RAPIDLab® 1200 Series Blood Gas Systems Sample Processing Online Training

Welcome to the RAPIDLab® 1200 Series Blood Gas Systems Sample Processing Online Training course. The RAPIDLab 1200 Series is intended for in vitro diagnostic testing of pH, blood gases, electrolytes, total hemoglobin, the corresponding hemoglobin fractions, neonatal total bilirubin (nBili), and glucose and lactate, in arterial and venous whole blood samples. In this course you will learn how to collect, handle, and process samples, and learn how to review results. Select Next to continue.   Identify how to enter patient sample data Identify how to properly collect and handle samples Identify how to view, recall and print patient results Identify the steps to process a sample Upon completion of this course you will be able to: Select Next to continue. Congratulations. You have completed the RAPIDLab 1200 Series Blood Gas Systems Sample Processing 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. Identify how to properly collect and handle samples Wear personal protective equipment, use sterile technique, and take universal precautions Sample types include: Arterial, capillary, venous and mixed venous blood Devices include: syringes and capillary tubes Arterial blood is the preferred specimen, but capillary blood is a practical and suitable alternative, provided sample is collected properly    Venous blood is not the preferred specimen for blood gas analysis; however, it can provide satisfactory pH, pCO2, metabolite and electrolyte results Mixed venous blood is used for blood gas analysis provided it is collected from an indwelling catheter in the pulmonary artery, which has been cleared of infusion fluid In glass syringes, air contamination is lower than synthetic syringes because the walls are resistant against air diffusion Synthetic syringes have gas dissolved in the material and therefore, there is a potential source of error when the timeframe between specimen collection and analysis is prolonged Only use specimen containers for whole blood that contain calcium-titrated (balanced) heparin or lithium heparin as an anticoagulant Mix specimen thoroughly after collection and before analysis Prevent/minimize air contamination, air bubbles, and hemolysis If air bubbles occur, expel them before mixing the specimen Do not expose nBili samples to light because it may affect the bilirubin concentration Identify the steps to process a sample. To process a syringe sample: Select the patient sample type at the Analysis screen (arterial, venous, mixed venous) Select the parameter(s) or panel to measure Scan the patient ID barcode, if required Insert the syringe into the sample port Select Analyze Remove the sample device when prompted and select Continue Enter demographic information, if prompted, and select Continue View the results and select Continue when finished With capillary samples, select the capillary sample type. Prior to inserting the sample into the sample port, remove the caps from each end of the tube With microsamples, there are two scenarios that can occur: operator determines there is insufficient sample volume prior to analysis, or, the system determines that the sample needs to be processed as a microsample based on the sample volume Microsample analysis occurs in two stages: First, pCO2 and pO2 are analyzed Second, the remaining parameters are analyzed When the operator has determined there is insufficient sample volume for routine analysis: Select the button for the patient sample type (arterial, capillary, venous, mixed venous) Select Microsample Select the parameter(s) or panel to measure Scan the patient ID barcode, if required Insert the sample device into the sample port Select Analyze Remove the sample device when prompted and select Continue Select Advance Sample to start the sample movement through the sample path of the measurement module Watch the sample move and select Stop Sample when the sample reaches position 1 Select Analyze Watch the sample as it moves through the sample path and inspect for air bubbles or gaps Ensure that the trailing edge of the sample remains in contact with the sample/ground temperature sensor, and that the leading edge of the sample fills the reference sensor Enter demographic information if prompted, and select Continue View the results and select Continue when finished Do not leave the sample device in the sample port after the system prompts removal of the device. Contamination of the wash fluid can occur and affect the next sample or system operation tHb and the corresponding fractions are not measured during Microsample mode on the RAPIDLab 1245 or 1265 systems Identify how to enter patient sample data At the Data Entry screen, scan the patient sample barcode ID or manually enter the data You can also scan the patient sample barcode ID at the Analysis screen If the patient ID is found, the system populates the patient ID plus additional