IMMULITE® 1000 Immunoassay System Troubleshooting Online Training

对于直径在5 cm以下的主动脉瘤，可用超声扫描监测。 大于该直径的动脉瘤破裂的风险增高——5 cm以上时约为10%，7 cm以上时超过60%。* 致病因素的预防以及动脉高血压等伴发疾病的治疗也很重要。 必须将收缩压降到120 mmHg下，尽可能缓解血管壁的压力。 通常，要让患者服用药物，以降低血压。 在整个过程中，密切监视动脉瘤尺寸的变化特别重要。 小型动脉瘤可每2-3年通过超声波或MR血管造影检查。 对于直径大于4.5 cm的动脉瘤，需要每半年检查一次；对于直径大于5 cm的动脉瘤，需要每3个月检查一次。 如果动脉瘤尺寸增大许多，必须及时决定实施手术或介入其它方法。   Welcome to the IMMULITE® 1000 Immunoassay System Troubleshooting Online Training course.  This course provides you with an overview of troubleshooting techniques which can be used as tools to identify and resolve instrument errors. Select Next to continue.   Identify error indicators Identify the steps to resolve common errors Navigate the Session Event Log and Help screen Upon successful completion of this course, you will be able to: Select Next to continue. Carter先生的动脉瘤最初是通过超声波扫描检测出的。两年之后，该动脉瘤的直径为5.2 cm。 Carter先生已没有手术禁忌征，因此为其安排并实施了手术。 Carter先生被置入了一根覆膜支架。他恢复得很快，从那时起一直定期接受随访。 在这些随访中，超声波扫描显示覆膜支架愈合或缝合处无出血，说明血液正常流过覆膜支架。   Congratulations. You have completed the IMMULITE 1000 Immunoassay System Troubleshooting 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:    Identify error indicators Audible Alarms Instrument alarm - a beeping sound that can be turned off by selecting the Alarm Mute button on the Display Panel Software alarm - an alarm sound that can be turned off by selecting the Sound button within an error box On Screen Messages - when an error occurs on the system, an error box displays on the screen with buttons: Help - opens up the Help screen to the information pertaining to that error message Sound - turns on/off the sound alarm associated with the error message if there is sound associated with that error Close - closes the error message Print - prints the error message Display Panel Messages - if an error occurs that causes the system to enter Pause mode, a message appears on Display Panel indicating the action the operator should take when the error is resolved. Navigate the Event Log and Help screen Session Event Log - event number, date/time of error, error message Help screen - information on how to resolve that error Identify the steps to resolve common errors Sample and Test Unit Errors Short sample - The sample volume required varies with the assay to be run and the number of replicates requested on that sample.  An additional dead volume is required, which is based on sample volume. Bad barcode - Possible causes include a dirty or damaged barcode and a dirty barcode reader o-ring.  If the cause is a dirty barcode reader o-ring, resolve by running BCODEON diagnostic while cleaning the o-ring. Main incubation carousel jam - If the cause is a sample cup on the main incubation carousel, resolve by running CARBACK diagnostic and removing the sample cup. Test unit limit exceeded - The maximum number of test units that can be placed behind a sample cup is five. Reagent Errors Missing reagent or diluent - When the barcode reader scans a test unit that does not have a matching reagent wedge loaded on the reagent carousel, the Display Panel will show the message "Reagent or diluent missing".  The system puts itself in Pause mode to allow time for the operator to load the correct reagent for the test unit whose barcode was just read. Reagent read before scanning kit - If a reagent wedge is loaded for a new kit lot that has been not scanned into the system, the Reagent Status screen will display that reagent wedge as red with the message "Not in Database"". If kit barcodes are scanned while the system is in Run mode, the operator must pause the system and then put the system back in Run mode. System Errors Failure to put system in idle - The system must be in Idle mode before downloading a new program.  The operator should always look at the Display Panel before downloading a new program to check that the message "IMMULITE IDLE" displays. Pipetting probe jams - Possible causes include not opening the caps of the reagent wedges and opening the reagent carousel cover while the pipetting probe is moving.  If the pipetting probe is damaged, the operator can replace it. Air in lines - The operator should remove any air in the lines while priming the syringes, water probe, and substrate probe during daily maintenance.  If the operator does not perform this maintenance and there is air in the lines, an error message will not post, and the test results will be impacted. In addition to priming during the daily startup procedure, the operator can remove air from the lines by priming in diagnostics.    Select Next to continue     急性主动脉夹层的症状比真性主动脉瘤的症状更特别。 由于其是突然发作并且有生命危险，因此需要紧急诊断和治疗。 