VersaCell® X3 Solution with Dimension® Integrated Chemistry Systems Connectivity Online Training

Located below the OGP View section are several radio dial buttons that will determine how the OGP Views display.  The default option is Name.  The other two options are by Body Part (Abdomen, Chest, elbow, etc) or by Acquisition type (Table, wall, etc).  The Group by is up to the Users discretion.  Similarly, the Sort By options located under the Examination Views, allow the user to change the display of the Examination Views. Welcome to the VersaCell® X3 Solution With Dimension® Integrated Chemistry System Connectivity Online Training course. The goal of this course is to familiarize the operator with aspects of operation that are unique when the VersaCell X3 system is connected to a Dimension system. The Sample Transfer Module (STM) is an additional component for the Dimension systems that provides connectivity to the VersaCell X3 system. The STM automates the transfer of samples from the interface wheel to the Dimension sample wheel. Due to exterior and hardware changes, the Dimension system will appear different with the addition of the STM module. Some of the software screens have been changed to allow monitoring of the STM.  Currently, the Dimension systems which can be connected to the VersaCell system are the Dimension®  EXL™ with LM, Dimension®  EXL™ 200 and Dimension®  RxL Max®  integrated chemistry systems. Select Next to continue. Describe how to operate and maintain the STM Describe how to run QC and patients Identify the steps of the tube journey List the steps to perform startup List the steps to resolve common errors Upon successful completion of this course you will be able to: Select Next to continue. Congratulations.  You have completed the VersaCell X3 Solution with Dimension Integrated Chemistry Systems Connectivity 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 the steps of the tube journey The steps in the tube journey include: The robotic arm scans the tube barcode and transfers the tube to the interface wheel The VersaCell X3 system sends the order to the Dimension system  The STM transfers an aliquot from the sample tube on the interface wheel to a well position in an aliquot sample segment on the Dimension sample wheel The tube is returned to a drawer by the robotic arm The results are sent from the Dimension system to the VersaCell X3 system, and then to the LIS List the steps to perform startup Shutting down the VersaCell X3 software daily is recommended to initiate a system backup.  It is not required to shut down the Dimension systems as part of the VersaCell X3 system shut down procedure.  When the VersaCell X3 software is initialized, the instrument status of the Dimension system should automatically go back to Running. After the VersaCell X3 system is rebooted, the Dimension system displays the error message "DMW Host Communication Problem" in red. The VersaCell X3 system displays a message in the Assay Errors section of the Instruments screen. Press Reset on the keyboard to clear the message on the Dimension system and initialize the Dimension system. If the Reset button is not pressed, the message will be automatically cleared when samples start to process from the VersaCell X3 system.  The system is ready to process samples when the instrument status on the VersaCell X3 Home screen displays Running. Describe QC and patient sample processing Controls: Control samples are ordered and placed directly on the Dimension system.  Manually ordered QC is programmed on the Enter Data screen on the Dimension system.  If QCC PowerPak® software is programmed on the Dimension system, barcoded sample tubes with QC in Small Sample Containers (SSC) are loaded directly in a standard segment on the Dimension system sample wheel.  Monitor the status of control test orders on the Dimension system, as pending control orders do not display on the VersaCell X3 software. Patients: Methods that have specific handling instructions such as urine drug screens or whole blood assays must be loaded directly onto the Dimension system. All other samples can be loaded onto the VersaCell X3 system drawers or loaded directly on the Dimension system. The VersaCell X3 Test Results screen will display orders and results for tests ordered from the LIS. The VersaCell X3 Test Results screen will display only results for tests ordered from the Dimension software. Describe how to operate and maintain the STM The STM is an additional component for the Dimension system that provides connectivity to the VersaCell X3 system. The STM automates the transfer of sample from the interface wheel to the Dimension system sample wheel. The STM includes these components: Transfer Arm (Carriage and Carriage Drive System) Pipette Tips Tip Feeder Tip Waste Container STM Keypad STM Segments Fluidics System (Air Pump, Tubing, Pressure Sensing PCB) STM Control Board STM software: STM Processing Status Segment Status Screen Aliquot Segments Screen The STM consumables that the operator must maintain: Aliquot Segments:  A new aliquot segment must be loaded when a System Needs message appears in the STM processing status or when the STM segment status boxes are green. Never remove an STM or aliquot segment when a segment status box is red, which indicates that the segment is being used to process a sample. Pipette Tips:  A rack of pipette tips can be loaded in the tip feeder at any time.  The tip feeder must be loaded when the Pipette Tips field on the Aliquot Segments screen displays zero. This halts the Sample Transfer Module from transferring samples and displays the "STM Needs" status. Tip Waste:  The tip waste container can be emptied at any time. When the Tips to Waste Full field on the Aliquot Segments screen is zero, the container must be emptied.  This stops the STM from transferring samples and causes the “STM Needs” message to appear.   There is minimal maintenance associated with the STM and no required daily maintenance.  Routinely clean the outside surfaces of the STM using a damp cloth and warm, soapy water.  Clean up spills immediately. It is recommended to perform Dimension system daily maintenance while performing the VersaCell X3 system daily shutdown. Additionally, the STM alignment guide may be used to perform alignments. List the steps to resolve common errors Common STM errors include: STM Invalid Aliquot Segment - Check for proper installation of aliquot segment and press Run. If the error reoccurs, replace it with new unused aliquot segment and press Run. STM Aspirated Air - Check for crimped tubing and bubbles or foam on top of the sample STM Tip Leaking - Check for a leak in the tubing, defective pipette tip(s) or air pump syringe STM Tip Plugged - Check sample quality for clots or fibrin and insufficient sample for possible gel aspiration   Cannot Find Home - If the component did not move through a complete cycle check for either interference or replace the home sensor for the particular component; for example, STM probe or shuttle. If the component did not move at all, first check the fuse. Lost Steps - Check for either something restricting or interfering with the movement of the component.  