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QBC Autoread™ Plus

Installation Training Documentation

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QBC AutoreadTM Plus Installation Training Documentation

Contents

QBC AutoreadTM Plus Installation Guide………………..……………….1 Techniques Tips- QBC Tubes…………...……………………….………...2 Running a Control……………………………………………………………3 Frequently Asked Questions……………………………………………….4 QBC AutoreadTM Plus Compatible Printers………………………………5 QBC Autoread TM Plus Error Lists………………………………………....6 QBC Autoread TM Plus Scan Data Interpretation………………………..7 QBC Europe Technical Support Procedure…………………………......8 Troubleshooting Centrifuge………………………………………………...9 QBC Autoread TM Plus Installation Training Documents……….…….10

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1. QBC Autoread™ Plus Installation Guide

1. Arrive 30 minutes early to set up the system

a. Remove everything from the box b. Place Autoread™, centrifuge, printer and power cords on the bench c. Ensure correct placement, power connections

2. Autoread™ Plus now in place

a. Discuss theory/technology of Autoread™ and QBC tubes i. Based on centrifugation and separation of the cells ii. Most dense (RC’s) on the bottom layer then WBC’s, platelets

and plasma iii. Float is the same density as the buffer coat (centres itself

over buffy coat) iv. Float is known density which descends into RBC. How far

determines Haemoglobin result

3. Introduce the Autoread™ Plus

a. Show power button, fuse location, power pack, tray, door, cal rod b. Turn on

- Internal tests - Electronics/optics/mechanics/LCD - ‘8s’ and ‘dots’

c. Show display - Power - Results - Messages - Contrast

d. Show Calrod e. Show mode buttons

i. Cal Check Mode- run cal check daily ii. Control Mode- whole liquid control iii. CBC Mode

- Select Patient iv. Options Mode

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4. Discuss Centrifuge

a. Show ON/OFF button, fuse location, power pack b. Power on- plug in centrifuge before turning power on c. Explain lid and show how to tighten d. Show where to place lid between centrifugation e. Show how the rotor is labeled for tube balancing

5. Centrifuge Operation

a. On/off button to start and abort spin b. Discuss speed 12,000rpm for 5 minutes c. Lid opens automatically when complete d. Should check centrifuge speed every 6 months with photo

tachometer 6. Run the Autoread™ Plus

a. Show how to fill and mix the tube b. Show running a sample c. Reprinting results d. Show troubleshooting techniques e. Diagnostic scan (Mode/Down) f. End of day turn off

7. Run a Calrod Check & Control

a. Cal Mode- Calrod b. Control Mode- whole liquid control

i. Date vial when opened ii. Open vial stability iii. Store 2-8oC iv. Explain assay sheet

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2. Technique Tips – QBC Tubes

Filling- Capillary

- Ensure an appropriate lancet is being used for collection - 1mm width, 1.4mm depth paediatric & 1.9mm adult - Use the thumb - Ensure hand is warm, better blood flow will result - Wipe first drop of blood away and don’t ‘milk’ thumb - Do not scrape blood from the thumb - Fill in-between the two black lines, avoiding bubbles

Filling- Venous

- Gently invert sample 10-15 times prior to filling tube - Twist the QBC pipettor barrel forward to load tube - GENTLY insert the tube- stopper end first - Once loaded, twist backward to close the barrel

Filling- General

- Always fill at the end of the white anticoagulant powder - Always cap at the end farthest away from the 2 black fill

lines - If bubbles are present, try to compensate with more

sample (an error will occur if sample is under or over filled)

- Wipe the tube with an alcohol wipe after centrifugation - Do NOT allow sample to touch the end white plug - ‘Seat’ plug with the blood lying midway within the tube - DO NOT touch the float with your fingers

Processing

- Centrifuge within 15 minutes of float insertion - Following centrifugation, analyse samples within 4 hours - Don’t sit tubes horizontally on the bench following

centrifugation - Store pre- analysed centrifuged samples vertically

- Don’t leave the tubes in the centrifuge following centrifugation, set upright in a rack