其综合征源于急性主动脉扩张或其相关影响。 肩胛辐射性刺痛是其典型症状。   具体症状取决于其在主动脉中的位置： 例如，心脏附近的夹层可致心包填塞和心源性休克。 其它症状包括急性腹部和神经功能障碍，或甚至急性截瘫（如果累及椎动脉）。 There are several ways in which the system alerts the operator that a problem is occurring. Select each tab below to learn about the types of error indicators.  When complete, select Next to continue. The system has two types of audible alarms: Instrument alarm - a beeping sound that can be turned off by selecting the Alarm Mute button on the Display Panel Software alarm - an alarm sound that can be turned off by selecting the Sound button within an error box   When an error occurs on the system, an error box displays on the screen with several buttons: Help - opens up the Help screen to the information pertaining to that error message Close - closes the error message Print - prints the error message Sound - turns on/off the sound alarm associated with the error message Note:  The Sound button will only display if there is an audible alarm associated with that error message. If an error occurs that causes the system to enter Pause mode, a message appears on the Display Panel indicating the action the operator should take when the error is resolved.  For example, the operator may have to select the Go button to put the system back in Run mode.   Information for errors that occur on the system can be found in the following screens: Session Event Log - event number, date/time of error, error message Help screen - information on how to resolve that error Error Log and Help Screen Learn how to use the Session Event Log and Help screen. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90005454/sim_IM1_SessionEventLogAndHelp_9Rev/sim_IM1_SessionEventLogAndHelp_9Rev.swfHTML5 File:/content/generator/Course_90005454/sim_IM1_SessionEventLogAndHelp_9Rev/index.htmlPDF File: The common errors that occur on the IMMULITE 1000 system can be grouped into three categories of errors:     • Sample and test unit errors   • Reagent errors   • System errors Select Next to continue.   Sample and test unit type errors include the following: Test Unit Limit Exceeded Short Sample Bad Barcode Main Incubation Carousel Jam Sample and Test Unit Errors Learn about sample and test unit errors. Select each tab below to learn more about sample and test unit errors.TitleTextTest Unit LimitExceededTab TitleTextIndicators When too many test units are placed behind a sample cup on the load chain, the message "Test unit limit has been exceeded" will appear on the screen.  The Display Panel does not post a message for this error. On the Home screen, the excess test units appear as white circles.  The excess test units will be transferred to the sample collection tray.  Cause The maximum number of test units that can be placed behind a sample cup is five.  If more than five test units are placed behind a sample cup, the "Test unit limit has been exceeded" error message displays on the screen.  Resolution If more than five tests need to be run on a sample, it is necessary to use more than one sample cup for that sample.  Transfer the sample to the necessary number of sample cups, and identify each of the sample cups with the same information in the Worklist Entry screen.  Short SampleTab TitleTextIndicators When there is an insufficient amount of sample in a sample cup, the message "No Sample Pipetted" appears on the screen.  On the Display Panel, the error message "Insufficient Sample Pipetted" displays. On the Home screen, the test unit that did not have sample pipetted appears as a white circle.  That test unit will travel around the main incubation carousel before being transferred to the sample collection tray.  Cause The sample volume required varies with the assay to be run and the number of replicates requested on that sample.  The exact sample volume required for each test can be found in the corresponding instructions for use. For proper instrument operation, an additional dead volume is required, which is based on sample volume: Sample Volume Dead Volume Less than 100 µl 100 µl Greater than or equal to 100 µl 250 µl Resolution To resolve a short sample error, retrieve the sample cup from the sample collection tray, add more sample to the sample cup, and place it back on the load chain followed by the appropriate test units.  The identification information for that sample will need to be re-entered in the Worklist Entry screen.  Bad BarcodeTab TitleTextIndicators When a test unit or sample cup barcode fails to be read by the barcode reader, the message "Bad Barcode" will appear on the screen.  