If nothing is observed, then alignments or lubricating the module may be recommended.  Aborting a run: Press the Control/Stop key combination   Error messages display on both the Dimension system and the VersaCell X3 system Select Next to continue.   The Presettings section includes options for image labeling and stand parameters.  These include: Mark Image: Automatic marking of stored acquisition images/series Options include either Yes (default) or No PT Position: The Patient Position field is set to "Not defined" w/in the PEX Editor.      Laterality: The Laterality field includes the following options.      Not Defined: no laterality      Left/Right/Both The left, right, and Both options enable user to pre-mark the visualized anatomy.       Unpaired: no paired organ can be seen in the image View position: Identify the position of the patient during examination: Options include: Not Defined: viewing position is not set      AP: anterior - posterior view      PA: posterior - anterior view      RL: right lateral view      LL: left lateral view      RLD: right lateral decubitus view      LLD: left lateral decubitus view      RLO: right lateral oblique view      LLO: left lateral oblique view Anatomically Correct View: Set the correct anatomical view. Flip: The options available include no change from previous OGP view or flip the image horizontal or vertical. Once selected, the location of the indicator can be adjusted by selecting 1 of the 6 pre-defined options. Rotate: Rotate the image either 0, 90, 180 or 270 degrees. Label: Presetting for left/right label. Once selected, the location of the label can be adjusted by selecting 1 of the 6 pre-defined options. The steps in the tube journey include: The robotic arm scans the tube barcode and transfers the tube to the interface wheel The VersaCell X3 system sends the order to the Dimension system  The STM transfers an aliquot from the sample tube on the interface wheel to a well position in an aliquot sample segment on the Dimension sample wheel The tube is returned to a drawer by the robotic arm The results are sent from the Dimension system to the VersaCell X3 system, and then to the LIS Tube Journey See the VersaCell X3 Solution with Dimension System connectivity in action.   Select the play arrow to begin the video.    When complete, select the X in the upper-right-hand corner to close the window and continue.   The first sub task card is the Fluoro subtask card. These settings impact the use of fluoro when performing a fluoroscopic examination. Fluoro Mode: Fluoroscopy modes include Automatic 1, 2, & 3.  This is called a Fluoro Triplet.  Automatic 1 is typically lower dose, Automatic 2 is typically for Average sized patients and Automatic 3 is for Larger patients. These modes can be changed at any time during the examination.   Pulse Rate: The number of pulses of fluoro per second. Options include 3, 7.5, 10, & 15. Dose Level ( or nano gray per pulse) nGy/p): Dose level per pulse. Possible values include 15-80 nGy/p, increments in 0.5 Exposure Points Dose Rate Index: Dose rate index This value can be used in combination with the Dose level to help acquire a good image at a very low pulse rate, while keeping the dose low.  Possible values range from 0.0 to 1.0. Fluoro Curve: System pre-sets to auto-adjust the kV and mA as the anatomical density increases or decreases. Curve selection is based on patient and exam specific factors such as contrast type or patient body habitus. Fluoro Filter Auto: Automatic use of the copper filter. Thickness of the copper filter ranges from 0.0-0.3 mm Noise Reduction (k Factor): Degree of integration for noise reduction or moving weighted averaging.  Possible values range from 1.0 to 8.0; 1=off Spatial Frequency Parameters: Adjusts the detail and background of the image.  Details of the Pre-defined options can be viewed by clicking the button to the right. Window Center (WC): WC represents the brightness of the image. These pre-defined values are set based on the organ program. Possible values range from 0 to 4095 Window Width (WW): WW represents the contrast of the image. These pre-defined values are set based on the organ program. Possible values range from 1 to 4096. Auto Window: Enables automatic windowing. If this option is selected WC & WW will be inactive. Width Factor: Possible values for Window width factor are 0.50 to 2.50. Center Shift: Possible values for Window center shift are -1000 to positive 1000 Bandwidth: The bandwidth determines how much the window center and window width can shift. Possible Window bandwidth range from 0 to 5; 0 =off Mark Image: Automatic marking of stored fluoro image (not possible for fluoro loop) Default: Select to activate the desired program mode. Starting up the system: Shutting down the VersaCell X3 software daily is recommended to initiate a system backup. It is not required to shut down the Dimension systems as part of the VersaCell X3 system shut down procedure. When the VersaCell X3 software is initialized, the instrument status of the Dimension system should automatically go back to Running.   Startup Learn about starting up the system. Slide NumberText BlocksCalloutsAudio ScriptImage File1 DMW Host Communication  After the VersaCell X3 system is rebooted, the Dimension system displays the error message "DMW Host Communication Problem" in red. The VersaCell X3 system displays a message in the Assay Errors section of the Instruments screen.    Press Reset on the keyboard to clear the message on the Dimension system and initialize the Dimension system.   If the Reset button is not pressed, the message will be automatically cleared when samples start to process from the VersaCell X3 system.    Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.After the VersaCell X3 system is rebooted and back online, the Dimension system displays an error message in red stating "DMW Host Communication Problem". This generates an Instrument Error message on the VersaCell X3 system. To clear the message on the Dimension system, press the Reset key on the keyboard. If the Reset button is not pressed, the message will be automatically cleared when samples start to process from the VersaCell X3 system. Select next to continue.2 Running  The system is ready to process samples when the instrument status on the VersaCell X3 Home screen displays Running. Select Next to continue. The system is ready to process samples when the instrument status on the VersaCell X3 Home screen displays Running. Select next to continue.3 Run The Run key on the Dimension system does not need to be pressed before processing samples on the VersaCell X3 system. Select Next to continue. It is not necessary to press the Run key on the Dimension systems before processing samples on the VersaCell X3 system. Select next to continue.4 Consumables If there is a need for consumables on the Dimension systems, a message displays in the Instrument Errors section of the Instruments screen.  