM1_InitializeDailyProbeCleaning_9/index.htmlPDF File:Press Go on Display PanelHTML      Select the play arrow to begin video.  Check the Dispense AngleHTML     Select the play arrow to begin video.   Close Diagnostics ScreenSimulationInstructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90005452/sim_IM1_CloseDiagnosticsRes__9/sim_IM1_CloseDiagnosticsRes__9.swfHTML5 File:/content/generator/Course_90005452/sim_IM1_CloseDiagnosticsRes__9/index.htmlPDF File: These two assays can be used tools for the assessment of fibrinogen.  The fibrinogen assay measures the quantity of fibrinogen while the thrombin time measures the functional capability of fibrinogen. Understanding which screening assay is abnormal can help to classify fibrinogen deficiencies, detect heparin contamination, and screen for elevated fibrinogen levels which may indicate the presence of acute phase reactants. The amount of thrombin used in the reagent is the primary differentiator between the two assays. Abnormal results can be due to deficiency of fibrinogen, or the presence of fibrin degradation products produced by thrombolytic drugs used to break up in-vivo clots, or the inhibition of fibrin formation due to antithrombotic drugs like heparin.   When the IMMULITE 1000 software is loaded on the system, the display panel prompts the operator to complete the daily startup tasks. This includes: Checking the consumables Priming the syringes Priming the water probe and substrate probe After completing the startup tasks, update the Daily Maintenance Record to keep track that the maintenance was complete. Perform System Startup Learn about performing system startup. Checklist TitleChecklist TypeChecklist ContentInitialize SoftwareSimulationInstructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90005452/sim_IM1_InitializeSoftware_9Rev/sim_IM1_InitializeSoftware_9Rev.swfHTML5 File:/content/generator/Course_90005452/sim_IM1_InitializeSoftware_9Rev/index.htmlPDF File:Select Press Go to StartHTML   Select the play arrow to begin video.   Check ConsumablesHTML   Select the play arrow to begin video.   Check WasteHTML    Select the play arrow to begin video.   Prime SyringesHTML   Select the play arrow to begin video.   Prime Water and Substrate ProbesHTML   Select the play arrow to begin video.    When complete, select the X in the upper-right-hand corner to close the window and continue.