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Roche AVL Compact 3 Bloodgas Analyzer

1. 2 6 Operator e ceseassacesdeesSesedsuccsassaeessdescedasesdoecteleseeceosoestess 2 12 3 INSTALLATION SHUTDOWN E 3 1 Shutdo even ee TUS 3 11 4 PATIENT TESTING Sample eise idee ees eee Eoo ae Pee nee eet o ae S eee FEN e aa Aog oe ee e n ANS YA See VANUS AUN ERE e e 6 EE a eo 4 1 Sample Measurement 2 M M 4 2 PASS ODER B M 4 10 Parameter and Data eese eese eese eene ntn that eset sense 4 12 gati nlii dde IE 4 19 5 QUALITY CONTROL RR 5 1 Edit urit 5 3 5 7 II Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents 6 CALIBRATION Automatic CalibrationS ss sssscessesesoessessesocssesssscesossosocssescesssssesoscesoss Conditioning dee t re EINST EEO SEED NEEESE Operator Initiated 7 DATA MANAGER 8 SYSTEM FUNCTIONS Manual Standby coseciscasccaddecescescccccsdeecavscdececccct
2. 10 2 Error Messages and Instructions for Elimination 10 3 Printed Warnings and Error Messages sccssscccssscessccccesccesescecescceeesseesscesescessesesesccesesseseeseees 10 8 Insufficient Wash and Diy y Cle noe een ee oo ea v ean oe C Pn vo ous ERE e e ansa to e ERR U RERO ERRASSE ER APER ess 10 8 Clogged Sample Path eerte ees nena aUe o ag anne na Denn Rn eee au sdedecsessaceses crass se 10 9 ncn PEE 10 9 Activating a Vacuum Cleaning Cycle e eme ee ee hee rennen he nre ne ne 10 10 Glass IDEM EE 10 11 Test Programs ine iere nee ere tide eroe odit Loir To a REL eese OP NEAN Roa Pose caa Edo DE TEN 10 13 Electrodes EE 10 14 RR NE dai ERR EUER 10 15 Valy6es iocis ee oto Pere ba e EE ak VOR C v EX Dp EVER TRY T Exe ER Opus epe 10 16 Display EE 10 17 Printer ien eek 10 17 Program Version ez dssdo tse TS es RU EE EE fee UO ua ea net 10 18 Autom Selftest ene RETE REP gene votes ERE RP EK CERE RR E PR E Ter PIRE PR mam RERO gen 10 18 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 1 10 Troubleshooting 10 Troubleshooting Your AVL COMPACT 3 is equipped with a variety of sensors
3. n 2 13 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 2 Description of the Analyzer 2 Description of the Analyzer Main Features The AVL COMPACT 3 is a fully automatic microprocessor controlled analyzer for quantitative in vitro measurement of whole blood of the following analytes pH hydrogen ion activity PCO partial pressure of carbon dioxide PO partial pressure of oxygen BP actual barometric pressure Based on measured parameters in conjunction with patient temperature ctHb and the following parameters can be calculated BE base excess BE gece base excess of extra cellular fluid BE act base excess at actual oxygen saturation BB buffer base HCO actual bicarbonate cHCO3 standard bicarbonate at a PCO 40 mmHg ctCO2 PCO of 40 mmHg pHs standard pH value at a PCO of 40 mmHg AaDO arterial alveolar oxygen partial pressure difference cH hydrogen ion concentration SO oxygen saturation ctO2 oxygen content Shunt measurement for the direct mixture venous blood in the oxygenated circulatory system Measurements The AVL COMPACT 3 analyzer is equipped with a sample detection system which identifies air bubbles in a sample controls the positioning of a sample in the instrument and determines the volume of a sample With a blood sample volume of at least 55 ul in place an automatic Blood Gas measurement is performed
4. 9 9 Measuring Chamber Valye iie E b Si EPA saben len teens 9 9 Yearly Maintenances cesecsenscescecingsaveSecsdedsavedssesessbentsaveeeSsnsccndcoascasess 9 10 Waste MM 9 10 Peristaltie Punip ee tiit eite rre teste des vex abo tr uev Ore SE ERE ENS SESS 9 10 9 10 Fill POE LR MEER ERG Rn OM 9 10 Pr yentive Maintenance eoe ue c HR ERRARE REVOIR ER cio og gas EE SERRA E E Vane EVER E ERE tease EE PERROS RE 9 11 Fall 9 11 Pump Spoolssescss5 ds rm 9 11 Car and Maintenance of Blectrodes eere ete puede ate pe vede ee 9 11 pH Blood Gas Electrodes eet evite ede bs eR ERU RU ERU bb ER Re ee duce ces Ed ERE DE ERR Ha 9 12 Zero Maintenance pH Blood Gas Electrodes sssessesese eem He eene 9 12 pH Reference Electrode rrt Gc eb Em De EO ee Ere CE PSU Eu e DERE ERR e OR 9 12 Remembranable pH Blood Gas 1 eme em erre 9 16 Cleaning eiecti ettet tenete ret e U Fee poe gavel ve in eee oet EE emer eb e idee 9 17 Measurins Capillary ceo e io e ete oerte eee ceto 9 17 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 1 9 Maintenance Introduction Decontamination Reagents AVL Deproteinizer 9 Maintenance This chapter describes regular m
5. ahh 8 24 Commenta oer eeu are Oe ee rv OP ede e ee aes peas A YN a 8 25 AVE Multitude isis i er a ERR HR EROR EE Rr RERO M ER ERROR ERA REEL Doar 8 26 2 Measurement dest m nda stadewe seed oes eerie Heese eine e SUR ed CU od 8 26 Display oseese 8 27 Mini Sample inrer esto e eua eain pede lonas ped deor a erra o oo Picea esise etninei ip Der euo 8 28 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 1 8 System Functions 8 System Functions Settings YES YES Man standby ON OFF UP DOWN UP DOWN Aut standby YES ON YES UP DOWN Time Date Cal interval pH Timings YES p Interv main calib Extend wash time Extend dry time UP DOWN 2 YES Parameter 9 Sample number A UP DOWN PN fn Units YES A UP DOWN Vs Default values UP DOWN Start time o k End time o k Saturday ready Sunday ready SI conventional tHb SI conv Temp tHb Pat temperature P50 adult PSO fetal Physiol range v YES english UP DOWN COMI o k YES Interface CONO COM3 ON OFF UP DOWN Operator s Manual AVL COMPACT 3 Rev 2 0 June 1
6. 3 3 3 5 Gas COMME CH ON ER 3 5 Fig 3 6 Position of calibration gas cylinder scccccscccscscccssscssscccescecsssseesceesesceesccsesesseessceeons 3 5 Fig 3 7 Removal of transport housing cesses esses esee nnne tesa nnne senses enne nsns esent nnne 3 6 VI Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents Fig Fig Fig Fig Fig Fig Fig 3 8 pH Reference Electrode yellow marking 3 6 3 9 pH Reference Electrode droplet ec eee ecce eese eese eese eene eene nennen nete ette tete eo 3 9 3 10 Paper insertiOn iieri eene eter eee oe vh eo Ye eR AS Eve ye Y EYE NV SEV EN SEE C EE SERV EVEN AE SEA PRESENT ER T 3 10 3 11 Transport housing hene senses tesa sess 3 13 3 12 Solenoid valve relief clamps fill module eee eee eese eese ee eene eene tenente etna tonne 3 13 3 13 Solenoid valve relief clamps peristaltic 3 14 3 14 Solenoid valve relief clamps bottle 3 14 CHAPTER 4 Fig EE WAP 4 1 Fig 4 2 Syringe measu r ment 261 eiiis eoru a Do eo do Deals da Les opea e Ded dese teasers s
7. 11 14 Fig 11 8 Interface 912 o1 rien e Iro doped etos o do Leo de e aio eo sored Oeo o PURA a Es T aa opea e OPER Deuda 11 20 Fis 11 9 Tel link 3 2 itor erste eere tta ives es aoro ae Heu ope 11 23 VIII Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents CHAPTER 12 Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig Fig 12 1 Remembranable pH Blood Gas 12 28 12 2 pH Electrode iori ire ree ee op esa VE Vi ep VERD AVES ad Va eee br ES SSSK see ep ve 12 29 12 3 Pull out the pH Electrode esee eene enne enne nannte sas nannte sse nennen nenne 12 29 12 4 Remove pH Electrode housing etes ne tanen nenne 12 30 12 5 Inner electrode O RiNng ssssesesseesssseosesseosessossesssssooseseossessoseosesscoseseosseseoseosesseosessooe 12 30 12 6 pH Electrode fix new housing 1 e eee eee eee eene eene eee eren enne e nee nne e eene 12 30 12 7 pH Electrode fix new housing 2 eeeeeeeeee esee esses 12 31 12 8 pH Electrode immerse into Buffer 1
8. approx 25 C Ambient air 740 mmHg Relative humidity Calibration cycles Settings of conversion factors Slope 1 000 Intercept 0 000 Measuring temperature 3T Whole blood tonometered at 377 n EE approx 50 96 default settings Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Verification of Performance Data Accuracy and Repeatability pH Parameter number of samples standard deviation within a set of measurements SD Instr standard deviation between instruments total standard deviation mean value of a set of measurements recovery in 96 The results of the measured data are compiled in the table below Specimen aqueous and serum based QC material AVL CONFITEST X SD TotSD n Level 1 7 207 0 002 0 004 40 Level 2 7 410 0 002 0 005 40 Level 3 7 630 0 002 0 005 40 Level 4 7 406 0 002 0 007 40 RNA Medical EQUIL x SD TotSD n Level 1 7 178 0 002 0 009 40 Level 2 7 422 0 002 0 005 40 Level 3 7 732 0 002 0 005 40 RNA Medical QUALIDATA Expected X SD SD Instr R n Level 1 6 841 6 841 0 002 0 003 100 0 60 Level 2 7 099 7 100 0 002 0 003 100 0 60 Level 3 7 382 7 383 0 002 0 003 100 0 60 Level 4 7 598 7 600 0 002 0 003 100 0 60 12 51 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Append
9. 3 4 Calibration Gras Connection seo tot ere te adobe es 3 5 Electrodes ices EH 3 6 pH Reference Electrode White esses eene hee eee hene re nhe rene rhe E 3 6 Inserting Printer Paper ss ione et ep Pete d RR Tee ED IRR REOR RE PERRA 3 10 sca E ssas oncdedecessica sea buccdeasoascasaianesetees saccedeceascasis secddeusoascasesseccedesesseasussnssdess 3 11 Longer than 3 Days noe EGO IRA E dex RO EE aed pe ee eee 3 11 Rinse and Dry th Tubes t ei tee E IRR ER UR ER EE SER REED E DR 3 11 El ctrode Cate ciii oerte bod tt sus jas Leite sheet Gades DER 3 12 Releasing the Peristaltic Pump Tube Im em e Hee mH mee enne mre renes 3 13 Releasing the TUDES EE ec te I e d e e E e e eee 3 13 Storage Transportation Ho et xr P Re dE eines ICE ER S ER seed 3 14 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 1 3 Installation Shutdown 3 Installation Shutdown This chapter describes the installation and shutdown procedures Installation After the AVL COMPACT 3 has been unpacked and placed in a location according to the requirements described in chapter 1 the following steps should be performed Check whether analyzer and accessories are complete and undamaged Check contents against the supplied packing list If parts are missing in