The message indicates which consumable needs to be replenished. Select Next to continue.  If there is a need for consumables on the Dimension systems, a message displays in the Instrument Errors section of the Instruments screen. The message indicates which consumable needs to be replenished. Select next to continue.5 Daily Start Up  Perform daily maintenance every 24 hours, and run QC when scheduled before processing samples from the VersaCell X3 system. When complete, select the X in the upper-right corner to close the window and continue.  Perform daily maintenance every 24 hours, and run QC when scheduled before processing samples from the VersaCell X3 system. The EXI Values section includes options to view or define clinical EXI ranges for specific doses. These values enable the user to determine optimal exposure for the patient. Identifier – System generated names to distinguish customized EXI values versus customer defined values. System generated identifiers are comprised of 4 characters:  c, d, or s followed by a number 000 - 999, e.g. c017. c = customer read-write access, d =default read-only access, s =service read only access. Name – Default names are correlated with system dose. Users can customize EXI values and then store these with a unique name. Min. EXI – The low end of the clinical EXI range (potential low exposure) Max. EXI – The high end of the clinical EXI range (potential high exposure) Target EXI – The mid-range of the Min & Max EXI values. This value must be included but acquiring the Target value is not required for optimal images. Controls: Control samples are ordered and placed directly on the Dimension system. Manually ordered QC is programmed on the Enter Data screen on the Dimension system. If QCC PowerPak® software is programmed on the Dimension system, barcoded sample tubes with QC in Small Sample Containers (SSC) are loaded directly in a standard segment on the Dimension system sample wheel. Monitor the status of control test orders on the Dimension system, as pending control orders do not display on the VersaCell X3 software. Patients: Methods that have specific handling instructions such as urine drug screens or whole blood assays must be loaded directly onto the Dimension system. All other samples can be loaded onto the VersaCell X3 system drawers or loaded directly on the Dimension system. The VersaCell X3 Test Results screen will display orders and results for tests ordered from the LIS. The VersaCell X3 Test Results screen will display only results for tests ordered from the Dimension software.   Manual Orders Learn how the system processes manual test orders. If you manually order a test on a Dimension system, you must manually load the tube on the Dimension system. The VersaCell X3 system sends test results to the LIS. Tests ordered manually at the Dimension system are not displayed on the VersaCell X3 system (only results are displayed). For tests manually diluted on the Dimension system, a dilution symbol with the dilution factor will appear on the Test Result screen for the result.  When complete, select the X in the upper-right corner to close the window and continue.    Rerun Testing Learn how the system processes rerun tests. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Automatic Reflex Testing Defined on Dimension System If the samples are loaded by the STM, with Automatic Reflex Testing defined on the Dimension system, the reflex test will run from the aliquot sample.   The reflex test orders generated by the Dimension system will only display on the VersaCell X3 system after the test is complete and the results are sent to the VersaCell X3 system. In the case of reflex testing, both initial and reflex results are sent.   Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.When Automatic Reflex Testing is defined on the Dimension system, the reflex test will run from the aliquot sample. The reflex test orders generated by the Dimension system will only display on the VersaCell X3 system after the test is complete and the results are sent to the VersaCell X3 system. In the case of reflex testing, both initial and reflex results are sent. Select Next to continue. 2 Panic Repeats Defined on Dimension System When the first panic result is completed, the repeated result will be performed from the aliquot sample, if the tube was delivered to the Dimension system by the VersaCell X3 system.   A result is not sent to the VersaCell X3 system until the repeat test is finished.   The Test Results screen displays both results.    Select Next to continue. In the case of panic repeats, when the first panic result is completed, the repeated result will be performed from the aliquot sample, if the tube was delivered to the Dimension system by the VersaCell X3 system. A result is not sent to the VersaCell X3 system until the repeat test is finished. The Test Results screen displays both results. Select next to continue.3 To Order Re-runs or Add a Test on the Dimension System Ordering Re-runs or to Add a Test cannot be done from the aliquot. It is not allowed.  The message says Cannot EDIT/RERUN STM aliquoted samples.   In order to rerun or add a test, the tube must be removed from the VersaCell X3 drawer and manually loaded on the Dimension system.    To most efficiently order the re-run, display the Enter Data screen and change the Sample Container Mode to barcoded tube. Then type or scan the barcode number and order the repeat test(s).  Load the tube and press Run.   Select Next to continue. When using the Dimension functionality to order reruns and add tests, it is not allowed to run from the aliquot. The message says Cannot EDIT/RERUN STM aliquoted samples. In order to rerun or add a test, the tube must be removed from the VersaCell X3 drawer and manually loaded on the Dimension system. To most efficiently order the re-run, display the Enter Data screen and change the Sample Container Mode to barcoded tube. Then type or scan the barcode number and order the repeat tests. Load the tube and press Run. Select next to continue.4 Ordering Re-runs on VersaCell X3 System Tests can be re-run using the Test Results screen in the VersaCell X3 system software.  