demographics. If the patient ID not found, only the patient ID will populate When using the barcode scanner, hold the scanner at an angle to the barcode without touching it. Scan the entire barcode When the system displays the Data Entry screen, enter the demographic information You can enter the patient name manually by selecting Last Name Selecting the Early Demographics option enables you to enter demographic data early during analysis. When you select a patient sample type or Microsample mode at the Analysis screen, insert the sample, and select Analyze, the Data Entry screen displays automatically Identify how to view, recall and print patient results The Results screen displays after you complete the Data Entry screen Result values display in yellow while analysis is in progress Parameters display as gray if a result cannot be reported because of system problems If you did not enter a required value, the screen does not display the parameter. Red symbols display when: Value is above or below the expected range Value is above or below the reported range System detects the presence of an interfering substance System has an atypical response when measuring a parameter Value is greater than or less than the analytical range limit  To search for a patient use the following criteria: Patient ID, Last Name, Accession Number, Operator ID, Start Date, or End Date To view, print and send results, use the Recall screen. Select Recall > Patients. To view results, select Results. To view results for additional reported parameters select More Results. To print results select Print, and to send results select Send The Print button is not available when the printer is out of paper, whether it is the internal or external printer Select Next to continue.   The RAPIDLab® 1200 Series can analyze 4 different sample types from 2 different sample devices. Follow proper collection and sample handling to achieve accurate results. For more in-depth information regarding the collection and handling of samples, refer to the Blood Gas Measurement Principles Online Training course in the General Laboratory planner. Note: Always wear personal protective equipment, use sterile technique, and take universal precautions when collecting, handling, and processing samples.   Collect and Handle Samples Learn about collecting and handling samples. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Sample Types: Arterial blood Venous blood Capillary blood Mixed venous blood Sample Device Types: Syringes (glass or synthetic) Capillary tubes   Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.The four sample types for collection are: arterial blood, venous blood, capillary blood and mixed venous blood. The device types are syringes and capillary tubes. Select next to continue. 2 Arterial blood: Preferred specimen source for the assessment of acid-base metabolism and oxygen status Capillary Blood: Practical and suitable alternative to an arterial puncture, provided the proper collection techniques are utilized Venous Blood: Not preferred for blood gas analysis because the oxygen change in the various regions of the body can lead to extreme difference in the values ; however; ;  werawer;ajklwnher; ; Can provide satisfactory pH, pCO2, metabolite, and electrolyte values Mixed Venous Blood: Appropriate specimen, provided it is obtained from an indwelling catheter in the pulmonary artery and the catheter is cleared of infusion fluid   Select Next to continue. Arterial blood is the preferred specimen source for the assessment of acid-base metabolism and oxygen status, although capillary blood is a practical and suitable alternative. It is important that proper collection technique is used if substituting with capillary blood. Venous blood is not preferred for blood gas testing analysis because of inconsistencies with result values due to the oxygen change in various regions of the body; however, it can provide satisfactory pH and pCO2 values. Mixed venous blood can be used as long as it is taken from an indwelling catheter in the pulmonary artery that is cleared of infusion fluid. Select next to continue. 3 Glass syringes  Exposure to air contamination is lower than with synthetic syringes, as the walls are resistant against air diffusion Synthetic syringes: Used by most facilities With gas dissolved in the material, there is a potential source of error the longer the timeframe is between sample collection and sample analysis  Measure sample as quickly as possible following collection with this type of syringe Capillary tubes: Avoid using mixing rods/fleas because hemolysis can result in abnormally high potassium values   Anticoagulants:   Only use devices for whole blood specimens that contain: calcium-titrated (balanced) heparin lithium heparin   Select Next to continue.  