This message includes the number of the last sample cup that was successfully read at the barcode reader, to help the operator find the test unit or sample cup with the bad barcode. The Display Panel does not post a message for this error. On the Home screen, the test unit that did not have sample pipetted due to the barcode error will appear as a white circle.  That test unit will travel to the sample collection tray.  Cause One possible cause of a bad barcode error is that the test unit or sample cup barcode is dirty or damaged.  If the barcode is dirty, the operator can clean it by gently wiping the barcode. Another possible cause of this error is that the barcode reader o-ring is dirty.  The barcode reader o-ring allows the test units and sample cups to spin at the barcode reader position so the barcodes can be read.  Select the resolution tab for this error to learn how to clean the barcode reader o-ring.  Resolution   Select the play arrow to begin the video.  Main IncubationCarousel JamTab TitleTextIndicators When the main incubation carousel jams, the message "Main Carousel Shutdown" appears on the screen.  On the Display Panel, the message "Fatal Front End Error" appears.  The system will put itself into Pause mode and attempt to complete any test units that are already in the luminometer.   Cause One possible cause of a main incubation carousel jam is a sample cup being loaded on the main incubation carousel.  This could potentially happen if sample cups are loaded in front of the first green arrow on the load chain during startup.  When the message "Remove all tubes from the load chain" appears on the Display Panel during the startup procedure, the operator should make sure that no sample cups are loaded in front of the first green arrow on the load chain. Select the resolution tab to learn how to resolve this error when the cause is a sample cup that was loaded on the main incubation carousel.  Resolution   Select the play arrow to begin the video. When complete, select the X in the upper-right corner to close the window and continue.    Reagent errors can include:     • Missing reagent or diluent   • Reagent read before scanning kit Reagent Errors Learn about reagent errors. Select each tab below to learn more about reagent errors.TitleTextMissing Reagentor DiluentTab TitleTextIndicators When the barcode reader scans a test unit that does not have a matching reagent wedge loaded on the reagent carousel, the Display Panel will show the message "Reagent or diluent missing".      Cause Causes of reagent or diluent missing errors include: The reagent or diluent for that test is not loaded on the reagent carousel. The reagent lot loaded on the reagent carousel does not match the test unit lot number. A standard test unit is loaded while in turbo mode, or a turbo test unit is loaded while in standard mode.   Resolution When a reagent or diluent missing error occurs, the system puts itself in Pause mode to allow time for the operator to load the correct reagent for the test unit whose barcode was just read. On the Display Panel, the message states "Hit Pause to ignore or Go to read reagents".  If the appropriate reagent for that test unit is available, load the reagent and press Go.  If the appropriate reagent is not available, press Pause and the system will go back into Run mode without reading the reagent barcodes.     If the correct reagent or diluent wedge is not loaded before the test unit gets to the pipetting position, the screen will display the messages "Does not match any reagent" and "No reagent pipetted".  On the Home screen, the test unit that did not have reagent pipetted will appear as a white circle.  That test unit will travel around the main incubation carousel before being transferred to the sample collection tray. Reagent ReadBefore Scanning KitTab TitleTextIndicators If a reagent wedge is loaded for a new kit lot that has not been scanned into the system, the Reagent Status screen will display that reagent wedge as red with the message "Not in Database".    Cause The message "Not in Database" on the Reagent Status screen should alert the operator that the kit barcodes for a new kit lot need to be scanned in the system. If the operator scans the kit barcodes at this point while the system is in Run mode, the barcodes will scan successfully, but the system will not match the kit barcode information with the reagent that is already onboard.  The message "Not in Database" will still appear on the Reagent screen.     Resolution If kit barcodes are scanned while the system is in Run mode, the operator must pause the system by pressing the Pause button on the Display Panel.  