Tests can only be re-run if they are patient tests that are in Complete status, and that were ordered originally by the LIS.   The robotic arm will re-deliver the tube to the interface wheel for repeat testing.   Select Next to continue. Tests can be re-run using the Test Results screen in the VersaCell X3 system software. Tests can only be re-run if they are patient tests that are in Complete status, and that were ordered originally by the LIS. The robotic arm will re-deliver the tube to the interface wheel for repeat testing in this case. Select Next to continue. 5 Auto Dilutions Defined on Dimension System For tests automatically diluted by the Dimension system, an error code of diluted is sent by the Dimension system to the VersaCell X3 system.   If the method is programmed for auto-dilution and the test result exceeds the assay range, the aliquot sample will be used to perform the repeat testing. If another higher priority error exists for the results, it will take priority in being sent as an error code and the auto dilution information is not sent.   When complete, select the X in the upper-right corner to close the window and continue. For tests automatically diluted by the Dimension system, an error code of diluted is sent by the Dimension system to the VersaCell X3 system. If the method is programmed for auto-dilution and the test result exceeds the assay range, the aliquot sample will be used to perform the repeat testing. If another higher priority error exists for the results, it will take priority in being sent as an error code and the auto-dilution information is not sent. There will be no indication at the VersaCell X3 system that the sample was auto-diluted. The STM is an additional component for the Dimension system that provides connectivity to the VersaCell X3 system. The STM automates the transfer of sample from the interface wheel to the Dimension system sample wheel. With the addition of the STM module to the Dimension system, the physical appearance of the instrument changes.  In addition, some of the software screens will include data regarding the monitoring the STM performance on the Dimension system. Select Next to continue.   The STM includes these components: Transfer Arm (Carriage and Carriage Drive System) Pipette Tips Tip Feeder Tip Waste Container STM Keypad STM Segments Fluidics System (Air Pump, Tubing, Pressure Sensing PCB) STM Control Board Pausing the STM Learn how to pause the STM. The STM can be paused by: Raising the tip feeder cover on the STM Raising the IMT lid Removing the tip waste container Raising the printer lid (Dimension® RxL Max® System only) Pressing the Pause button on the STM keypad When the STM is paused, it continues operations for the current sample that is being transferred until the carriage returns to the home position.  The blue “STM Paused” status appears in the Instrument Status box at the top of the Dimension systems screen. If the STM was paused by raising the tip feeder cover on the STM or the IMT lid or printer lid, closing the lid automatically resumes STM operations. If the STM was paused by pressing the STM Pause button, press the STM Continue button on the Dimension® RxL Max® System or the Load button on the Dimension® EXL™ System to resume STM operations.   When complete, select the X in the upper-right corner to close the window and continue.   Report Slips Learn about report slips. Report slips for samples processed using the STM have the same format and contain the same information as those processed without the STM.  A lowercase letter in the Segment field indicates the STM sample. When complete, select the X in the upper-right corner to close the window and continue.     STM Components Learn about the STM components and their function. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Transfer Arm The transfer arm consists of the carriage and the carriage drive system. The carriage probe transfers an aliquot of sample from the sample tube on the interface wheel to the Dimension system sample wheel. A disposable pipette tip is mounted on the probe for each sample. Sensors monitor the position of the carriage as it shuttles back and forth on the carriage drive. The carriage drive system moves the carriage between the sample access position and the Dimension sample wheel. Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.The transfer arm consists of the carriage and the carriage drive system. The carriage probe transfers an aliquot of sample from the sample tube on the interface wheel to the sample wheel. A disposable pipette tip is mounted on the probe for each sample. Sensors monitor the position of the carriage as it shuttles back and forth on the carriage drive. The carriage drive system moves the carriage between the sample access position and the Dimension sample wheel. Select next to continue.2 Pipette Tip A pipette tip carries the sample from the sample tube and deposits it into an assigned position of an aliquot segment in the Dimension system sample wheel. Tips are mounted and removed automatically for each sample transfer. An optical sensor checks for the presence of a tip. As needed, the operator loads racks of 200 pipettes into the tip feeder.   The STM draws from 200 ul – 550 ul sample  in 50 ul increments based on the tests ordered.  The system ensures enough is drawn for dilutions and repeats by doubling the volume drawn for the three highest volume test requests up to a maximum total volume of 550uL.  If clog or air is aspirated then the STM carefully returns sample to the tube.      Select Next to continue. A pipette tip carries the sample from the sample tube and deposits it into an assigned position of an aliquot segment in the Dimension sample wheel. As needed, the operator loads racks of 200 pipettes into the tip feeder. The tips are mounted automatically onto the STM probe before each sample transfer then removed from the probe after the sample transfer. An optical sensor checks for the presence of a tip. The STM draws from between 200 ul and 550 ul of sample in 50 ul increments based on the tests ordered. The system ensures enough is drawn for dilutions and repeats by doubling the volume drawn for the three highest volume test requests up to a maximum total volume of 550uL. If clog or air is aspirated then the STM carefully returns sample to the tube. Select next to continue.3 Tip Feeder The tip feeder tray holds 400 pipette tips in two racks of 200 tips each. Lifting the tip feeder cover activates a sensor which pauses the STM transfer movements. The tip tray moves to the front of the tip feeder compartment where the tip racks can be removed and replaced. The STM resets to normal operation after the cover is closed.  