Exposure to room air contamination is lower with glass syringes compared to synthetic syringes because the walls are resistant to air diffusion. Today, most facilities utilize synthetic syringes. With gas dissolved in the synthetic material, there is a potential source of error the longer the timeframe is between sample collection and sample analysis. It is very important to measure the sample as quickly as possible after collection. With capillary tubes, avoid using mixing rods because hemolysis can result in abnormally high potassium values. Only use devices for whole blood specimens that contain calcium-titrated or lithium heparin. Select next to continue. 4 Fill Volumes:   Required minimum fill volumes to ensure that the system aspirates sufficient sample for analysis: 1-mL syringe - 200 uL* 3-mL syringe - 200 uL 5-mL syringe - 500 uL Capillary tube - 175 uL *Volumes are based on the RAPIDLab 1265 system. Refer to Appendix C in the Operator's Guide for a detailed list of fill volumes for each system.      Select Next to continue. The RAPIDLab 1200 Series requires minimum fill volumes in the sample devices to aspirate sufficient sample for analysis. The volumes shown here are based on the RAPIDLab 1265 system. To see a detailed list of fill volumes for each system, refer to Appendix C in the Operator's Guide. Select next to continue. 5 Collecting and Handling Specimens:   The following points are crucial to collecting and handling blood gas specimens properly: Expel any bubbles introduced into the device immediately after collection Mix the specimen immediately after collection and before analysis Cap the specimen immediately to prevent air contamination Prevent/minimize hemolysis For neonatal total Bilirubin (nBili) samples, immediately protect the sample from light exposure because light affects the bilirubin concentrations  Follow your institution's infection control policy when disposing of the sample device  When complete, select the X in the upper-right corner to close the window and continue.  When collecting and handling specimens for blood gas analysis always expel any bubbles that are introduced into the sample device immediately after drawing. Mix the specimen, and then cap immediately to prevent contamination of the specimen with ambient air. For neonatal total Bilirubin samples, avoid light exposure which may cause inaccurate bilirubin values. When disposing of any device, follow your facility's infection control policy. When complete, select the X in the upper-right corner to close the window and continue. Sample processing begins after the sample is properly collected and handled. There are specific steps to processing each sample type. Always wear personal protective equipment, use sterile technique, and take universal precautions when collecting, handling, and processing samples. Processing Syringe Samples Learn about processing a syringe sample. Checklist TitleChecklist TypeChecklist ContentPatient Sample TypeHTML Select the patient sample type at the Analysis screen (arterial, venous, or mixed venous). Select each checkbox to learn more about processing a syringe sample.  Select ParametersHTML Select the parameter(s) or panel for measurement.  Patient ID BarcodeHTML Scan the patient ID barcode, if required.  Insert SyringeHTML   Insert the syringe into the sample port.  AnalyzeHTML Select Analyze.  Remove DeviceHTML   Remove the sample device when prompted, and select Continue.  Enter InformationHTML   Enter demographic information, if prompted, and select Continue.  View ResultsHTML   View the results, and select Continue when finished. When complete, select the X in the upper-right corner to close the window and continue.   Processing Capillary Samples Learn about processing a capillary sample. Checklist TitleChecklist TypeChecklist ContentCapillary Sample TypeHTML Select the capillary sample type at the Analysis screen. Select each checkbox to learn more about processing capillary samples.  Select ParametersHTML   Select the parameter(s) or panel for measurement.  Patient ID BarcodeHTML   Scan the patient ID barcode, if required.  Insert Capillary TubeHTML Hold the capillary tube at the end closest to the sample port, and insert the capillary tube firmly into the sample port.  Note: Remove both capillary end caps prior to analysis.  AnalyzeHTML Select Analyze.  Remove DeviceHTML Remove the sample device when prompted, and select Continue.  Enter InformationHTML Enter demographic information if prompted, and select Continue.  View ResultsHTML View the results, and select Continue when finished. When complete, select the X in the upper-right corner to close the window and continue.   Processing Microsamples Learn about the steps to processing a microsample when identified by the operator. Checklist TitleChecklist TypeChecklist ContentPatient Sample TypeHTML   Select the patient sample type (arterial, capillary, venous, or mixed venous). Select each checkbox to learn more about processing a microsample.  Select MicrosampleHTML Select Microsample.  