Then, when the Go button is pressed to put the system back in Run mode, the reagent wedge barcodes will be reread and the system will match the scanned kit barcodes with the reagent wedges onboard. When complete, select the X in the upper-right corner to close the window and continue.      System errors can include:     • Failure to put system in idle   • Pipetting probe jams   • Air in lines System Errors Learn about system errors. Select each tab below to learn more about system errors.TitleTextFailure to Put Systeminto IDLETab TitleTextIndicators If the system is not in Idle mode when a program is downloaded, an error will occur.  Examples of possible error messages include: "To change between Standard and Turbo modes, select Cancel and put IMMULITE into Idle." "Computer cannot communicate with the instrument."  Cause These types of errors occur when the operator downloads the standard running software, the turbo software, or any diagnostic program while the system is not in Idle mode.  One common cause for this error is trying to switch between standard and turbo mode without putting the system into Idle mode.  Resolution The system must be in Idle mode before downloading a new program.  The operator should always look at the Display Panel before downloading a new program to check that the message "IMMULITE IDLE" displays. If the system is not in Run mode, select the Alarm Mute and Go buttons simultaneously on the Display Panel to put the system in Idle mode. If the system is in Run mode, select the Pause button on the Display Panel three times to put the system in Idle mode. Pipetting Probe JamsTab TitleTextIndicators If the pipetting probe hits an obstruction while moving, an error will occur.  Examples of possible error messages include: "Reagent level sense error." - the system continues processing tests "Pipettor X-direction has jammed." - the system puts itself into a front end shutdown, in which any tests already in process will attempt to complete Cause One possible cause of a pipetting probe jam is not opening the caps on the reagent wedges when loading them in the reagent carousel.  In this case, the system will post the "Reagent level sense error" message.  The operator needs to pause the system, open the reagent wedge caps, and put the system back in Run mode. Another cause of a pipetting probe jam is the operator opening the reagent carousel cover while the pipetting probe is moving.  If the pipetting probe hits the cover, the message "Pipettor X-direction has jammed" will appear. Once any in progress tests are complete, the operator should check if the pipetting probe is damaged and if necessary replace the probe.  Select the resolution tab for this error to learn how to replace the pipetting probe. Resolution   Select the play arrow to begin the video.  Air in LinesTab TitleTextIndicators The operator should observe if there is any air in the lines while priming the syringes, water probe, and substrate probe during daily maintenance.  If there is air in the lines, it must be removed by priming.  If the operator does not perform this maintenance and there is air in the lines while the system processes tests, an error message will not post, and the test results will be impacted. Cause Possible causes of air in the lines include: Empty water, probe wash, or substrate bottles Disconnected lines attached to the bottles Loose fittings along the lines Loose syringes In addition to priming during the daily startup procedure, the operator can remove air from the lines by priming in diagnostics.  Select the resolution tab for this error to learn how to prime the lines in diagnostics.  Resolution To prime the lines in Diagnostics: Open the diagnostics screen by selecting the Diagnostics button from the Startup screen. Select the Diagnostics button on the Common Diagnostic screen. Select the appropriate diagnostic for the component to be primed: To prime the syringes, select PRIME. To prime the water probe, select SOLE1W. To prime the substrate probe, select SOLE2S. Select Run. When the message “Press Go to start” appears on the display panel, press Go. Prime the component until any air has left the line. Stop the diagnostic by pressing the Alarm Mute and Go buttons simultaneously on the display panel. NOTE: Before selecting Run on the Diagnostics screen, it is important to check the Display Panel to ensure the system is in IDLE mode. NOTE: It is recommended to hold the water probe and substrate probe over a clean empty container while priming. When complete, select the X in the upper-right corner to close the window and continue.