Optical sensors inventory the number of tips in the tip racks each time the cover is raised and closed, ensuring that the Dimension system maintains an accurate count of available tips.    Select Next to continue. The tip feeder is located inside the upper compartment of the STM cabinet. Pipette tips are housed in tip racks on the tip tray inside the tip feeder. The tip tray holds two racks of 200 tips each for a total of 400 pipette tips. When the tip feeder cover is raised, a sensor is activated, pausing all transfer movements on the STM. The tip tray moves to the front of the tip feeder compartment where tip racks can be removed and replaced. The STM resets to normal operation once the lid is closed. Each time the tip feeder cover is opened and closed, optical sensors inventory the number of tips remaining in the tip racks. This ensures that the Dimension system maintains an accurate count of available tips. The available tip count is displayed in the Pipette Tips field at the top of the Aliquot Segment screen. When the field reaches zero, an “STM Needs” status message displays, and STM operations pause. The empty tip racks must be replaced before STM operations can continue. Select next to continue.4 Tip Waste Container The tip waste container is located inside the compartment underneath the tip feeder and holds up to 1600 pipette tips.  After the transfer of each sample, the used pipette tip is stripped from the STM probe at the tip removal station and deposited into the container. To ensure that this capacity is not exceeded, the number of used pipette tips is monitored continually by the Dimension system and is displayed. Select Next to continue. Located inside the compartment underneath the tip feeder, the Tip Waste Container holds up to 1600 pipette tips. After the transfer of each sample, the used pipette tip is stripped from the STM probe at the tip removal station and deposited into the container. The number of used pipette tips is monitored continually by the Dimension system. Select next to continue.5 STM Keypad The STM keypad is used to pause the STM.  If the STM is paused by pressing the STM Pause button, press the STM Continue button on the Dimension® RxL Max System or the Load button on the Dimension® EXL™ System to resume operations. Select Next to continue.  Another modification is the STM keypad. If the STM is paused by pressing the STM Pause button, you must press the "Continue" or the "Load" button on the STM keypad in order for the Dimension system to resume operations. Select next to continue.6STM Segment An STM segment consists of the Segment base and Aliquot segment. Segment base: The STM segment base contains a bar code label which identifies the segment with a lower case letter. This letter appears in one of the six boxes of the STM segment status area on the screen.   Select Next to continue. A sample is carried within the pipette tip then dispensed into an STM segment on the Dimension system sample wheel. The STM segment consists of two components: a segment base and an aliquot segment. The segment base contains a bar code label which identifies each specific STM segment letter. This letter appears in one of the six boxes of the STM segment status area on the screen. Select next to continue.7STM Segment (continued) Aliquot segment: The aliquot segment is placed securely on the segment base to create an STM segment. Each aliquot segment also is identified by a unique barcode number and contains 63 sample positions. The sample wheel holds up to six STM segments or any combination of STM segments and standard Dimension systems primary tubes/sample cup segments.  Therefore, there can be up to 378 specimens per instrument. The sample viability is 90 minutes for most assays.  The STM will stop aspirating to aliquot trays if specimen viability in the aliquot trays will time out before they can be aspirated to the cuvettes; default is set to 60 minutes. Aliquot segment lids are provided to keep sample fluid from splashing out of the aliquot segment while transferring the used segment to the laboratory disposal container. Select Next to continue.The aliquot segment is placed securely on the segment base to create an STM segment. Each aliquot segment also is identified by a unique barcode number and contains 63 sample positions. The sample wheel holds up to six STM segments or any combination of STM segments and standard Dimension systems primary tubes/sample cup segments. Therefore, there can be up to 378 specimens per instrument. The sample viability is 90 minutes for most assays. The STM will stop aspirating to aliquot trays if specimen viability in the aliquot trays will time out before they can be aspirated to the cuvettes; default is set to 60 minutes. Aliquot segment lids are provided to keep sample fluid from splashing out of the aliquot segment while transferring the used segment to the laboratory disposal container. Select next to continue.8 Fluidics System The fluidics system consists of four components for sample aspiration and dispensing and liquid level detection: Air Pump:  Provides volumetric displacement needed to generate the air pressures required to aspirate and dispense the sample  Pipette:  Carries sample from the sample tube to the sample wheel Pressure Sensing Printed Circuit Board (PCB):  Monitors the air pressure within the fluidics system during sample transfer operation Tubing:  Provides the pneumatic interconnection between the air pump, pipette, and the PCB board.   Select Next to continue.  The fluidics system has three primary functions: sample aspiration, sample dispense, and liquid level detection. Disposable pipettes transport the sample from the sample tube to an aliquot position on the Dimension sample wheel. The fluidics system cycle begins with the detection of the level of sample as the pipette descends into the sample tube. Once liquid level is determined, a volume of sample is aspirated into the pipette tip and transported to the Dimension sample wheel where it is dispensed into an STM segment. During this cycle, in addition to level sensing, a pressure profile is recorded and analyzed to determine that the proper amount of sample was aspirated successfully. The fluidics system consists of four components. The air pump provides volumetric displacement needed to generate the air pressures required to manipulate the sample. The pipette carries sample from the sample tube to the sample wheel. The Pressure Sensing Printed Circuit Board monitors the air pressure within the fluidics system during a sample transfer operation. The tubing provides the pneumatic interconnection between the air pump, pipette, and the PCB board which is sized to provide appropriate response to determine proper level sensing and aspiration of the sample. Select next to continue.9 STM Control Board An additional Control Board on the Dimension system is required for the STM.     