Select ParametersHTML   Select the parameter(s) or panel for measurement.  Patient ID BarcodeHTML   Scan the patient ID barcode, if required.  Insert DeviceHTML Insert the sample device into the sample port and select Analyze.  Remove DeviceHTML   When prompted, remove the sample device and select Continue.  Advance SampleHTML   To move the sample through the sample path, select Advance Sample.  Stop SampleHTML Watch the sample move through the sample path of the measurement module, and when the sample reaches position 1, select Stop Sample. Then select Analyze.  Watch SampleHTML Watch the sample move through the sample path of the measurement module, and inspect the sample path for any bubbles or gaps. If bubbles or gaps are present, select Cancel. If no bubbles or gaps present, select Analyze. Ensure that the trailing edge of the sample remains in contact with the sample/ground temperature sensor, and that the leading edge of the sample fills the reference sensor. Demographic InformationHTML If prompted, enter demographic information and select Continue.  View ResultsHTML View the results. When finished, select Continue. Note: tHb and the corresponding fractions are not measured when using Microsample mode on the RAPIDLab 1245 and 1265 systems. When complete, select the X in the upper-right corner to close the window and continue. Two Scenarios with Two Stages of Analysis Learn about two scenarios to processing a microsample. There are two scenarios in which the system analyzes samples with insufficient sample volume. Operator determines that there is insufficient sample volume for routine analysis, and processes sample as a microsample System determines that the sample is insufficient or that bubbles are present, and prompts operator to position the sample as a microsample Once identified as a microsample, the system performs analysis in two stages: First, pCO2 and pO2 are analyzed Second, the remaining parameters are analyzed When complete, select the X in the upper-right corner to close the window and continue.   Results Screen: The Results screen displays automatically after analysis is complete. Use this screen to: View results Send reports to a data management system or an LIS Print reports View, Recall and Print Patient Results Learn about viewing, recalling and printing results. Slide NumberText BlocksCalloutsAudio ScriptImage File1Viewing Patient Results: Result values display in yellow while analysis is in progress A parameter displays in grey on the Results screen if a result cannot be reported because of a system problem, such as failed QC If a required value for a calculated parameter was not entered, the parameter will not display  Certain symbols display in red with the results on the screen and in the printed report.    Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.Result values and parameters can display differently depending on the scenario. Select next to continue. 2 Performing a Patient Search:   To search for patient data: Select: Recall > Patients > Search In the Search criteria fields, enter data matching one or more search criteria:   Patient ID Last Name Accession Number Operator ID Start Date End Date Note: Each criterion, except Start Date and End Date, must first be enabled in Setup.       Select Next to continue. To search for patient data select Recall, Patients, and then Search. In the search criteria fields, enter data matching one or more search criteria. The criteria include: Patient ID, Last Name, Accession Number, Operator ID, Start Date and End Date. Select next to continue. 3 Recalling Patient Sample Results:   The Recall screen can be used to view and print results for previously analyzed patient samples.   Results also can be sent to a data management system or LIS.   Select: Recall > Patients to display a list of patient samples and locate samples Results to view the results for the selected sample More Results to view results for other reported parameters Send to send results to a data management system or LIS Print to print the patient sample report   Select Next to continue. The Recall screen can be used to view and print results for previously analyzed patient samples. Results also can be sent to a data management system or LIS. Select the Recall button and Patients to display a list of patient samples, and locate a desired sample. To view the results for the selected sample, select Results. To view results for other reported parameters, select More Results. To send results to a data management system or LIS, select Send, and to print the patient sample report, select Print. Select next to continue.4 Printing Reports: Reports can be printed using the internal printer or if installed, an external printer Reports contain the report name and the system name created in Setup   The system disables the Print button when the printers are out of paper  Error messages are filtered by the system so that only messages that affect the reported results are printed   Internal Printer: The system feeds sufficient paper at the end of every report to provide a "tear-off margin". When complete, select the X in the upper-right corner to close the window and continue.  