10. eaa 5 7 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 1 5 Quality Control 5 Quality Control QC Measurement Perform at least daily one quality control measurement with recommended AVL control material to check performance and measurement accuracy of the analyzer Take an ampoule of the selected level out of the package and shake it Tap the ampoule with your fingernail to remove any fluid from the ampoule neck Break the ampoule open and fill the sample into a capillary NOTE Use caution gloves or tissue to prevent injury while opening an ampoule Do not use the same ampoule or capillary twice Use only control material within one minute after opening the ampoule To perform a measurement the analyzer must be in the READY mode Aspirate sample with adapter or capillary READY mu un mu un open the flar User programs For measurement Press USER PROGRAMS QC measurement Press to start the QC measurement GC MERSUREMENT For measurement oren the flar Open the flap Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 1 5 Quality Control 5 2 Press and insert the tip of the ampoule adapter or capillary filled with the corresponding level of the desired QC material securely into the fill port The sample will be aspirated into the measuring chamber As soon as the requisite sample volume is aspirated an acoustic signal will sound
11. Electrode PO Electrode The PO Electrode consists of Electrode body the electrode body is a glass electrode containing the cathode 4 platinum wires and a silver anode Electrode housing the tip of the housing is covered by an O permeable membrane Membrane the two foil membrane is sealed with silicon grease Electrolyte enables the chemical reaction and the transport of charges electrode housing membrane electrode body Fig 12 38 Electrode Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 47 12 Appendix Analytical Performance Introduction Definitions Standard Accuracy Inaccuracy Recovery Imprecision 12 48 AVL verifies and checks continuously the specifications of the devices and measuring parameters by doing measurement series according to international directions e g International Federation of Clinic Chemistry IFCC to guarantee the performance characteristics The following measuring data are an abstract of the results of the 510 k test series all performed with AVL COMPACT devices A substance to determine the concentration of the sample All AVL calibration standard solutions and QC materials are prepared with known highly purified chemicals regarding e g NIST directions National Institute of Standards and Technology Accuracy is the agreement between the mean estimate of a measurement series of a certain quantity and its true value
12. OH OFF is blinking Switch between and OFF by pressing Nv or AA Activate the blinking selection by pressing YES If OH is activated the following display appears USER PROGRAMS COM 1 Mode Confirm by pressing YES By pressing or A the following connections can be selected 1 PC Host Printer 2 Ticket printer 3 Barcode Confirm the selection by pressing YES By pressing or AL select the following display USER PROGRAMS COM 1 Baucdrate 7 Confirm by pressing ES Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions Barcode Scanner Baucdrate ok Activate the corresponding baud rate by pressing or select by pressing another baud rate Available are 1200 2400 4800 7200 and 9600 baud Confirm the selection by pressing ES the display will fade out By pressing select the next display LISER PROGRAMS COM 1 Handshake 7 Confirm by pressing ES USER PROGRAMS HOWE Handshake ok 7 By pressing or A you can select between 1 None 2 XON XOFF Confirm the selection by pressing YES Connect and affix the barcode scanner to COM 1 The barcode scanner is programmed with a Header STX and a Trailer ETX The reading units are pre programmed for the code types e 2aus5 Interleaved e Codabar e Code 128 e Code 39 Note If you use the original AVL I
13. USER FROGRAMNS Please wait Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 21 4 Patient Testing System Status 4 22 The error report will be printed and then the following display appears USER PROGRAMS Printout Erase error report Press if you want to delete the stored alarms otherwise exit this program by pressing Esc This printout shows information about the general status of the analyzer e information about the last calibration data e indicates the next pH 1P calibration and the next main calibration e limits e electrode voltages Activate User Programs 3x Nw Printout 4 1 TL tabus YES Th mn For details please refer to chapter 12 section Description of Various Reports Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 Quality Control 5 QUALITY CONTROL OC Measurement ose Vet ovscucetusecenetecscveces 5 1 QC Edit Fu nctlOn z iioi ed ease eve vu geo ee resa esee secu c esee odas erue 5 3 Entering New Lot Number eet er eet suet yarteck weteusebs pee eee py Ped ge eoe 5 3 Entering Expiration Date 2 eet 5 4 Entering Target Ranges p e ee a cR et o ee e RR Es 5 4 QC Statistics oru eoo eee eee eae eoe aUa no eva Peng oveuetied oobsenebecsasteeseseueUes bee vovet eeeUrt cao
14. transmit data Pim 3 R amp D 5s receive data Pin 7 GND signal Ground 7200 baud 7 Data bits 2 stop bits even Parity Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface Software Report Control Hex Description ACK 06 AF acknowledge ETX 03 AC end of text CR 0D AM carriage return LF 0A J line feed BEL 07 G bell When the Datalink to the AVL COMPACT 3 is activated and the AVL 912 has completed measurement it sends a DC2 Hex 12 and a ETX Hex 03 to signal the AVL COMPACT 3 that a datalink report is ready to be transmitted The AVL COMPACT 3 answers with a BEL Hex 07 to receive the datalink report If the AVL 912 does not receive the BEL from the AVL COMPACT 3 an entire datalink report will be transmitted Installation Connect the AVL COMPACT 3 and the AVL 912 with the connecting cable to the provided interfaces Turn the analyzers on and wait for the mode Activating the Datalinks on the AVL COMPACT 3 Settings YE 5x en User Programs YES Interface YES USER PROGRAMS Interface 1 7 By pressing you may select 2 or COM 3 The following display appears if you have selected COM 2 USER FROGRAMNS Interface COM 2 7 Press to confirm Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 21 11 Interface USER FROGRAMNS OH OFF EU m 7 Select OH and co
15. to get Internal Gas 1 The electrodes are continuously attached with Gas 1 5 5 20 balanced N3 Internal Gas 2 The electrodes are continuously attached with Gas 2 10 CO balanced Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting External gas Gases to be used gas mixtures e g calibration gases gas to determine the zero point of PO Note Do not use pure and CO gas This could damage your electrodes Measuring range 2500 mV to 2500 mV Buffer 1 Measuring range 970 2100 mV Buffer Type 1 measured like a sample Buffer 2 Measuring range 1570 1410 mV Buffer Type 2 measured like a sample Sample external To measure an external sample with specified pH PCO and values Gas 1 toggle This function simulates the conditioning during the READ state Wash Like Wash in the user program Maintenance Pumps With this test program the user can check the functionality of the pumps PROGRAMS ds t em Lest Pures 7 Confirm by pressing By pressing or AL you can now select Peristaltic pump speed 1 Peristaltic pump speed 2 Vacuum pump KCl pump Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 15 10 Troubleshooting Valves 10 16 Confirm the selected pump with YES USER PROGRAMS Fumes P Pumr speed i 7 By pressing it is now
16. Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 Quality Control QC Statistics This function allows the printout of the QC measurement statistical results USER PROGRAMS Ol statistics Press YES LISER PROGRAMS GO Statistics GC Leusl 4 At this point you may select Level 1 Level 2 Level 3 or All Levels by pressing or A and confirm the selected level by pressing YES USER PROGRAMS The QC Statistics Report of the selected level or all levels for all parameters pH PCO and is now printed If the function Multirule for details please refer to chapter 8 section AVL Multirule is activated corresponding information will be printed on the QC statistics report For details about QC Statistics Report printout please refer to chapter 12 Exit this program by pressing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 7 5 Quality Control 5 8 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 6 Calibration 6 CALIBRATION Autoinatic C alibrations et eeu vanus aE EEE S E VEET EEEE oeecedes ETETE NEEE EEES 6 1 Main Calibrations S E RO up de E 6 1 pH UP Calibration Center ette Ee Dr eite heec pe EEE Pm EIER er PETERSE En TRS 6 1 Gas TP caliDratiOD d eere etre eene ee See e eder pres ede T Osee eT E CO 6 1 6 2 Opera
17. eene eene nennt s nete n estne nnn 12 31 12 9 pH Electrode cleaning procedure 1 eeeeeeeeeee esee ee eene eee nennen enhn 12 32 12 10 pH Electrode cleaning procedure 2 12 32 12 11 pH Electrode cleaning procedure 3 sscscscssscssscccsesceessccceesceeesscesccseesseessseeons 12 33 12 12 pH Electrode immerse into Buffer 1 12 33 12 13 PCO Electrode cele ie eve eee ees Sede se nee neus dea aae aca Fees vasco sous tavi o eese edere Ca RE 12 34 12 14 PCO Electrode remove Inner 1 12 35 12 15 PCO Electrode Inner element ecce eese esee esee eee eet eset ense sese etes ee sese etes eo sese ee 12 35 12 16 PCO Electrode cleaning 12 35 12 17 PCO Electrode inner shaft cccsccscsccecsccscsccccsccscncnscscsscsccscscsscscsscscsccscscesssceees 12 36 12 18 PCO Electrode cleaning procedure 1 12 36 12 19 PCO Electrode cleaning procedure 2 ccsssscssssccsescecssscesscccsesceeesscesescessssesenee 12 37 12 20 PCO Electrode cleaning procedure 3 sccssscssssccsssceesesccsscceeesceescccsesceseesesenes 12 37 12 21 PO LElectr de ce erre beer e too ee re eol eee eve ee sacestedseasedvbescssededaeseasbevseesoet aavesveuseasesedees 12
18. enean iseis oessa sess sese 13 4 Fig 13 3 Main arteries in the body eese esee 13 5 Fig 13 4 Use of AVL Microsampler ieee iS 13 6 Fig 13 5 Puncture of the heel newborn 13 7 Fig 13 6 Capillary puncture at the eee eee eee eene nn sense nnns nnne 13 7 X Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Method Sheet IUDA 1 Clinical Significance PTT sess 1 jupe TREE 1 corp 1 0r 2 Principles of Procedure isi eee eee ve eres E EE TE VPE NE VERS REUS SUSPEN EE ETE Y 2 Reagents and Accessories irs ie eee eere nre en ee n ae va unn eee neg aee 5 Specimen Collection and Handling c eeee eese eee esee esset eese tesa n oseese 9 Safety MMC IEEE 9 Sample Requirements i iret pede ge ein i ee ed RENE RAE Ore Paid dares 9 ANTICOAGULANTS ARN IL TEE 9 sample Collection Devices RO RD Ye UP t IS 9 Handling and Storage of Samples 11 Pes 11 11 NIU NEL TD te