- Place the tube into the instrument with the cap to the left - Select correct test mode (CBC mode/Control Mode)

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3. Running a Control

1. Store QC’s in the middle of the fridge to allow complete air circulation around the box

2. Remove one vial of QC from the fridge at a time 3. Remember open-vial stability is 4 days 4. Date the QC vial upon opening 5. Use control immediately after removing from the fridge 6. Roll vial in hands for at least 45 seconds (using timer) 7. Gently invert control 10-15 times 8. Load the tubes with the control and roll the blood in the acridine orange at

least 10 times until it is completely mixed into the sample 9. Wipe around the top of the control vial with a lint free tissue. This will

prevent dried up matter falling into the control sample 10. Following centrifugation wipe the tube with an alcohol wipe prior to

analysis 11. Run the control in the correct mode

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4. Frequently Asked Questions – QBC AR™

What sample type can be used? Capillary or anticoagulated whole blood (EDTA) How much blood is required to test on the Autoread™ system? AccuTubes- 70µL Standard Capillary- 60µL Standard Venous- 111µL How long may a sample be stored prior to running on the Autoread™? Venous – 8 hours in anticoagulated blood tube at room temperature

Capillary – Process immediately (no longer than 15 minutes) After centrifugation the tubes can be stored vertically and analysed within

4 hours How often do I run the Calrod? The Calrod should be tested daily prior to testing patient samples Can a reprint of results be obtained? Yes, a result reprint can be obtained by pressing the NEXT button whilst the sample is still in the analyser Can I use the QBC pipettor with Accutubes? Yes, a special Accutube spacer has been developed which adds to the pipettor to ensure the correct sample size is obtained Does the speed of the centrifuge need to be recorded?

Yes, it is recommended that centrifuge speed is checked every 6 months with photo tachometer

Can a sample be rerun on the instrument? Yes a tube can be rerun upto 4 hours after filling

How do you print out a diagnostic scan?

When the analysed tube is still in the Autoread™ press the mode and down arrow key to produce a diagnostic scan

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What is the QC recommendation? Each user must follow any quality control requirements from their own regulatory or accreditation agency. QBC controls are available for performance monitoring.

What causes “buffy-coat unreadable” error? This error is generally sample-related. If using venous blood, ensure samples are well mixed prior to testing. 12 to 15 inversions of the venous tube, or 5 minutes on a mechanical mixer is required. If using capillary samples, warm the finger, use an appropriate lancet, and wipe off the first drop of blood. Process sample within the 15-minute limit after collection. Certain illnesses or disease processes may cause errors. In some cases patients should be tested via another method and a manual differential requested. My QBC pipettor (used to fill Standard venous or Accutubes) is not drawing samples correctly- What can I do? Ensure that the plug at the bottom of the tube has not been seated. Make sure that there is no dried material stuck within the pipette body. If the pipettor seems clogged, the barrel can be removed and replaced. If this does not remedy the issue, replace the entire pipettor. The Autoread™ runs the test but I don’t get a printout- Why? Power off the printer and follow the instructions in the Operator’s manual to reset the print format. Power printer back up and test calrod or sample. Check that the printer head is moving appropriately. Confirm that ink cartridge is not empty and is installed correctly.

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5. QBC Autoread™ Plus Compatible Printers

Manufacturer Model Brother HL-2070N Brother Brother HL-5240 Brother Brother HL-5250DN Canon BJC 85 Canon BJ 30 Epson LX 300 Plus

Samsung ML 2570

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6. Common Autoread / Autoread Plus Error Messages

Error Message/Symptom Cause Action 1. ‘’Error 03 Cal rod’’ & ‘’Error Locating Meniscus’’

A. Lamp burned out A. With AR software version 3.95 or higher, turn off/on. Look on display for ‘’lamp test failure’’ to confirm lamp is out. If so then initiate repair or give customer repair options.