Reports can be printed using the internal printer or if installed, an external printer. Each report contains the report name and the system name created in the Setup screen. The system disables the Print button when the printer is out of paper. Error messages are filtered by the system so that only messages that affect the reported results are printed. With the internal printer, the system feeds sufficient paper at the end of every report to provide a "tear-off margin". When complete, select the X in the upper-right corner to close the window and continue. During sample analysis, the system displays the Data Entry screen. Enter data by: Scanning the patient sample barcode Entering patient information manually Note: You can scan the barcode before beginning analysis at the Analysis screen or at the Data Entry screen.   Scanning Barcodes and Entering Demographics Learn about scanning barcodes and entering data. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Scanning Patient ID Barcodes:   When scanning a patient ID barcode at the Analysis screen, the system searches all the records on the system. If the patient ID is found, the last name displays on the Analysis screen. The system also enters the patient ID, name, sex, and date of birth, if available, at the Data Entry screen If patient ID is not located, the Not Found message is displayed on the Analysis screen, and the system only enters the patient ID    Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.When scanning patient ID barcodes at the Analysis screen, the system performs a search of all the records on the system. If the patient ID is found, the last name displays on the Analysis screen. Also, the patient ID, name, sex, and date of birth, if available, display on the Data Entry screen. If the patient ID cannot be located, a Not Found message displays on the Analysis screen and only the patient ID displays. Select next to continue. 2 Barcode Scanning Technique:   There is a technique to ensure that the barcode scanner is being operated correctly:   Hold the scanner at an angle to the barcode without touching it   Move the scanner to a distance that allows the beam to scan the entire barcode   Select Next to continue. If a barcode scanner is installed on your system, it is important to follow the proper technique. Hold the scanner at an angle to the barcode without touching it. Move the scanner to a distance that allows the beam to scan the entire barcode. Select next to continue. 3 Manual Entry of Patient Demographics:   If a barcode scanner is not available, enter the Patient ID or patient's demographics manually, when the system displays the Data Entry screen.     To manually enter the patient's name: Select Last Name  To enter data for additional demographics: Select the down pointing arrow button  When finished:  Select Continue   Select Next to continue. If you don't have a barcode scanner installed on your system, you can enter the patient demographics manually at the Data Entry screen. To enter the patient's name, select Last Name. To enter additional demographics, select the down arrow button. When you are finished entering data, select Continue. Select next to continue. 4 Early Demographics:   Early Demographics is a system feature which allows entry of demographic data early in the sample analysis process. The Data Entry screen displays automatically after:   Patient sample is selected at the analysis screen, the sample is inserted, and Analyze is selected Microsample mode is selected at the analysis screen, the sample is inserted, and Analyze is selected Data entry must be completed before sample analysis proceeds. If data entry is complete but aspiration is not, the Wait screen displays until aspiration completes. The system then prompts removal of sample device and analysis continues If data entry is finished and aspiration is complete, the system prompts removal of sample device and analysis continues   When complete, select the X in the upper-right corner to close the window and continue.  The RAPIDLab 1200 system allows entry of demographic data early in the sample analysis process. This feature is called Early Demographics. When enabled, the Data Entry screen automatically displays after the patient sample or Microsample is selected at the Analysis screen, the sample inserted, and Analyze selected. You must complete data entry before sample analysis proceeds. If you finish but the system has not aspirated the sample, the Wait screen displays until aspiration completes. If data entry is finished and aspiration is completed, the system prompts removal of sample device and analysis continues. When complete, select the X in the upper-right corner to close the window and continue.