19. Controlling the Datalink Signal Level Software Report Transfer of Report Data The AVL 988 3 sends Control G Hex 07 The AVL COMPACT 3 responds with Control F Hex 06 logical 1 2 12 3 V logicalO 3 12 max cable length 3m When the Datalink to the AVL COMPACT 3 is activated and the AVL 988 3 has completed measurement it sends a BEL Hex 07 to signal the AVL COMPACT 3 that a datalink report is ready to be transmitted The AVL COMPACT 3 answers with a ACK Hex 06 to receive the datalink report If the AVL COMPACT 3 does not answer the BEL the AVL 988 3 sends a further signal every 10 seconds If this does not occur until the start of a new measurement Data not transmitted will be shown If the AVL 988 3 receives an ACK from the AVL COMPACT 3 an entire datalink report will be transmitted The single lines of the protocol whose sequence corresponds to the printed protocol are separated by CR Hex 07 and LF Hex 0A The first transmitted sign is Control G the last transmitted sign is EOT Hex 04 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 9 11 Interface Installation of the Units Connect the AVL COMPACT 3 and the AVL 988 3 with the connecting cable to the provided interfaces Turn the analyzers on and wait for the REAL mode Activating the datalink on the AVL COMPACT 3 User programs YE 5x S7 Settings YE 5 Interface YES U
20. Inaccuracy is the numerical difference X between the mean of a set of replicate measurements MV and the true value TV This difference may be expressed in the units in which the quantity is measured or as a percentages of the true value Influences on the accuracy are calibration cycle calibration solutions all not known systematic errors A simple verification of the accuracy can be done by determining the recovery Recovery experiments include the measurement of two samples which are identical except that a known amount of pure chemicals are added to the sample The following should be taken into account e the added chemicals must be completely dissolved e the pure substance can have another matrix as having in their natural environment which can lead to interferences The imprecision is defined as the standard deviation SD of the results in a set of replicate measurements Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Repeatability within Run Repeatability between Day or Day to Day Repeatability between Laboratories or between Instrument Comparison Requirements and Limitations Replicate measurements of identical sample during a short time period e g minutes or hours done by one person using one device Replicate measurements of identical samples during a longer time period e g days done by one person using one device Replicate measurement
21. Decontaminate fill port with a cloth or gauze pad saturated in disinfectant Procedure 1 Activate User Programs Bx Nw Open flap Decontaminate fill port 2 3 4 Close flap 5 Press the key twice upon completion of this maintenance procedure The system performs a washing drying procedure and will return to the READY screen Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 Introduction Flap Decontaminate the inside and outside of the flap with a cloth or gauze pad saturated in disinfectant Procedure 1 Activate User FroSrams 7 Bx Nw Sustem best 7 YES Electrodes 7 YES 2 Open 3 Decontaminate the inside and outside of the flap and wait until disinfectant has dried 4 Close flap only after disinfectant has dried completely to avoid damaging the lacquer when reopening the flap 5 Press the key twice upon completion of this maintenance procedure The system performs a washing drying procedure and will return to the READY screen Keyboard Decontaminate the keyboard with a cloth or gauze pad saturated in disinfectant NOTE Decontaminate with damp cloth only using a disinfectant Do not use sprays Surfaces Decontaminate all outside surfaces and cover with a cloth or gauze pad saturated in disinfectant Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 7 1 Introduction Sample path Measuring chamber Cleaning with AVL Deproteinizer should be performed only
22. Immerse the electrode tip in Buffer Type 1 for at least one hour optimal 12 hours Fig 12 12 pH Electrode immerse into Buffer 1 Attach a new pH Electrode housing and reinstall the electrode in the measuring chamber block Reconnect the electrode connector and the electrode clip Close the cover Initiate a pH 2P calibration Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 33 12 Appendix PCO Electrode Cleaning before Replacing the Housing 12 34 The PCO Electrode consists of the inner electrode the housing with the membrane and the electrolyte solution and is marked with a green grip The membrane housing should be replaced periodically Membrane replacement can be easily performed by the operator Reference Electrode Black O ring x o Q 1 m 2 Shaft Cable Holder 9 lt lt Fig 12 13 Electrode NOTE Do not use abrasive cleaning solutions which may damage the inner element Make sure that the electrolyte solution is free of air bubbles The inner element and the entire electrode must never dry out The inner element or the entire electrode must be stored in PCO Filling Solution with the Ag AgCl electrode ring completely immersed NOTE Never allow the tip of the glass electrode to touch hard surfaces e g glass Place a sof
23. Procedure e Push end of tension lever to the right and slightly against the pump plate until it locks with a click Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 3 3 Installation Shutdown Filling and Connecting the Bottles Waste Bottle Rinse pH Reference Solution Buffer Type 1 Buffer Type 2 Cleaning Solution 3 4 Located under the measuring chamber and the fill module the reagent compartment houses the fluid containers The screw on caps with tubing for the containers are connected to the liquid circulation system which projects from the rear wall of the reagent compartment NOTE Ensure to place the caps to the corresponding reagent bottles and pay attention that no tube is folded Before screwing the cap on the Waste bottle ensure that the ring seal is properly in place If the seal is in place screw the cap onto the empty Waste container and insert the bottle into its socket in the bottle compartment NOTE Ensure that the Waste bottle is completely airtight to allow a trouble free operation The necks of the bottles are sealed with aluminum foil Remove the foil by cutting along the edge of the bottleneck NOTE When removing the foil make sure that the fluids are not contaminated NOTE If you do not use the Rinse reagent fill the bottle with distilled water and add one ampoule of Rinse Additive Screw the caps on the bottles and place them in their sockets in the bottle compa
24. Sample CAPILLARY ven andard Measurement Report ee page 12 4 nput values The first number 46 is the sample number of the arterial sample the second number 47 is the sample number of the venous sample The second number is deleted when the Shunt volume is only determined with one measurement Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 17 12 Appendix Requirements 12 18 The Shunt volume can only be calculated at a patient temperature not 37 C By deviating from the temperature will be indicated on the report Principally there are four possibilities to calculate the Shunt volume 1 sample type must be arterial or capillary 2 sample type must be arterial or capillary and venous but the sequence is not important 3 such as 1 but in datalink to CO Oximeter 4 such as 2 but in datalink to CO Oximeter Shunt calculation with one measurement with or without oximeter e The measurement values pH PCO and PO are valid e The sample type must be arterial or capillary NOTE It may not be venous Shunt calculation with two measurements with or without oximeter e The measurement values pH PCO and PO are valid e The sample type must be arterial or capillary the previous measurement must be venous or vice versa e The patient data Pat number age sex and the patient parameters Pat temperature tHb a f RQ of the two measurements must confo
25. With a blood sample volume of gt 25 to 55 ul Microsampler a semi automatic measurement of pH PCO and PO will be performed Calibration The following calibrations are initiated and performed automatically Main calibration pH IP calibration The following calibrations are operator initiated calibrations and will be performed automatically 2P calibration Gas 2P calibrations For details please refer to chapter 6 Calibrations Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 1 2 Description of the Analyzer Analyzer Components Display and Keys Thermal Printer 2 2 Display SAVES mae numeric keypad Fig 2 1 Display Measured results calculated parameters and diagnostic informations appear on a four line alphanumeric LCD display The keys and the numeric keypad in conjunction with the display provide control of all analyzer functions measurements data input programming maintenance system test Fig 2 2 Thermal printer The analyzer is equipped with a 24 column thermal printer using special 58 mm wide paper with one heat sensitive surface The following data can be printed out measured values calculated values calibration data electrode voltage system messages Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 Description of the Analyzer Cover It is essential to ensure the cover of the analyzer is closed during meas
26. euer e eie de vetu ede ka reped ete eO oues E ess ete e Ey agre ap Ege dele ees 8 7 Extending the Wash Cycle eee eie ee oe IS EORR Ue 8 7 Extending the Drying Cycle ee ER Deer do PR vet Pe ER Se E 8 8 Parameter 8 9 Sample Number sche RI em 8 9 Units EE 8 10 Default Values R 8 11 Physiological Rang s Erde dete noe eret poe qi ee eie Ree PE 8 12 DAN PUPPI 8 13 LACE p RETE 8 14 COM eter tan Soap Gag tees Data efe e ace be or eoa a PO tese efe o ote Tct pet opta 8 14 Barcode Scanners e ecol ace tuvo Deo onore vues CR HER DIS BE Oe TUS 8 15 COM 2 COM 3 irn RE eter oe EE ERES DERI EO ceto venga Zone eoe ec Pega Ee e Does bo o siete Peso dob 8 16 PASSWOLG P 8 19 Device LOCK ics eese eere e e eva pE e 8 21 quee 8 22 Main Calibration Report Re EE Dee EE E ue tee 8 22 pH PER E RERO DAER ERRER POR HEBR C 8 23 MV Report PE P 8 23 Report Editor