2. ‘’Carriage error, no sensor’’ or ‘’carriage……’’ accompanied by a grinding noise

A. Carriage not hitting sensor B. Sensor not working C. Carriage stuck (most common) sometimes accompanied by a grinding noise- may be intermittent progressing to often

A. Initial action: instruct customer to power unit off, wait 30-60 seconds, power unit on. Unit should go through System Check and may clear carriage error, if not proceed to B and/or C B. If no service agreement, inform customer this could be a one off problem or it may occur again or progress, suggest either repair or wait C. If no service agreement, use judgement to bring in unit for repair or wait D. NOTE: Perform this step if customer is willing and able, again use your judgement. If customer has a patient to run, has no service agreement and the carriage will not clear with Action A, instruct to do the following: Wearing gloves, remove the 4 platform screws, remove platform and manually turn the lead screw counter clockwise (towards the front of the Autoread) until the tube is as far left as possible. This should clear carriage for use, if not offer repair

3. ‘Position Error’ A. Usually power related, i.e…Power fluctuation B. Tube not seated properly in collet

A. Instruct customer to follow the messages on the display window, paying particular attention to pressing the buttons when instructed on the display. E.g. ‘’open door’’, ‘’remove tube’’, ‘’close door’’, ‘’press NEXT’’ etc… NOTE: The AR memory will save the ‘’position error’’, therefore trying to reset the AR memory will save the position error message. Customer MUST follow instructions on the display window

4. ‘’PC connected’’ A. Usually caused by power fluctuations B. Someone has pressed the wrong buttons and inadvertently changed this setting

A. See Technical Bulletin TB-010-6/95, ‘’Disabling the PC connected?’’ option, or the ‘’waiting for PC message’’

5. Filter Wheel Error 01 A. On start-up: the filter wheel has bypassed its stop position B. On patient samples: a definite filter wheel problem

A. On start-up: open/close door to reset filter wheel B. On patient samples: unit needs to be repaired

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Common Autoread / Autoread Plus Error Messages

Error Message/Symptom Cause Action 6. ‘’Calibration (backlash)’’ NOTE: Seen on startup only

A. Loose motor coupling B. Carriage not freely moving C. Drive train slipping

A. Re-run the tube in question or another tube. If error message continues initiate repair

7. ‘’Rotation Error’’ NOTE: Seen in cal mode A. The tube is not being properly rotated

A. To verify whether or not the tube is rotating, place the cal rod with orange/black label in AR with label facing up. Close door and watch display for ‘’scan 4’’, open door, (‘’abort’’), close door and wait for the tube to return to the home position. Open the door. At this point the orange/black label should be facing down (toward the bottom of the AR). If not, the tube is not rotating properly. Initiate repair.

8. ‘’Error locating meniscus’’ A. For standard and EZ prep tubes: the plasma meniscus is outside (above or below) the tube fill lines or the fill lines are obscuring the plasma meniscus B. For Accutube: since there are no fill lines…….

A. Based on the tube type the customer is using, determine where the meniscus is falling by verbally reviewing the tube traits (i.e. cap, lines on tube, etc..) Have customer re-set if under or over filled

9. ‘’Can’t ID tube type’’ A. Problem with fill volume A. Based on the tube type the customer is using, determine if the tube is filled properly, if there is a float (no clear space between red cells and plasma or no dark to light red layer separation), blood seepage in standard tube caps OR tube filled backward

10. ‘’Error locating float’’ A. Haemolysis, platelet clumps or fibrin strands resting on top of float B. Also can be due to a binding carriage, defective lamp or defective LED

A. Have a customer inspect tube for presence of haemolysis or clumps on top of float. If none, re-run tube or set-tube and re-run B. If tube has been re-set and this error continues- initiate repair

11. ‘’Too many bubbles found in tube’’

A. Bubbles or air pockets created are present in the QBC tube and have been caused by harshly mixing specimen before drawing into tube or creating bubbles or air pockets by not drawing in a steady stream of sample into the tube

A. Have customer inspect tube for air bubbles or pockets. If present reset a new tube

12. ‘’Grans Unreadable (1-5)’’ NOTE: ‘’Grans unreadable 1 & 2 are most common A. Streaming of red blood cells into granulocyte layer. Numbers 1-6 indicate severity, from a slight blurred red cell/granulocyte interface to no differentiation between the two layers. Most prevalent in practices where patient population is prone to RBC problems such as: paediatrics, oncology/radiology, rheumatology, anaemia’s, sickle cell, thalessaemia