Select Next to continue. An additional Control Board is required for the STM on the Dimension system. Select next to continue.10 STM Components   The STM includes these components: Transfer Arm (Carriage and Carriage Drive System) Pipette Tips Tip Feeder Tip Waste Container STM Keypad STM Segments Fluidics System (Air Pump, Tubing, Pressure Sensing PCB) When complete, select the X in the upper-right corner to close this window and continue. You have just learned about the STM components and their function. In this section, you will learn how to use the Dimension software with an STM: STM Processing Status Segment Status Screen Aliquot Segments Screen STM Processing Status Learn about STM processing statuses. When the Dimension system includes the STM, the Instrument Status Area at the top of the screen displays STM Status information in the 4th status box.   STM Processing Status Messages STM Standby:  Ready to receive STM work STM Processing: Transferring samples from the interface wheel to the sample area STM Needs: STM aliquots, Pipette tips and Tips to waste full needs must be met before STM can continue sampling STM Pausing: STM is completing current sample transfer and returning to Home position STM Paused: Dimension system will not accept any STM work STM Error: The Dimension system will not accept any work until the STM error message is resolved   When complete, select the X in the upper-right corner to close the window and continue.   Segment Status Area Learn about the segment status area. With the STM, the Segment Status area displays an STM segment with a lowercase letter and a primary tube/sample cup standard segment with a capital letter. STM segment status boxes can appear in one of three background colors: Red:  Do not remove or replace this STM segment or the aliquot segment from the sample wheel.  It is currently being used by the Dimension system to process samples. Yellow:  The STM segment has unused aliquot positions available on it and should not be removed. The instrument is not using this segment to process samples. Green: This STM segment or aliquot segment is completely used and no more positions are available to process tests.  This STM segment or the aliquot segment can be removed or replaced if desired Note:  A dash (-) can also appear in a green background box.  This means the Dimension system has not identified an STM segment or regular segment in that position on the sample wheel. Warning:  Never place a previously used or partially used aliquot segment onto the sample wheel. This will cause erroneous patient results.   When complete, select the X in the upper-right corner to close the window and continue.     Aliquot Segments Screen Learn about the Aliquot Segments screen. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Aliquot Segments Screen   To access the Aliquot Segments screen, press the Alt/S key combination, and if necessary, F2: STM.   The Aliquot Segments screen displays: How many unused aliquot positions are available How many pipette tips are available How many pipette tips until the tip waste is full Current status of each aliquot position STM Backlog   Select Next to Continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.The Aliquot Segments screen displays useful information to assist with workflow and status needs. In this section, you will learn about the information provided on this screen. Select next to continue.2 Sample Wheel Positions   Sample wheel position numbers 1-6 on the left side of the Aliquot Segments screen correspond to the Dimension system sample wheel positions 1-6.     Select Next to continue.  On the left side of the Aliquot Segments screen are sample wheel positions. Positions 1-6 correspond to the sample wheel positions on the instrument.3 Sample Status   Each STM aliquot segment contains 63 sample positions. The Aliquot Segments screen displays the current status of each position.  In addition to the standard letters used by the Dimension systems to indicate the status of samples on the screen, there are two STM specific marks that appear on the screen: - Red: This aliquot position is not available for use. It has been used or aborted.  + Green: This aliquot position has not been used. The letters that appear on the screen have the same meaning and colors as those used with the Dimension systems. For example, a yellow B indicates the sample has begun processing. Select Next to continue.  There are 63 positions available for samples in each STM aliquot segment. The Aliquots Segment screen displays the current status of each position. Two STM specific marks also will appear on this screen. A minus sign with a red background color indicates the position is not available for use. A plus sign with a green background color indicates the position has not been used. Select next to continue.4 Consumables   The Aliquot Segments screen provides information on the consumables required for sample processing and the available STM aliquots positions and pipette tips. The Tips to Waste Full field indicates the number of tips that can be added to the waste. Select Next to continue.  The Aliquot Segments screen provides information about the consumables required for sample processing and the available STM aliquots positions and pipette tips. The Tips to Waste Full field indicates the number of tips that can be added to the waste. Select next to continue.5 Backlog Time   The STM backlog indicates the time until the last sample transferred by the STM to the Dimension system sample wheel will be processed.   The VersaCell X3 system uses this time to stop sending samples to the Dimension system which prevents loss of volume from evaporation in the aliquot segment.     Select Next to continue. The STM backlog indicates the time until the last sample transferred by the STM to the Dimension system sample wheel will be processed. The VersaCell X3 system uses this time to stop sending samples to the Dimension system which prevents loss of volume from evaporation in the aliquot segment. Select next to continue.6 Summary   The Aliquot Segments screen displays: How many unused aliquot positions are available How many pipette tips are available How many pipette tips until the tip waste is full Current status of each aliquot position STM Backlog When complete, select the X in the upper-right corner to close the window and continue.  The Aliquot Segments screen displays useful information to assist with workflow and status needs, including information on sample status, consumables, and backlog time. In this section, you have the opportunity to think about these STM questions. Read each question then review the corresponding answer to see if you match the response.   