27. measured value standardized to normal condition 740 mmHg information when the next calibration will occur Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Calibration Alarms Printed out on the Calibration Report VALUES pH Buffer 1 pH Buffer 2 pH slope PCO Gas1 PCO Gas 2 PCO slope PO Gas 1 PO Gas 2 PO slope PRINTOUT PCO2 Gas 1 PCO2 Gas 2 PCO2 slp PO2 Gas 1 PO2 Gas 2 PO2 slp Other Printed Alarm 12 Appendix ALARMS RANGE REPRO DRIFT NO GAS 970 2100 1570 1410 430 Printout RANGE REPRO DRIFT NO GAS NO BUFFER POWER FAIL Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Description the electrode voltage is out of range less reproducibility between two measurements e g 2 x Buffer Type 1 aspirated less reproducibility between two calibrations shows a drift typical for low CO e g system leak gas cylinders empty No buffer solution available Indicates that there was no power for more than just a few seconds e g switch off If the power fail lasted less than 20 minutes the analyzer is still READY after switching on the analyzer If the power fail lasted longer than 20 minutes a main calibration is required after switching on the analyzer 12 7 12 Appendix System Status Report 12 8 AVL COMPACT 3 BLOOD GAS SYSTEM STATUS REPORT COBA3 XX XXX Calibration report page 12 6 pH Bl REPRO DRIF pH B2 REPRO
28. 0 53 21 1 1 50 20 7 0 60 20 6 1 05 20 8 1 00 44 7 44 4 1 00 44 44 1 12 43 3 0 64 43 3 1 68 43 8 0 93 76 0 67 6 1 55 68 6 0 55 68 8 0 58 69 7 0 57 68 7 0 92 96 2 95 7 10 70 96 7 0 96 97 5 0 88 97 1 1 10 96 7 0 92 135 6 137 3 3 25 136 3 1 24 137 4 1 38 137 8 1 14 137 2 1 95 300 7 290 8 3 60 295 1 1 87 294 12 8 18 293 7 3 06 293 4 4 81 344 0 336 9 6 65 342 1 4 07 3436 3 48 343 6 9 93 341 5 6 55 501 2 492 1 11 11 489 1 7 19 4867 8 39 494 3 9 30 490 5 9 11 659 5 640 1 12 61 1647 7 11 80 644 6 12 22 641 6 20 55 643 5 14 75 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 25 Method Sheet Bibliography 1 10 26 Teitz Norbert W Ed Clinical Guide to Laboratory Tests 2nd Ed Philadelphia W B Saunders Co 1990 Shapiro BA Harrison RA Cane RD Kozlowski Templin R Clinical Application of Blood Gases 4th ed Chicago Year Book Medical Publishers Inc 1991 Mahoney JJ Wong RJ Van Kessel AL Reduced Bovine Hemoglobin Solution Evaluated for Use as a Blood Gas Quality Control Material Clin Chem 1991 39 5 874 879 Mahoney JJ et al Changes in Oxygen Measurements when Whole Blood is Stored in Iced Plastic or Glass Syringes Clin Chem 1991 37 7 1244 1248 National Committee for Clinical Laboratory Standards Blood Gas Pre Analytical Considerations Specimen Collection Calibration and Controls Approved Guideline NCCLS Doc
29. 16 1 37 0 TA Oies 44 0 Patient temperature Temp F 98 6 351 2 s 111 2 Half saturation pressure P50 adult mmHg 26 7 15 05 40 0 kPa 3 56 2 00 5 33 P50 fetal mmHg 21 5 10 0 40 0 kPa 2 86 1 393 9 5 33 Fraction of inspired oxygen FIO 0 21 0 11 0 99 Respiratory quotient RQ 0 84 0771 ue 1 99 Adult fetal HB adult adult fetal Activate i Settings Sx NV Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 11 8 System Functions Physiological Ranges 8 12 Select the desired parameter by pressing v or A and confirm the selected parameter by pressing YES Proceed in the same way as described in chapter 4 section Parameter Input during and after Measurement Exit this program by pressing This function allows you to set the upper and lower limits for PO PCO and pH Specified Parameter Input Range PO 0 200 pH 6 80 7 80 PCO 20 80 Activate Settings YES 3x N Parameters YES 3x NV Phasa range YES USER FROGRAMS OH OFF Pigs range Ok 7 OH is blinking Select either OH or OFF by pressing v or A Activate the blinking symbol by pressing YES USER PROGRAMS Phasiol range POZ If OH is activated you can select PCO or pH by pressing Nv A and confirm the selected parameter by pressing YES Operator s Manual
30. 200 mmHg 0 8 4 0 mmHg pH 6 000 8 000 lt 0 005 Input Value Range conv Default Patient temperature 14 44 C 37 Total Hemoglobin tHb ls 26 g dL 15 g dL 0 7 16 1 mmol l 9 3 mmol l 260 g l 150 g l Hemoglobin type adult fetal adult P50 adult io 40 mmHg 26 7 mmHg P50 fetal 10 40 mmHg 21 5 mmHg Fraction of Inspired Oxygen FIO 0 11 0 99 0 21 Respiratory Quotient RQ 0 71 1 99 0 84 Patient number 10 digits max Patient age 99 Patient sex male female SI units are also available Calculated Values Range Actual bicarbonate HCO HCO3 100 mmol l Total CO Base excess in vitro Base excess in vitro at actual oxygen saturation ctCO TCO2 BE BEact Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Tou 100 mmol l 40 40 mmol l 40 40 mmol l 12 1 12 Appendix Calculated Values Base excess in vivo Buffer base Standard pH Standard bicarbonate Oxygen saturation Oxygen content Alveolar arterial oxygen partial pressure difference Hydrogen ion concentration Alveolar arterial oxygen partial pressure difference Standardized ionized Calcium at Datalink with AVL 988 3 PO at patient temperature PCO at patient temperature pH at patient temperature relative Shunt volume Data Management niCa pH 7 4 Range BEecf 40 40 mmol l BB Ig 100 mmol l st pH RE 8 0 HCO st HCO3 ETAT 1
31. Code 2 5 Interleaved 0123456789 un 0123456789 ABCDEFGHIJ 1229 Code 128 Fig 11 5 Types of barcode Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 7 11 Interface Datalink AVL COMPACT 3 to AVL 988 3 Description of the Interface AVL 988 3 Baud Rate Transmission Format The Datalink allows the AVL 988 3 to be connected via interface to the AVL COMPACT 3 and convey the respective measurement data The connection of the different instruments is possible due to the built in interface in the AVL 988 3 NOTE Please see that the connection takes place before the instruments are turned on Use the proper interface cable BVI811 for the connection to the COM 2 of the AVL COMPACT 3 or BV1814 for the connection to the COM 3 of the AVL COMPACT 3 Pinning The 25 pin interface socket is located on the back of the analyzer above the power supply plug RS232C Interface Fig 11 6 Interface AVL 988 3 4 transmit data Pin 3s ws receive data Pin 7 GND signal ground 9600 baud standard 8 Data bits 1 Stop bit ASCII code no Parity Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface
32. EXCEPT calibrations and measurements an interruption by pressing must be confirmed by pressing 3 e input of all numerical values Except time date SSS 200S 0696 e input of signs at each key touch the cursor will be placed back for one digit without deleting other digits 0 EXCEPT patient number Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 Description of the Analyzer Timeout If no key was pressed the analyzer automatically returns within 30 sec from each user program to READY Exception the user program System Test Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 13 2 Description of the Analyzer Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 Installation Shutdown 3 INSTALLATION SHUTDOWN Wns tallati Om T scevscstegeescedessveccodesensscccdbeccodsdedscoseseaccodesenscdedbeescodsseseccenssedeceneesceteees 3 1 Location ive eee ae te lee ee t ee Ee e eis gunt 3 2 Solenoid Valve Relief Clamps ied er sir Per HER RP s TEOSTE ROTRA SEEST 3 2 Peristaltic Pimp Tube sce eyed os etr Pe et ente e wired asks EUH EET See 3 3 Filling and Connecting the Bottles e He emere hen ent entrent eene 3 4 Waste Bottlez e enu DU e RI EE 3 4 Rinse pH Reference Solution Buffer Type 1 Buffer Type 2 Cleaning Solution
33. Level 2 110 860 0 9 1 4 40 Level 3 74 120 0 8 1 4 40 RNA Medical EQUIL X SD TotSD n mmHg mmHg mmHg Level 1 149 140 1 2 2 0 40 Level 2 56 480 0 8 1 3 40 Level 3 20 540 0 7 0 7 40 RNA Medical QUALIDATA X SD TotSD n mmHg mmHg mmHg Level 1 72 310 0 7 1 1 40 Level 2 110 750 0 9 1 5 40 Level 3 150 310 0 9 1 6 40 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 53 12 Appendix Comparison of PCO2 Measurement between Sample Types Specimen tonometered Whole Blood at 37 C PCO mmHg Expected X SD Recovery mmHg mmHg mmHg 9c Syringe 17 8 18 1 0 23 101 6 Capillary 17 8 18 0 0 27 101 0 Mini Sample 17 8 17 8 0 45 99 8 Micro Sample 17 8 17 9 0 27 100 6 Total 17 8 18 0 0 32 100 8 Syringe 20 6 20 9 0 34 101 2 Capillary 20 6 20 9 0 26 101 2 Mini Sample 20 6 20 9 0 28 101 2 Micro Sample 20 6 20 6 0 35 100 1 Total 20 6 20 8 0 31 100 9 Syringe 27 5 28 1 0 37 102 3 Capillary 27 5 28 2 0 23 102 5 Mini Sample 27 5 27 6 0 26 100 6 Micro Sample 27 5 27 7 0 25 100 9 Total 27 5 27 91 0 28 101 6 Syringe 27 5 27 9 0 38 101 5 Capillary 27 5 28 0 0 55 101 7 Mini Sample 27 5 27 7 0 46 100 5 Micro Sample 27 5 23 37 0 42 100 5 Total 27 5 27 8 0 46 101 0 Syringe 37 7 38 2 1 07 101 3 Capillary 37 7 38 0 0 78 100 9 Mini Sample 37 7 38 7 0 35 102 8 Micro Sample 37 7 38 3 0 18 101 6 Total 37 7 38 3 0 69 101 6 12 54 PCO mmHg Expected X SD
34. Valve 2 6 The sample is injected or aspirated into the fill port of the AVL COMPACT 3 using a syringe capillary or AVL Microsampler The fill port is made of soft PVC and serves as an interface between the sample container and the sample path The fill port is designed so those samples can be injected or aspirated via syringe capillary or Microsampler without the need of an adapter The sample flows through the preheating tube The metal sample inlet path heats the sample up to 37 C The sample inlet path is also the first contact for sample detection and the first contact path Mini Sample The analyzer aspirates the sample from the sample inlet path into the measuring capillary In the measuring capillary the sample contacts the electrodes Before the sample reaches the measuring chamber valve it passes the second electrical contact for sample detection In the measuring capillary an electrical contact for sample detection is positioned between the PO and PCO Electrode The AVL COMPACT 3 detects the sample and controls the filling of the measuring capillary by means of contact paths After the pH blood gas measurement is completed the sample is moved into the waste bottle The electromagnetic measuring chamber valve closes the measuring chamber and avoids the direct filling of a syringe sample into the measuring chamber The sample is pushed into a bypass tube This construction ensures a continuous and bubble fre