A. Review the QBC density methodology, i.e. How cells layer based on density. How RBC morphology is involved B. For paediatric practices, review finger stick technique paying special note to ‘’milking’’ of finger. This can lead to ‘’grans unreadable’’

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Common Autoread / Autoread Plus Error Messages

Error Message/Symptom Cause Action 13. ‘’Buffy coat unreadable (6)’’ NOTE: 8 scans of each tube are

taken by the AR as the tube is rotated. At least 4 must reproduce. If less then 4 reproduce, this error will appear A. Accutube: lym/mono layer not taking up the stain due to improper mixing of blood specimen with stain in Accutube B. All tube types: Platelet clumps from poor capillary stick blood collection

A. Verify proper dated and stored controls B. Have customer wipe outside of tube to remove finger prints, glove powder etc…. re-run tube C. Accutube: After re-running original tube and customer still gets ‘’Buffy…’’, instruct customer to put tube in upright position for 5 minutes then re-run. If ‘’Buffy….’’ Persists, have customer set specimen up again in new Accutube and review proper mixing procedure making sure blood does not contact closure. If blood does come into contact with closure, the blood will no longer move within the tube. Have the customer open the cap, let a small air pocket into the tube and re-cap. Continue with mixing procedure

14. ‘’Buffy coat unreadable (2)’’ A. May indicate lymph layer did not pick up enough stain B. May indicate no distinction between buffy coat layers due to a large layer obscuring other adjacent smaller cell layers, i.e. leukaemias (^^WBC populations) C. Very small cell layer, i.e. Pancytopenia (low cell counts)

A. Have customer visually inspect tube and review layer identification. Is patient anaemic/leucopenic/ thrombocytopenic? B. If pancytopenia is suspected and this has occurred in capillary mode, suggest a venous withdraw of patient. Venous samples produce larger cell layers easier for the AR to see C. If elevated WBC is suspected and this has occurred in venous mode, suggest a capillary redraw of patient. Capillary samples produce smaller cell layers easier for the AR to see D. Suggest assay by a different method

15. ‘’Buffy coat unreadable (3)’’ A. Platelet cell layer has extended very close to the top or possibly extends beyond the top of the float. The AR must see a space between the platelet layer and the top of the float. High platelet and lym/mono counts may be the cause (the high lym/mono layer pushes the platelet layer up to the top of the float) This error does nit indicate platelet clumps

A. Have customer visually inspect tube and review layer identification B. If occurred in venous mode then obtain capillary sample and re-run. Capillary samples produce smaller cell layers C. Suggest assay by a different method

16. ‘’Buffy coat unreadable (4)’’ A. Cells clump at/on top of float due to platelet clumps from poor sample collection technique and/or QBC tubes prepared with samples that are passed the ‘’90 minutes after collection’’ time period

A. Have customer visually inspect tube and review layer identification B. Review proper blood collection technique and suggest obtaining a new specimen which has been properly collected

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Common Autoread / Autoread Plus Error Messages

Error Message/Symptom Cause Action 17. ‘’Buffy coat unreadable (5)’’ A. Lym/mono band is extremely

small or has not properly taken up the acridine orange stain

A. Verify properly dated and stored reagents B. Obtain a fresh sample and re-run Suggest a different assay method

18. ‘’Programme reset’’ A. Power fluctuation A. Instruct customer to turn AR off then on to clear error

19. ‘’Improper fill venous, capillary or Accutube sample’’

A. Too much or too little blood collected in QBC tube

A. Review tube markings with customer to determine accurate fill. If not instruct customer to re-set a new QBC tube and re-run

20. Black boxes in display window A. Software related: not seated properly, none present etc..

A. Turn AR off, reseat or re-insert software cartridge

21. Print is condensed and writing is overlapped on printout

A. Usually caused by power fluctuations B. Someone has reset the print format to labels

A. See Technical Bulletin TB-011-6/95, ‘’Re-setting the print format’’ NOTE: Make sure the power s turned OFF during this procedure