Question Answer On the Dimension System, an STM segment appears with which type of case letter in the segment status box? An STM segment appears with a lower case letter, ex., a What does a red background color for a segment status box indicate? A red background color for a segment indicates it is currently being used for processing and should not be removed. What does a yellow background color for a segment status box indicate? A yellow background color indicates the STM segment or the aliquot segment has unused aliquot positions available for use. What does a green background color for a segment status box indicate? A green background color indicates the STM segment or the aliquot segment is completely used and can be replaced. Why should a partially or partially used aliquot segment never be placed back on the segment wheel? Never place a previously or partially used aliquot segment on the sample wheel as this could cause erroneous patient results. Select Next to continue. The STM consumables that the operator must maintain: Aliquot Segments:  A new aliquot segment must be loaded when a System Needs message appears in the STM processing status or when the STM segment status boxes are green. Never remove an STM or aliquot segment when a segment status box is red, which indicates that the segment is being used to process a sample. Pipette Tips:  A rack of pipette tips can be loaded in the tip feeder at any time.  The tip feeder must be loaded when the Pipette Tips field on the Aliquot Segments screen displays zero. This halts the Sample Transfer Module from transferring samples and displays the "STM Needs" status. Tip Waste:  The tip waste container can be emptied at any time. When the Tips to Waste Full field on the Aliquot Segments screen is zero, the container must be emptied.  This stops the STM from transferring samples and causes the “STM Needs” message to appear.   Loading Pipette Tips Learn how to load pipette tips. Steps to load pipette tip racks: Raise the tip feeder cover and wait for the tip tray to move the tip racks to the front of the feeder. Remove the empty pipette tip rack or racks and dispose them using your laboratory’s biohazard waste procedures.  Do not reuse the empty pipette tip rack. Place the new rack or racks onto the tip tray. Close the tip feeder cover. The Dimension system automatically inventories the number of tips in both racks of the tip tray.  The total number of inventoried tips appears in the Pipette Tips field at the top of the Aliquot Segments screen.  When complete, select the X in the upper-right corner to close the window and continue.   Loading Aliquot Segments Learn how to load aliquot segments. Checklist TitleChecklist TypeChecklist ContentSelect PauseHTML Press the Pause key to halt the movement of the sample wheel.  After the “Samplers Off” status appears, the sample wheel can be moved manually to remove the aliquot segments. Select each checkbox to learn more about loading Aliquot Segments.    Remove SegmentHTML Remove the used aliquot segment from the segment base. Place a lid on the used aliquot segment to keep fluids from splashing and discard according to your laboratory’s biohazard disposal procedures.    Load SegmentHTML Place a new, unused aliquot segment on the segment base and ensure it is fully seated.      Select PauseHTML Select the Pause key on the Dimension system keyboard.      Select Run KeyHTML Press the RUN key. The Dimension system scans the sample wheel and updates the Aliquot Segments screen and Segment Status box. The aliquot segments replaced will appear with green plus signs (+) in all positions.  Note: To access the Aliquot Segments Screen, press the Alt/S key combination and if necessary, F2: STM.  When complete, select the X in the upper-right corner to close the window and continue. Emptying Tip Waste Learn how to empty the tip waste. Steps to empty the tip waste: Open the STM cabinet door and remove and empty the tip waste container. Place a biohazard bag liner inside the empty container, place the container back in the cabinet and close the door. Display the Systems Counter screen from the Operating Menu by pressing F4: Systems Prep, then F6: Sys Counters Move the cursor box to the Replace column of the STM Tip Waste field. Press the Enter key to change the NO to YES, and then press F1: Store Changes.  Answer the prompt by typing a “y” for yes. The Cycles column changes to zero and the Last Replaced column changes to the current date and time.   When complete, select the X in the upper-right corner to close the window and continue.   There is minimal maintenance associated with the STM and no required daily maintenance.  Routinely clean the outside surfaces of the STM using a damp cloth and warm, soapy water.  Clean up spills immediately. It is recommended to perform Dimension system daily maintenance while performing the VersaCell X3 system daily shutdown. Additionally, the STM alignment guide may be used to perform alignments.   Using the Alignment Guide Learn how to use the alignment guide. Alignments must be performed after replacing the Photometric Sample probe on the Dimension systems or the IMT Sample Probe on the Dimension RxL Max system. When the STM is installed on the Dimension system, the Cup Alignment gauge is no longer be used.  The STM Alignment Gauge is used instead.  The only recommended alignments specific to the STM are the: Sample Probe to Aliquot Segment Outer/Inner Holes (all Dimension systems) IMT Probe to Aliquot Segment Outer/Inner Holes (Dimension RxL Max systems) All other STM specific alignments are performed by field service.  Follow the instructions in the Dimension clinical chemistry system Sample Transfer Module Operator’s Guide.   When complete, select the X in the upper-right corner to close the window and continue.   Common STM errors include: STM Invalid Aliquot Segment STM Aspirated Air STM Tip Leaking STM Tip Plugged Cannot Find Home Lost Steps Aborting a run: Press the Control/Stop key combination Error messages display on both the Dimension system and the VersaCell X3 system Recovering from Control/Stop Learn how to recover from Control/Stop. If the Control /Stop key combination is pressed when a run needs to be aborted: The STM Status on the Dimension system displays STM Error. The error message field on the Dimension system displays User Aborted Processing in red. On the VersaCell X3 system, the Dimension system status displays Error Stopped. After the Reset key is pressed on the Dimension system keyboard, the Dimension system status on the VersaCell X3 system displays Initializing. When initializing is complete, the Dimension system status on the VersaCell X3 system displays Running. Note: If Pause is pressed, the VersaCell X3 system displays Analyzer Paused for the Dimension system status. If only the IMT is paused, the system still displays Running. When complete, select the X in the upper-right corner to close the window and continue. STM Errors Learn about STM errors. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Troubleshooting Help   If an error message appears on the Dimension system, press the Alt/M key combination to display troubleshooting help.  However, not all STM error messages have Alt/M troubleshooting help. The error message displays an error code number in parentheses.  The Dimension® Clinical Chemistry Sample Transfer Module Operator’s Guide provides STM specific error message explanations and steps to resolve by the error code number displayed with the message.   Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.If an error message appears on the Dimension system, press the Alt/M key combination to display troubleshooting help. Not all STM error messages will have the Alt/M troubleshooting help. The error message displays an error code number in parentheses. The Dimension clinical chemistry Sample Transfer Module Operator’s Guide provides STM specific error message explanations and steps to resolve by the error code number displayed with the message. Select next to continue.2 Aliquot Segment Errors Examples of aliquot segment related error messages which may display on the Dimension system are: STM Invalid Aliquot Segment caused by missing or bad aliquot segment (801) Explanation: The barcoded aliquot segment was not detected by the barcode reader in the sample wheel   Possible Solution: Check for proper installation of aliquot segment and press Run. If the error reoccurs, replace it with new unused aliquot segment and press Run. STM Invalid Aliquot Segment caused by STM attempt to reuse a used aliquot segment (802) Explanation: A previously used aliquot segment was found on the sample wheel and the segment has been deleted.   Possible Solution: Check the Aliquot Segments screen for all red dashes in the display. Remove the aborted aliquot segment and load a new unused one.  Select Next to continue. Aliquot segment related error messages display on the Dimension system . The error message posted is STM invalid aliquot segment. When the error is caused by a missing or bad aliquot segment, error code 801, this indicates that the barcoded aliquot segment was not detected by the barcode reader in the sample wheel. The first step to resolve is to check for the proper installation of the aliquot segment and press Run. If the error reoccurs, replace it with a new aliquot segment then press Run. When the error is caused by the STM attempting to reuse a used aliquot segment, error code 802, a previously used aliquot segment was found on the sample wheel and the segment has been deleted. Check the Aliquot Segments screen for all red dashes in the display, remove the aborted aliquot segment and load a new unused one. Select next to continue.3 Fluidics Errors During a sample aspiration and dispensing cycle, the STM fluidics system monitors air pressure to determine that the proper amount of sample was detected and transported.  STM sample aspiration problem error messages can be caused by: STM aspirated air (782) Explanation:  Abnormal pressure data indicates no fluid was aspirated Solution:  Check for crimped tubing and bubbles or foam on top of the sample STM tip leaking (780) Explanation:  Abnormal pressure data indicates sample leaked from tip. The sample and pipette tip are discarded. Solution:  Check for a leak in the tubing, defective pipette tip(s) or air pump syringe STM tip plugged (781) Explanation:  Abnormal pressure data indicates the pipette tip was plugged during aspiration Solution:  Check sample quality for clots or fibrin and insufficient sample for possible gel aspiration    Select Next to continue. During a sample aspiration and dispensing cycle, the STM fluidics system monitors air pressure to determine that the proper amount of sample was detected and transported. STM sample aspiration problem error messages can be caused by the STM aspirating air and the tip leaking or being plugged. Abnormal pressure data indicates that no fluid was aspirated, that sample leaked from the tip or the tip was plugged during aspiration. To resolve these issues, check for crimped or leaking tubing, sample quality and sufficient sample depending on the specific error code. Select next to continue.4 Cannot Find Home / Lost Steps Similar to other components on the Dimension system, the STM also may have error messages that display “Cannot Find Home” or “Lost Steps”. “Cannot Find Home” messages Explanation: The control system did not detect movement of the component.   Solutions: If the component did not move through a complete cycle check for either interference or replace the home sensor for the particular component; for example, STM probe or shuttle If the component did not move at all, first check the fuse. “Lost Steps” messages Explanation: The component did not move the proper distance   Solutions: Check for either something restricting or interfering with the movement of the component.  If nothing is observed, then alignments or lubricating the module may be recommended.     Select Next to continue. As with any component on the Dimension system, the STM may have error messages that display “Cannot Find Home” or “Lost Steps”. “Cannot Find Home” messages generally are associated with either interference or a home sensor for the particular component; for example, STM probe or shuttle, if the component did not move through a complete cycle. If the component did not move at all, first check the fuse. “Lost Steps” messages generally are associated with something restricting or interfering with the movement of the component. If nothing is observed, then performing alignments or lubricating the module may be required. Select next to continue.5 Summary   Common STM errors include: STM Invalid Aliquot Segment STM Aspirated Air STM Tip Leaking STM Tip Plugged Cannot Find Home Lost Steps   Follow the guidelines for troubleshooting outlined in the Dimension® clinical chemistry system Sample Transfer Module Operator’s Guide for the error code number displayed.   If an error message is not resolved by following the troubleshooting help, contact the Technical Solutions Center.  When complete, select the X in the upper-right corner to close the window and continue.   Common STM errors include STM Invalid Aliquot Segment, STM Aspirated Air, STM Tip Leaking, STM Tip Plugged, Cannot Find Home, and Lost Steps. Follow the guidelines for troubleshooting outlined in the Dimension clinical chemistry system Sample Transfer Module Operator’s Guide for the error code number displayed. If an error message is not resolved by following the troubleshooting help, contact the Technical Solutions Center.