35. and the following display appears GC HMEBHSLEEMEHT Remoue carillars close the flar Remove the ampoule adapter or the capillary from the fill port and close the flap NOTE Do not open the flap during measurement The analyzer performs a QC measurement and detects automatically the corresponding level of the used control material On completion the results are displayed and printed GC MEASUREMENT Aol 7 651 PCOZ FO2 75 23 BE ak ee If the measured values are within the entered ranges of the specified level the values will automatically be stored in the memory If one or more values are outside the ranges of the specified level the operator can either reject the measurement values or select the appropriate values for storage in the memory GC MEARSUREMEMT 891 7 651 PECOZ FOS py2 2 BE GO Lewel 1 7 By pressing A you may now select the level which you have entered Press to confirm your selection The analyzer starts with the conditioning and get READY for further measurements or QC measurements Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 Quality Control QC Edit Function If you start with a new lot of QC material it is necessary to enter correctly the lot number expiration date and the specific target ranges NOTE For lot numbers expiration date and target ranges please refer to the package insert sheet of the
36. enables the chemical reaction and the transport of charges electrode housing membrane electrode body Fig 12 36 PCO Electrode Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Principle of O2 Partial Pressure Measurement The PO determination of the AVL COMPACT 3 is based on an electro chemical process Oxygen molecules dissolved in an aqueous solution are reduced electro chemically at a precious metal electrode platinum cathode with a constant potential of 0 7 V polarization voltage between the cathode and the pH Reference electrode anode The electrons donated by the cathode and accepted by the anode produce an electric current within the solution The outer part of the circuit is closed at the input circuit of the amplifier Between cathode and membrane there is a very thin electrolyte layer The O diffusion through the membrane dependent on the O partial pressure of the sample continuously replaces the O molecules of the electrolyte layer consumed during the cathode reaction A very small constant current representing the oxygen partial pressure PO of the sample passes through the electrode amplifier ay Y N 1 1 1 polarization potential 0 7 special glass body anode silver 4 electrolyte NaCl cathode s platinum oxygen permeable membrane blood sample or calibration gas Fig 12 37 Operating principles
37. the display will fade out At this point you may either select another time setting by pressing Or A and activate the selected setting by pressing or exit this program by pressing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions Parameter In addition to the values that are defined for each measurement default values to all subsequent measurements can be programmed Activate Settings Sx NV Farameter YES The following default values can be selected Sample number Units Standard values Physiological range Sample Number The sample number is a sequential number which increases by one with each measurement It may also be set or reset by the operator Activate Settings YES 3x v USER PROGRAMS Sample number GB Sample number oak The first digit of the sample number is blinking You may enter the sample number with the numeric keypad Confirm the correct number by pressing As soon as the entered number is valid the display will fade At this point you may select another parameter by pressing v and A or exit this program by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 9 8 System Functions Units Activate 4 lt 8 8 27 22 a m ct in E lt m wn USER PROGRAMS Units Slconvent ions Confirm by pressing YES The display shows 1 and conventional and o
38. 000 8 000 0 005 For PCO2 and PO2 whole blood was tonometered at 37 C to various levels of gravimetrically prepared gases with CO and O concentrations Five measurements were obtained at each of 10 levels of gas and Mean and SD were calculated for each of the four sample modes available on the AVL COMPACT pH Blood Gas Analyzer Syringe Capillary Mini and Micro Sample Measurement was also performed on the AVL OMNI Analyzer Mini Micro Syringe Capillary Sample Sample TOTAL Target X 1185 X 1SD X ISD X 1SD X 1SD 17 8 18 1 0 23 18 0 0 27 17 8 0 45 17 9 0 27 18 0 0 32 20 6 20 9 0 34 20 9 0 26 20 9 0 28 20 6 0 35 20 8 0 31 27 5 28 1 0 37 28 2 0 23 27 6 0 26 27 8 0 25 27 9 0 28 27 5 27 9 0 38 28 0 0 55 27 7 0 46 27 7 0 42 27 8 0 46 37 7 38 2 1 07 38 0 0 78 38 7 0 35 38 3 0 18 38 3 0 69 41 2 42 07 0 35 41 8 0 58 41 6 0 88 41 8 0 43 41 8 10 59 67 8 37 6 1 55 68 6 0 55 68 8 0 58 69 7 0 57 68 7 0 92 68 8 70 5 0 60 70 4 0 42 69 7 1 05 70 7 0 73 70 3 0 73 103 1 102 9 0 76 103 5 0 90 104 0 1 54 104 0 1 68 103 6 1 28 139 5 139 5 1 64 140 0 1 99 137 6 2 80 140 8 4 17 139 5 2 82 24 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet PO Measurements Mini Micro Syringe Capillary Sample Sample TOTAL Target X 1SD X SD X 1SD xX 18 X 1SD 0 0 1 07 10 47 10 89 0 47 0 83 0 36 0 70 0 57 0 87 0 47 21 0 20 9
39. 2 0 June 1998 1 Method Sheet The PO value of arterial blood has become the primary tool for the evaluation of arterial oxygenation status Values below the normal arterial PO arterial hypoxemia are usually caused by pulmonary circulatory or respiratory abnormalities e g bronchial obstruction vascular problems decreased cardiac output increased oxygen demand anatomical heart defect low inspired O content Generally PO levels above 100 mmHg do not contribute significantly to the oxygen content since with normal hemoglobin concentrations 80 100 mmHg PO provides a 97 saturation level and a level greater than 100 cannot be achieved Principles of Procedure pH Measurement There are 4 electrodes used in the AVL COMPACT 3 pH Blood Gas Analyzer a pH Electrode a pH reference electrode a PCO Electrode and a PO Electrode pH of a solution is defined by the negative logarithm of the activity of Hydrogen ions and described by the equation pH log H A single measurement of the electric potential of a solution under proper conditions can be directly related to the concentration of Hydrogen ions In pH measurement systems a bulb of special glass is filled with a conductive buffer solution of known pH in contact with the measuring instrument through a conductive metallic electrode When this special electrode is immersed in an aqueous solution water molecules diffuse into the structure of the glass and f
40. 28 3 037 99 capillary 20 28 5 280 023 98 8 00 syringe 20 57 0 566 044 99 capillary 20 570 567 039 99 13 97 syringe 20 99 6 99 1 058 99 capillary 20 99 6 99 6 046 100 16 00 syringe 20 114 1 113 9 058 100 capillary 20 114 1 15 2 084 101 20 00 syringe 20 142 6 144 2 1 16 101 capillary 20 142 6 140 8 1 56 99 30 00 syringe 20 213 9 213 2 0 72 100 capillary 20 213 9 210 8 2 62 99 50 00 syringe 20 356 5 3526 2 13 99 capillary 20 356 5 3504 2 73 98 80 00 syringe 20 570 4 5653 597 99 capillary 20 570 4 562 9 2 82 99 Linearity Number of pairs n 180 slope m 0 9872 0 0008 y intercept b 0 7362 0 1920 correlation coefficient r 0 9999 All specific performance characteristics tests were run with default instrument calibration and after normal recommended equipment quality control checks were performed see Operator s Manual Specimens at each level were analyzed in replicates of two for 20 days The within run and between day standard deviations were calculated by the analysis of variance method Model equation for regression statistics is results of AVL COMPACT 3 Analyzer slope m x comparative method results intercept b 22 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Correlation to Other Methods Who
41. 300 7 293 7 3 06 97 7 Total 21 0 20 8 1 00 99 3 300 7 293 4 4 81 97 6 Syringe 44 7 44 4 100 99 3 344 0 336 9 6 65 97 9 Capillary 44 7 44 4 1 12 99 3 344 0 342 1 4 07 99 5 Mini Sample 44 7 43 3 0 64 96 9 344 0 343 6 3 48 99 9 Micro Sample 44 7 43 3 0 88 96 9 344 0 343 6 9 93 99 9 Total 44 7 43 8 0 93 98 1 344 0 341 5 6 55 99 3 Syringe 76 0 77 1 0 61 101 4 501 2 4921 11 11 98 2 Capillary 76 0 714 0 65 101 8 501 2 489 1 7 19 97 6 Mini Sample 76 0 78 3 0 51 103 0 501 2 486 7 8 36 97 1 Micro Sample 76 0 714 1 01 101 8 501 2 494 3 9 30 98 6 Total 76 0 77 5 0 72 102 0 501 2 490 5 9 11 97 9 Syringe 96 2 95 7 0 70 99 5 659 5 640 1 12 61 97 0 Capillary 96 2 96 7 0 96 100 5 659 5 647 7 11 80 98 2 Mini Sample 96 2 97 5 0 88 101 4 659 5 644 6 12 22 97 3 Micro Sample 96 2 97 1 1 10 101 0 659 5 641 6 20 55 97 3 Total 96 2 96 7 0 92 100 6 659 5 643 5 14 75 97 6 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 55 12 Appendix Comparison of pH Measurement between Sample Types Specimen tonometered Whole Blood at 37 C pH value pH value OMNI x SD OMNI x SD pH Syringe 7 005 6 974 0 007 7 443 7 428 0 009 Capillary 7 002 6 976 0 005 7 434 7 430 0 009 Mini Sample _ 7 003 6 984 0 014 7 436 7 431 0 015 Micro Sample 7 003 6 988 0 009 7 436 7 431 0 007 Total 7 003 6 980 0 0
42. 38 12 22 PO Electrode cleaning procedure 1 esee eee eese eene eene tenete nne 12 39 12 23 Electrode cleaning procedure 2 eee eee 12 39 12 24 PO Electrode cleaning procedure 3 eee esee eee eee eee eet nette e tena 12 39 12 25 Electrode housing with protective cap eeeeeeee eee eese eene n nennen nnn tesa nennen nnne 12 41 12 26 Filling electrode housing with electrolyte Leceeee ecce eese eee eee ee eene nennt nenne 12 41 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents Fig 12 27 Remove air bubbles 12 42 Fig 12 28 Insert inner Part ssscccsiscsccevcosccvsssesseaeseassssssbecsavededecsecssaesseesssesceseseossectesesasces 12 42 Fig 12 29 Insert inner part 2 EV v o PE eeu Rode 12 42 Fig 12 30 Close overflow hole of the electrode housing ecce eene eene 12 43 Fig 12 31 Silicon grease of the tip of the electrodes sscscssscccssscessscccessceesssceescesseseeeescees 12 43 Fig 12 32 Operating principles pH Electrode eeeeeeee eese eese eene enne enne nne nennen nnn 12 44 Fig 12 33 pH reti ee eee ore tpa ea SEN o Sete EE YII PA UY Ru eon ONT aere aee 6 pue