22. No printout (printer is ‘’on’’ and ‘’online’’)

A. No printout selected A. See Technical Bulletin TB-011-6/95, ‘’Re-setting the print format’’ NOTE: Make sure the power s turned OFF during this procedure B. To determine if the AR has been set to ‘’no printout’’ with results still on the AR display AND the tube still in the AR, press NEXT. If a printout is printed, reset AR to a printout type. If printout is NOT printed, troubleshoot printer etc….

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7. QBC Autoread TM / Autoread TM Plus Scan Data Interpretation

The QBC Autoread TM takes transmittance and fluorescence scans and red/green float scans. From these scans, data is obtained identifying tube markings and sample characteristics

Scan 1: Transmittance and fluorescence scan taken when light passes through the QBC tube, RBC’s, float and Buffy Coat. Cell populations show transmittance differences.

Scan 2: Eight scans of red and green fluorescence are taken to examine the float and buffy coat, identifying the grans, lymph/mono and platelet populations.

Scan 3: A transmittance and Fluorescence scan of the plasma. This is a continuation of scan 1.

Scan Data Interpretation

Line 1 Autoreader SN#xxxxx = Serial number – This is not the instrument serial number but remains consistent in the instrument so that scans can be linked to the instrument PromDate/Time = software date and version Line 2 Sample Type = Sample type identified by fill lines and/or by meniscus location. In early errors the tube type may be identified incorrectly. Full evaluation did not occur Date: and Time: = Date and time sample was run

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Line 3 Results obtained from evaluation of the scan data. Values are only approximations on unreadable tubes. A value of -100 indicates a result out of instrument range (high or low) Line 4 L1 – L6 = Band lengths. L3 is the granulocyte band. This value is invalid if a grans unreadable #1 is obtained. L3 is obtained before the GR value is obtained Fill Vol = Length of volume in the QBC tube. Min-Max: 2608-3092 Standard Capillary, 4000-4215 Standard Venous, 2843-3387 Accutube Fill Corr = Factor applied to band lengths to compensate for an overfilled or under filled tube so that tubes correlate DM = Hb calculation. This value is used in the algorithm but not in scan evaluation GR = Gran Ratio – Average value of eight GR’s taken. Value must be >0.35 for the grans to be readable Line 5 GR1-GR8 = Gran ratio taken in eight scans of the float. Lines at top of float scan are interfaces from only one scan. The GR ratio is obtained by following the line down to the bottom of the scan for the gran and lym/mono interfaces. The areas under the curve on both sides of the grans interface are compared. The left side of the line should be much greater than the right. The ratio becomes closer to one as the gran value increases. Values for each individual scan must be >0.35 to be acceptable Assay error# = Code for each individual error code NumTrys = Number of times the Autoread tried to find the transmittance scan (closure, float etc…) AnlzErr = Same as AssayError# Line 6 BA1 – BA8 = Before and after ratios. Ratio also looks at RBC/gran interface. If the Gran count is >1.5 then the BA must be >1.35 or a BCU#4 will be obtained. If the Gran count <1.5 then the BA must be >1.75 or a BCU#4 would be obtained AvgBA = Average of B1 – B8

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By IntRatio = Looks for lym/mono peak. Ratio should be <0.6. A box is drawn for the entire buffy coat and the lym/mono is compared to the entire area in the box. A low lym/mono peak would be a buffy coat with no definition BCU#3 RPRatio = Red Scan Plasma Ratio. Area above the float should have greater signal than the plasma on the float. If there are platelets or white cells (i.e. CLL) above the float, then the ratio changes BCU# 3. MxPlas = Max fluor reading in plasma scan – Indicates that illuminator lamp is functioning. Value can fluctuate Line 7 Ctype = Closure type: 0 = standard and 1 = EZ prep EZcLen = Length of easy prep cap (250-280) l1start = Bottom of the RBC’s on the transmittance scan rtofall = Rise to fall of the closure. On the EZ prep tube the number should be small because the rise and fall should be about the same place. On the standard tube the rtofall should be larger since light passes through this cap BkLsh = Backlash <15 steps. A/R scans in one direction and then turns around and scans the next direction. The backlash or loss of steps should be small in order for the scans to line up for comparison (>11 or 5= Backlash Error) NumRns = Number of runs: Updated each time the instrument scans a tube Oxff = Uses hexadecimal to determine which of the 8 scans are to be used for results Miv = meniscus indicates Venous: 0 = found by normal method of finding fill lines. 1 = when using how far up the plasma was found to ID the tube CTF = Cells on top of float – This is the number of scans which detect cells on top of the float. If the number is >4, then BCU#4 is obtained L/Mderiv = Lym/mono derivative – also used to determine if there really is a lym/mono peak. The derivative = the measurement between the top and bottom of the lym/mono peak. Should be >115. If less, a BCU#5 would be obtained. Could see this with a small lym/mono population or cloudy filters in the A/R Line 8 Float Length = Typically 1215 +/- 10 steps. If cells are present at the top of float this value may increase L7 position = Interface at top of plasma L7 Deriv = Value determines if this is a good interface Mode = 0 = sample, 1 = control, 2 = cal, 3 = proficiency test, 4 = fibrinogen CntlTube = 0 regular run mode GRSize = Normal is >20, 000 – If less, Grans Unreadable Error #3

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RedOffset = Red offset – Makes sure the amplifier is not giving off signals with the light source turned off. Only the gain would be figured in this value. Usually 10-40. Should be <100 MaxTrans = Maximum transmission on the scan Lines 9 &10 These are five major interfaces found for each of the float scans. The interfaces between the RBC’s and grans, grans and lym/mono, lym/mono and platelets and plasma and then the top of the float are marked with the left side of the scan being zero. Values for all scans should be very close in a readable tube.

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8. QBC Europe Technical Support Procedure Purpose This procedure explains the process of taking a Technical Support call. Scope This applies to all calls received regarding technical service issues. Procedure 1. Receive as much information as possible from the initial conversation with

the customer. 2. Determine the nature of the call to verify if it is a technical support related

call. 3. Record customer information on the Technical Support Log data base.

Include date, name, contact number, instrument type & serial number, tube type. Obtain as much specific information as possible.

4. Listen to the description of the customer problem or question. 5. Gather as much information as possible relevant to the call including,

control lot number, expiry dates, when did problem begin, for how long? Establish their level of knowledge.

6. Can this call be resolved immediately? Yes- end call; add all information to the database. No- Verify the customer call-back phone number, request any useful information needed to troubleshoot the problem (i.e. test/control results, diagnostic scans).

7. Review the information supplied. Look for an obvious sampling error.

QBC STAR™ Troubleshooting Control Problems Ask the following questions:

1. Which QC are they using? 2. Have they being having problems with the entire lot number or just started

having problems? 3. What is the control expiry date? 4. What is the expiry date of the tubes? 5. Which level and result is out of range? 6. How long has the current vial been open? (Open-vial stability is 4 days) 7. Do they lift the whole box out of the fridge or one at a time? 8. Are they looking at the right control results sheet?

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9. Have they tried a new vial? 10. Ask how they mix the control vial? 11. Ask how they mix blood in the STAR™ tube? 12. What is the control fridge temperature (2-8oC)? 13. Do they monitor the fridge temperature? 14. Where in the fridge are the controls kept? 15. Did the controls arrive on scheduled date? 16. Did they arrive cold? 17. Is the control haemolysed? 18. Does one person perform the QC each day? Is the person new? 19. Ask for a diagnostic scan (Mode/Down) 20. Actually talk the customer through a control run.