43. 4 0 34 0 50 PO 240 741 0 78 1 42 Material AVL CONFITEST Aqueous pH Blood Gas Control Level 4 Parameter n Mean Swr St pH 240 7 406 10 0012 0 0045 PCO 240 443 0 25 0 29 PO 240 2886 1 93 5 43 Material RNA Medical QUALIDATA pH Blood Gas Electrolyte Control Level 1 Parameter n Mean St pH 240 7 44 0 0016 0 0043 PCO 240 170 3 0 55 0 87 PO 240 72 0 70 1 13 Material RNA Medical QUALIDATA pH Blood Gas Electrolyte Control Level 2 Parameter n Mean Swr St pH 240 7 395 0 0016 0 0065 PCO 240 44 5 0 24 0 34 240 10 89 1 54 Material RNA Medical QUALIDATA pH Blood Gas Electrolyte Control Level 3 Parameter n Mean Swr St pH 240 17 596 0 0013 0 0073 PCO 240 23 0 0 18 0 38 PO 240 150 3 0 93 1 59 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Material RNA Medical EQUIL Reduced Bovine Hemoglobin Blood Tonometry Material Level 1 11 0 20 93 Os balance N Parameter n Mean Swr St pH 240 17 178 0 0015 0 0087 PCO 240 742 0 58 1 08 PO 240 149 2 1 19 1 95 Level 2 5 13 7 80 balance N Parameter n Mean Swr St pH 240 17 422 0 0017 0 0047 PCO 240 134 6 0 28 0 41 PO 240 56 5 0 75 1 25 Level 2 1 50 2 91 O5 balance N Parameter n Mean Swr St pH 240 17 732 0 0016 0 0048
44. Analyzer Location For correct trouble free operation the following environmental specifications must be observed Ambient temperature 15 C to 32 C 50 F to 90 F Avoid direct sunlight Avoid hazardous gases and vapors Relative humidity 20 90 Avoid locations beside strong electromagnetic fields electric motors transformers X ray apparatus etc Avoid the use of cellular telephones close to the device Avoid vibration use a solid surface Allow sufficient space at least 20 cm 8 Inch minimum around the analyzer for air circulation and electrical supply General Information AVL COMPACT 3 should be switched on at all time For switch off periods of more than 12 hours the shutdown procedure described in chapter 3 must be performed Do not place liquids on top of the analyzer Perform regular quality control tests for further information please refer to chapter 5 Handling Blood and Blood Products Hygienic Handling of Blood Always handle blood with caution as it may contain hazardous biological substances WARNING Waste liquids must be disposed of in accordance with local regulations biohazard Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 3 1 Introduction Handling AVL Reagents NOTE AVL Medical Instruments cannot guarantee the performance of the analyzer if any of the following situations occur Reagents other than those recommended are used Expiration d
45. Electrode housing droplet Fig 9 3 pH Reference Electrode If the droplet has formed wipe it off carefully insert the electrode into the measuring chamber and secure with the clip Exit this program by pressing Remove old drip tray and insert new Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance Every 6 Months Measuring Chamber Valve The measuring chamber valve electromagnetic valve is located at the far right in the measuring chamber block It separates the measuring chamber unit from the sample path so that syringe samples are not directly inserted in the measuring chamber but in the bypass Procedure e Pull out the securing clip of the valve and remove the measuring chamber valve from the measuring chamber e Acover with a silicone O ring is located at the tip of the valve e Remove the cover from the valve e Place a new cover on the valve Be careful that the silicone O ring is not pushed out at the front e Return the measuring chamber valve into the measuring chamber and secure with clip e Close the cover Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 9 9 Maintenance Yearly Maintenance Waste Container Peristaltic Pump Tube Exchange Pump Tubes Fill Port Dispose of the waste container in accordance with local regulations Fig 9 4 Peristaltic pump tubes Unlock tension lever and disconnect pump tube Press tension lever against pum
46. In addition to this password code an operator identification code can be adhered This alpha numeric operator identification code identifies the operator on the measurement protocol e Password code corresponding to password codecard 1 superior e Password code 2 corresponding to password codecard 2 authorized operator e Password code 3 corresponding to password codecard 3 operator NOTE Access codes have different priorities l highest access code 2 reduced access code 3 performance of measurements 2 AVL COMPACT 2 E HEX active reading area 2 2 Access Code S Zugriffsberechtigung a Code d acc s C digo de acceso z M AVLCOMPACT gt z 5 Ss active reading area 2 Access Code Zugriffsberechtigung a Code d acc s ul C digo de acceso z TZ Aca K AVL COMPACT active reading area Access Code Zugriffsberechtigung Code d acc s C digo de acceso MEDICAL INSTRUMENTS TATA AVL Fig 8 1 Password codecards with different access codes Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions Device Lock MESSUNG A Pakwortcode 1 2 3 MESSBEREIT lt Paftworteingabe mit Barcode Scanner Met Ht QC Kalibrierung _ Ausdruck gt Wartung Einstellungen System OM ow Xo of PaRwort Pa wort Pa wort Pa wort Pa wort Pa
47. No samp Mo 01 No samp Mo 01 No samp Mo 01 No samp Mo 01 No samp Mo 01 No samp Mo 01 POWERFA Th 04 No Rinse Th 04 Ju POWERFA Th 04 Ju POWERFA Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 9 12 Appendix QC Measurement Report AVL COMPACT 3 BLOOD GAS QC REPORT Lot 13442 lot number of the selected Level Sample CAPILLARY LEVEL 1 measured Level Th 04 Jul 96 13 25 No 17 sample number Baro 7123 8 mmHg actual air pressure pH 7 199 PCO2 16 9 measured parameter 02 130 7 0p ID operator identity If the function Multirule is activated the following notes can be printed on the report e OUT OF CONTROL e WARNING These notes allow to detect as early as possible random or systematic errors of the instrument and of the operation For details please refer to section AVL Multirule QC Procedure page 12 15 12 10 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix QC Statistics Report Example Level 1 PCO AVL COMPACT 3 BLOOD GAS Qc STATISTICS REPORT Th 04 Jul 96 13 57 SN 00260 LEVEL 1 PCO2 gt aes measured Level parameter Range 128 14 target range X 25 to X 2s according mean value X 136 standard deviation s 4 to the 3442 lot number of the measured Level insert Expiration date 07 95 137 503 mmHg J M mean value of the stored values 5 568 SD standard deviation of
48. Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing Press and only 60 ul sample will be aspirated As soon as an acoustic signal will sound remove the capillary and close the flap The remaining sample volume can be used for measurements in another analyzer oximeter or ISE If the displayed Mini sample was not confirmed by YES the sample will be aspirated as long as the measuring chamber is completely filled After the acoustic signal will sound remove the capillary and close the flap NOTE If the flap is opened again while the sample is being aspirated and not closed before the countdown reaches 000 a continuous beep will sound until the flap is closed If the flap is opened during the measurement the measurement will be aborted NOTE Do not open the cover during measurements HEBHSLUREENEHT gis Edit Fatient data 7 The analyzer performs a fully automatic measurement The transparent illuminated measuring channel enables the user to observe the movement of the sample and to identify blockages or air bubbles During measurement data input is possible If a barcode scanner is installed it is possible to scan in the patient number during measurement from sample stop up to reaching READ as well as during the function Data input Patient number Please refer to chapter 8 Settings section Interfaces for further information The countdown running in the upper right corner o
49. PCO 240 11 0 0 09 0 24 PO 240 20 5 0 49 0 46 Aliquots of Reduced Bovine Hemoglobin material were tonometered at 37 C For each level two replicates were run in two runs on three AVL COMPACT 3 pH Blood Gas Analyzers for twenty days Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 19 Method Sheet Precision and Linearity Precision and Linearity of pH on Phosphate Buffer Solution Linearity of pH on Whole Blood 20 Ampoules of precision pH buffer solutions with values traceable to N I S T were analyzed in random order in sets of 10 measurements on each of 6 AVL COMPACT pH Blood Gas Analyzers Precision pH Value 37 n WRSD 6 841 0 005 60 6 8409 0 0023 7 100 0 005 60 7 0993 0 0025 7 383 0 005 60 7 3823 0 0024 7 600 0 005 60 7 5976 0 0019 Linearity Number of pairs n 240 slope m 0 9974 0 0010 y intercept b 0 0179 0 0073 correlation coefficient 1 0000 180 runs were made on two AVL COMPACT pH Blood Gas Analyzers and on 1 AVL 995 after being tonometered to various concentrations of CO and gas at 37 C Number of pairs n 180 slope m 0 9979 0 0016 y intercept b 0 0118 0 0114 correlation coefficient r 0 9998 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Precision and Recovery on Whole Blood Method Sheet Whole blood was tonometered at 37 C to various levels of gravimetrically prepared gases with CO and
50. PCO inner electrode should be cleaned when it looks contaminated Carefully remove the PCO Electrode from the measuring chamber Remove and dispose of the green electrode housing according to applicable safety regulations or procedures Replace the electrode O ring if necessary e g if brittle or worn Moisten the chamois leather of the electrode cleaning box with a few drops of distilled water Squeeze a small amount of electrode cleaning paste onto the moistened chamois leather Fig 12 18 PCO Electrode cleaning procedure 1 NOTE Do not attempt to clean the Ag AgCl brown ring of the electrode with electrode cleaning paste Holding the electrode between your thumb and forefinger polish it with the chamois leather for about 15 seconds with circular movements applying slight pressure Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Fig 12 19 PCO Electrode cleaning procedure 2 Remove any cleaning paste from the electrode with distilled water and a clean moistened tissue Fig 12 20 PCO Electrode cleaning procedure 3 Immerse electrode tip into PCO Filling Solution for at least one hour optimal 12 hours Fit a new PCO Electrode housing see page 12 41 fill the housing with PCO Filling Solution and insert the inner part into the housing Reinstall PCO Electrode into the measuring chamber block secure the electrode clip and reconnect the electrode plug Close