QBC STAR™ Troubleshooting Patient Sampling Ask the following questions:

1. Did you use the thumb? 2. Was it a difficult collection? 3. Which tube was used? 4. Which end of the tube was sampled? 5. Was the float inserted? 6. Did you have to ‘milk’ or scrape the thumb? 7. How long was taken between collection, centrifugation and analysis? 8. Was the first blood drop wiped away? 9. Did sample touch the end white plug? 10. Was the tube wiped with an alcohol wipe pre-analysis? 11. Has there been a problem with more than one patient? 12. Explain mixing and capping procedure Patient may have to be tested by other method. Explain extensive troubleshooting has been performed, cannot resolve problem, and the instrument needs to be serviced.

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9. Troubleshooting Centrifuge Model 424740

Yellow LED ‘POWER’

Green LED ‘SPEED’

Centrifuge Status

Operator Action

Off Off Power off, no motor motion

Turn on power switch

Flashing Off Ready to spin, lid latched

Press ON button

On Off Power on, no rotor motion, lid not

latched

Load or unload tubes

On Flashing Power on, lid latched, rotor under speed

Rotor is usually accelerating to design speed

On On Power on, lid latched

No action

Flashing Flashing Power on, lid latched, over

speed shutdown

Request service

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10. QBC Autoread™ Plus Installation and Training Documentation

Name of Institution: Address: Primary Contact: Phone: QBC Autoread™ Instrument Model Number: Serial Number: Software Version:

Installation and Training Topics

Name of Installer/Trainer: Name of Trainee: Date of Installation and Training:

The above mentioned trainee has undergone a period of formal training and has demonstrated competence in the following areas:

YES 1. Instrument Overview

a. Power pack _____ b. Power switch _____ c. Display _____ d. Display adjustment _____ e. Function Keys _____ f. Loading platform _____ g. Calrod _____ h. Collection tray _____ i. Software cartridge/port _____ j. External connection ports _____ k. Printing _____ l. Centrifuge _____ -Power supply _____ -ON/OFF button _____ -Lid _____ -LED _____

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2. Instrument Menu a. Function keys & modes _____ b. CBC Mode _____ -Select Patient _____ c. Fibrinogen Mode _____ d. Cal Check Mode _____ e. Control Mode _____ -Set Date & Time _____ -Set Print Format _____ - Haem Diagnostic Reminders (HDR) _____ -Cartridge Type _____ -Set Baud Rate _____ 3. Instrument operation:

a. How the Autoread™ Plus performs a CBC _____ b. Startup- Self test _____ c. Shutdown _____ d. Calibration _____ e. Reprint results _____ f. Update software _____

4. Autoread™ Plus Tube:

a. Overview of QBC tube _____ b. The principle of capillary action _____ c. QBC tube methodology _____ d. Fill lines _____ e. Acridine orange _____ f. EDTA _____ g. Applications of the tube float _____ h. Parameters measured _____

5. Sample Collection

a. Tube expiry dates _____ b. Appropriate lancet size _____ c. Use of the thumb _____ d. Obtaining capillary blood sample _____ e. QBC pipette technique for venous samples _____ f. Correct filling, mixing and capping _____

6. Centrifugation

a. Correct centrifugation _____ b. Lid tightening _____

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c. Leave the lid in between runs _____ d. Balancing _____ e. Centrifuge decontamination procedure _____

7. Sample Processing

a. Analyser limits of linearity _____ b. Starting an assay _____ c. Samples can be rerun _____ d. Discard sample tubes- biohazard container _____ e. Diagnostic scans _____ f. Identify system errors _____ g. Troubleshooting _____ h. External printing _____ i. Reprinting results _____

8. QBC Control Processing a. Correct control storage (2-8oC) _____ b. Use 1 vial at a time _____ c. Expiry date _____ d. Open-vial stability time _____ e. Correct control preparation technique _____ f. QC recommendations _____ g. Importance of keeping control records _____ h. Run a control _____ i. View results and follow correct procedure in the _____ event of a QC failure

9. The trainee has undergone a satisfactory period of _____ supervised observation The trainee named above is deemed to be fully competent in the procedures described and able to complete QBC Autoread™Plus CBC tests Signed Trainer: Name in Full Signed Trainee: Name in Full Date:

This completed and signed documentation serves as a certificate of QBC STAR™ installation and training