51. Recovery mmHg mmHg mmHg 9c 41 2 42 1 0 35 102 1 41 2 41 8 0 58 101 3 41 2 41 6 0 88 100 8 41 2 41 8 0 43 101 3 41 2 41 8 0 59 101 4 67 8 67 6 1 55 99 7 67 8 68 6 0 55 101 2 67 8 68 8 0 58 101 5 67 8 69 7 0 57 102 8 67 8 68 7 0 92 101 3 68 8 70 5 0 60 102 5 68 8 70 4 0 42 102 3 68 8 69 7 1 05 101 4 68 8 70 7 0 73 102 7 68 8 70 3 0 73 102 2 103 1 102 9 0 76 99 9 103 1 103 5 0 90 100 4 103 1 104 0 1 54 100 9 103 1 104 0 1 68 100 9 103 1 103 6 1 28 100 5 139 5 139 5 1 64 100 0 139 5 140 0 1 99 100 0 139 5 137 6 2 80 98 7 139 5 140 8 4 17 101 0 139 5 139 5 2 82 100 0 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Comparison of PO2 Measurement between Sample Types Specimen tonometered Whole Blood at 37 C PO mmHg PO mmHg Expected X SD Recovery Expected X SD Recovery mmHg mmHg mmHg 7c mmHg mmHg mmHg Syringe 0 i 0 47 x 135 6 137 3 3 25 101 2 Capillary 0 0 9 0 47 135 6 136 3 1 24 100 5 Mini Sample 0 0 8 0 36 E 135 6 137 3 1 38 101 3 Micro Sample 0 0 7 0 57 135 6 137 8 1 14 101 6 Total 0 0 9 0 47 135 6 137 2 1 95 101 2 Syringe 21 0 20 9 0 53 99 6 300 7 290 8 3 60 96 7 Capillary 21 0 21 1 1 50 100 6 300 7 295 1 1 87 98 1 Mini Sample 21 0 20 7 0 60 98 7 300 7 294 1 8 18 97 8 Micro Sample 21 0 20 6 1 05 98 4
52. Y oy 1531 Av 1dsid 4 QHOMSSVd 39uhd Svo x x Y 30VJH3INI 90v amp HSVM x x X x M Y y 39v eye amp 5 amp SAATWA JOVNONYI NMOGLNHS pute E M Y Y yw QH SdNnd 4 OVA WO dz SVO m X zx Y M amp 30VJH31NI SONIWIL ONINV3TO WO 2710 dz Hd SJA SJA x x x 5 n v LNAILWd u3lsvuv LOWLNO 15 OLN amp HSVM INI 1UOd3u iO di Hd 2 101 MIN 90 aH air A x RC E Y 4 INOINIHd assis MP ej ue 5 1 ABONV LS NVIA 1 434 amp INANI Viva 27161115 90 HTO 1NaWaunsvaw S3X S3X SHA Sax S34 SJA Sak 21531 j 2 INSINSH usn MBs SONILL3S 4 3ONVN3INIVI amp 2 90 ES SJA Fig 12 43 User programs AVL COMPACT 3 12 63 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix ICS Flui uonnjos Jang Jayng sury 9 uonnios Hd Fig 12 44 Fluidics Operator s Manual AVL COMPACT 3 Rev 2 0 J
53. accept H ions proton acceptor calomel reference electrode amplifier display glass electrode saturated solution of potassium chloride metallic mercury cellulose cotton wool saturated solution of mercurous chloride membrane blood sample or calibration buffer solution Fig 12 32 Operating principles pH Electrode 12 44 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix PH Electrode and pH Reference Electrode The pH Electrode consists of a single glass tube whose bottom part is covered with special glass In the area between inner and outer swell layer an electric potential is generated To determine the value of this electric potential the circuit has to be closed On the inside of the glass electrode electrical contact is made by an Ag AgCl Electrode on the outside by the pH Reference Electrode The pH Electrode comprises the following parts an electrode body which consists of a pH glass electrode electrode housing electrode housing electrode body Fig 12 33 pH Electrode The pH Reference Electrode includes the following components an inner part which contains mercury an electrode housing which comprises a membrane and reference electrolyte inner part electrode housing Fig 12 34 pH Reference Electrode Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 45 12 Appendix Principle of Partial Pr
54. activatec e The liquids are aspirated and the tubing system is dried USER FROGRAMS Shutdown Switch off analuzer pui Switch off the power supply Close the valve of the calibration gas cylinders Insert the solenoid valve relief clamps Empty decontaminate and dry the waste bottle and put it back into the analyzer Disconnect the electrode cables and lift the electrode clips The electrodes may now be removed NOTE Reinsert the electrode clips to avoid losing them Storage for only one day To prevent the electrodes from drying out fill the protective caps with pH Electrode Buffer Type 1 PCO Electrode PCO TCO Filling Solution PO Electrode do not fill pH Reference Electrode pH Reference Solution and seal them with Parafilm Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 Installation Shutdown Transport only for Remembranable Electrodes e Remove the electrode housing from the corresponding electrode e Fill the transport housing with the corresponding electrolyte Exception PO Electrode e Remove the outside O ring from the transport housing for opening the Mu m he Fig 3 11 Transport housing e Fit the electrodes with the filled transport housing Releasing the Peristaltic Pump Tube Unlock tension lever Push on hook shaped until tension lever moves left and pump tube tension is released Releasing the Tubes To prevent t
55. and III exceed Out of Control the same X 1 X o limit Observation period is three runs 9x Nine QC values level I II and III fall Out of Control on the same side of the X Observation period is five runs Table 1 Overview of AVL Multirules All rules shown in Table 1 are implemented in the AVL COMPACT 3 QC software and are used for every QC measurement if the function AVL Multirule was activated in the user program Settings Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 15 12 Appendix NOTE e The operator has to activate the AVL Multirule procedure see chapter 8 e Use only one QC material of one lot e g AVL CONFITEST do not mix the QC materials Single measurements are stored automatically if the results of all three measurements are within the range 3 o Otherwise the operator has to decide whether the results should be stored or not e For each new lot of QC material the user has to enter the corresponding mean values and standard deviations see chapter 5 according to the package insert sheet When using actual QC data to re define the mean values and standard deviations AVL recommends making more than 20 QC measurements for calculating these new target values This new mean value and standard deviation influence the Levey Jennings Diagram and the results of the Multirule analysis but they do not influence the stored data e A maximum of 34 single measurements are s
56. be acute as the result of pulmonary edema airway obstruction or medication or maybe be chronic as the result of obstructive or restrictive respiratory diseases The PCO value of arterial blood is used to assess how well the body eliminates carbon dioxide in relation to the metabolic rate of CO production A PCO below the normal range is termed respiratory alkalosis and indicates hypocapnia a condition caused by increased alveolar ventilation such as hyperventilation An arterial PCO above the normal range is termed respiratory acidosis and indicates hypercapnia a sign of hypoventilation and failure resulting from cardiac arrest chronic obstructive lung disease drug overdose or chronic metabolic acid base disturbances The PO value of arterial blood has become the primary tool for the evaluation of arterial oxygenation status Values below the normal arterial arterial hypoxemia are usually caused by pulmonary circulatory or respiratory abnormalities e g bronchial obstruction vascular problems decreased cardiac output increased oxygen demand anatomical heart defect low inspired content Generally PO2 levels above 100 mmHg do not contribute significantly to the oxygen content since with normal hemoglobin concentrations 80 100 mmHg provides a 97 saturation level and a level greater than 10046 cannot be achieved Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 Introduction Handling the
57. easy identification Listed from left to right white gray green blue PCO PO Fig 2 8 Electrodes The peristaltic pump is used to transport all samples and liquids inside the analyzer Fig 2 9 Peristaltic pump Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 Description of the Analyzer Warning and identification plates with model and serial numbers are located on the rear panel of the unit Rear Panel NOTE Only a trained service engineer is authorized to open the rear panel Fig 2 10 Rear panel Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 L d OVELabel D d TUV Label L 511 CSA Label al Fig 2 11 Warning and identification plates w ACHTUNG VOR WECHSEL DER SICHERUNG 2 NETZSTECKER ZIEHEN wn o amp 5 CAUTION DISCONNECT POWER BEFORE 5 CHANGING FUSE BETRIEBSANLEITUNG BEACHTEN OAS NUR VON AUTORISIERTEN DAS GERAT DARF NICHT IN PERSONAL GE FFNET WERDEN 10 CO ATTENTION COUPER LE COURANT AVANT EXPLOSIONSGEF HROETEN VOR FFNEN DES GEHAUSES NETZSTECKER 5 bal z DE REMPLACER LE FUSIBLE BETRIESEN WERDEN ZIEHEN F 2 FOLLOW THE DIRECTIONS THE OPENING OF THIS DEVICE I PERMITTED ATENEO LINER ANTES GE RERMRLAXAR DON T OPERATE THIS INSTRUMENT ONLY BY AUTHORIZED TRAINED PERSONNEL
58. empty Reinstall a new bottle Zr inn solution Check pH Reference Electrode and sample pH Reference Electrode empty path for tightness check sample path for leaks sample path clogged Ho REF Bottle empty Reinstall and insure the seal tight Confirm Fill electrode by pressing VES This function activates the automatic filling of the pH Reference Electrode housing Bottle of the pH Reference Screw on cap of the bottle tight Electrode leak RIHSE Bottle empty Replace by just filled RINSE bottle or empty bottle completely Refill with distilled water and add one ampoule Rinse Additive A wash dry cycle will be automatically performed Meas Fath Measuring chamber soiled Clean measuring chamber arl Filled Vacuum system leak Screw on cap of waste bottle tight Check quad ring inside the Waste cap Sample path clogged See page 10 9 Activate Maintenance Wash or Maintenance cleaning If an external waste container is _Check back pressure valve see chapter 12 present optional Appendix section Options External Waste The back pressure valve in the Container cover possibly leaks Vacuum pump defective Call AVL customer support 10 4 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Error Messages Possible Cause Instructions for Elimination Check Temperature Check SF tempera
59. in a sample at the time diffuse into the hydrated glass layer and generate an electric potential This potential is conducted through a gelled buffer solution of constant pH to the instrument through an AgCl coated silver pin immersed in the buffer and connected to the instrument with a cable and plug The electrical circuit is completed through the sample path to the pH Reference Electrode and a second instrument input The potential difference measuring voltage is amplified for easier processing With the help of a calibration curve determined by calibration points near 7 38 and 6 84 and by using the measured voltage of the sample the ion concentration of the sample is determined and converted to pH for display The pH Reference Electrode consists of a glass tube filled with calomel paste mercurous chloride in contact with mercury surrounding a platinum wire This mixture is kept moist with a cotton plug at the end of the glass tube immersed in a solution of potassium chloride KCl and contained in a disposable housing The mixture of metals in the electrode generates a constant voltage A porous membrane at the tip of the housing provides a liquid junction with the sample and the KCI solution serves as a salt bridge establishing contact between the instrument calomel element and pH Electrode through the sample in contact with the KCI at the housing tip The PCO Electrode consists of a pH glass electrode and an Ag AgCl reference electrode
60. input Patient data YES Patient number YES It is possible to enter a 10 digit patient number The first digit of the patients number is blinking With the numeric keypad the digit can be entered Confirm the correct digit by pressing YES At this point you may select another parameter with or A or exit from the program by pressing Esc If a barcode scanner was installed it is possible to read the patient s number with the help of this active reading unit For details please refer to chapter 8 Settings section Interface Activate Parameters input Patient data ix Nv Sex YES The display shows male and female and one of the parameters is blinking Select either male or female with or A Activate the blinking selection with At this point you may select another parameter with or A or exit the program by pressing Esc Activate Parameters input Patient data 2x v Hae YES You may now enter the patient s age between 0 and 99 using the numeric keypad When you confirm the correct age with the display will fade out At this point you may select another parameter with or A or exit the program by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing Printout This user program enables you to obtain a printout of last measurement report last three measurement reports calibration report error report system sta
61. number are printed on each package 0521 For periodic cleaning of the measuring system after lipemic samples or as required for decontamination Each dispensing bottle contains 100 mL of solution Sodium hypochlorite 16 0 g L Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each container label Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 PCO Filling Solution Filling Solution Calibration Gas 1 Order number Use Contents Composition Additives Storage Stability Order number Use Contents Composition Additives Storage Stability Order number Use Contents Composition Storage Stability Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet BP1286 Electrolyte solution used in remembranable PCO Electrodes Each dispensing bottle contains 100 mL of solution Potassium chloride 25 0 mmol L Sodium bicarbonate 10 0 mmol L Germicides Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each container label BP1414 Electrolyte solution used in remembranable PO Electrodes Each dispensing bottle contains 100 mL of solution Ethylene glycol 1000 g L Regent grade water 100 g L Disodium hydrogen phosphate 5 34 g L Potassium dihydrogen phosphate 2 45 g L Sodium chloride 0 58 g L Germicides Temperature 5 30 C 41 86 F Expiratio
62. pH Electrode related problem remove the pH Electrode clip and take the electrode out of the measuring chamber block by pulling it towards in rear Fig 12 3 Pull out the pH Electrode Carefully remove the pH Electrode housing Dispose of the electrode housing according to applicable safety regulations or procedures 12 29 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Fig 12 4 Remove pH Electrode housing Replace the inner electrode O ring if necessary e g if brittle or worn Fig 12 5 Inner electrode O Ring Fix new pH Electrode housing Fig 12 6 pH Electrode fix new housing 1 NOTE Press forefinger against the tip of the housing to avoid forcing out the O ring at the tip Without releasing the pressure rotate the inner section one quarter turn in both directions 12 30 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Fig 12 7 pH Electrode fix new housing 2 NOTE This procedure avoids that the inner part is pushed back out of the housing after it is released due to the elasticity of the O ring Reinstall the pH Electrode in the measuring chamber block and reconnect the electrode cable and electrode clip Close the cover and initiate pH calibration NOTE Should the pH Electrode complete or inner element only be exposed to air for more than two hours place it in a small cup filled with Buffer Type 1 Immerse the top ap
63. pH S PCO2 DRIF mmHg PCO2 Gas2 PCO2 51 PO2 Gas 1 DRIFT mmHg 5 0 P02 Gas 2 71 PO2 51 120 Electrode values mV pH PCO2 2 B2 588 B2 595 6 B1 1245 1251 1249 2 pH 1242 302 0 1 0355 1091 19 counter 000470 Conversion factors SLOPE INTERCEPT P02 1 00 0 0 PCO2 1 00 0 0 pH 1 000 0 000 The system status report contains of a calibration report and the following additional system information the actual program version language is indicated limits of the calibration values Buffer Type 2 Buffer Type 2 reproducibility of the values pH Buffer Type 1 Buffer Type 1 Buffer Type 1 reproducibility of the values pH drift of the pH values actual Gas 1 value mV drift of the Gas 1 value mmHg actual Gas 2 value mV drift of the slope value earliest after two calibrations Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Error Report On this report all appeared errors maximal up to 20 report are printed Each further error will be printed at the end of this report at which the first error of the report will be deleted AVL COMPACT 3 BLOOD GAS RROR REPORT Printout Th 04 Jul 96 11 49 01 Jul 96 13 24 No GAS 1 Mo 01 Jul 96 13 24 Check electrodes Mo 01 13 30 PCO2 NOT BRATED Mo 01 J ul 45 sampl Mo 01 pH NOT Mo 01 pH NOT Mo 01 pH NOT Mo 01 POWERFA Mo 01 POWERFA Mo 01 No samp Mo 01
64. request to send clear to send Pin 6 DSR data set ready Pin 7 GND signal ground Pin 20 DTR data terminal ready Pin 1 8 19 21 25 Not connected The baud rate can be set in the user program Settings Available are 1200 2400 4800 7200 9600 baud 9600 default Transmission Format 8 Data bit 1 Stop bit no Parity Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Reports Transmission Report 11 Interface The data flow is controlled by Software Handshake XON XOFF can also be activated deactivated in the user program Settings Interface Following control sequences are part of the report and are sent to the interface Control sequences Hex Ctri STX 02 B start of text end of text carriage return line feed continue transmission stop transmission The sequence of the report lines can be set in the user program Settings for details please refer to chapter 8 Settings STX CR LF AVL COMPACT 3 CR LF BLOOD GAS CR LF ACID BASE REPORT CR LF CR LF 36 Name F CR LF 18 CR LF CAPILLARY CR LF cap CR LF n0 ple LF 12 Jul 96 15 54 CR LF 30 CR LF 724 8 mmHg CR 15 2 0 38 2 g dL CR AC CR LF 7 200 7 184 17 0 14 9 CR LF mmHg CR 1 92 19 28 6 126 3 133 97 CR LF values CR LF Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1
65. respiratory alkalosis An increase in blood serum or plasma pH alkalemia may be due to increased plasma bicarbonate or a feature of respiratory alkalosis due to an increased elimination of CO due to hyperventilation A decreased pH value acidemia in blood serum or plasma may occur due to an increased formation of organic acids an increased excretion of H ions in certain renal disorders an increased acid intake such as in salicylate poisoning or loss of alkaline body fluids Respiratory acidosis is the result of a decreased alveolar ventilation and may be acute as the result of pulmonary edema airway obstruction or medication or maybe be chronic as the result of obstructive or restrictive respiratory diseases The PCO value of arterial blood is used to assess how well the body eliminates carbon dioxide in relation to the metabolic rate of CO production A PCO below the normal range is termed respiratory alkalosis and indicates hypocapnia a condition caused by increased alveolar ventilation such as hyperventilation An arterial PCO above the normal range is termed respiratory acidosis and indicates hypercapnia a sign of hypoventilation and failure resulting from cardiac arrest chronic obstructive lung disease drug overdose or chronic metabolic acid base disturbances 1 Teitz Norbert W Ed Clinical Guide to Laboratory Tests 2nd Ed Philadelphia W B Saunders Co 1990 p 436 Operator s Manual AVL COMPACT 3 Rev
66. simulated via terminal commands the buttons on the AVL COMPACT 3 are deactivated e General activation deactivation will be performed in the user program Settings e Default values are deactivated Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 23 11 Interface 11 24 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix 12 APPENDIX Specification of the AnalyZ r cc c0sccccseecscssacssevsacescececesscvesescovscensseescsescascecedaosdevedensceussessseuscvessecss 12 1 Description of Various Reports eese eese eese eese eese eene nets est nettes st sa tesa ases 12 4 Standard Measurement Report oe serere pie repete deae eo ore e E Er ex oer dre tee e ege 12 4 Report with Patient Related ee e ee mee men he rennen 12 5 Calabration Report ue eee RE e a Gre e eR DE E ERR es 12 6 Calibration Alarms Printed out on the Calibration Report ssssess eeeeeeene een eene ees 12 7 Other Printed Alarms uo bes dea Reime Ete wun RENTA C UNa N CURES GONG PEU Eu 12 7 System Status Report sete ettet e oot ee ce eee Co deae Eo e dete Ede see EE P Eye pe e een 12 8 Error Report iei NE od et tee cole eost Le oe nue 12 9 QC Measurement Report ue ee ete a eii eR ss cab bees Ree Ree EE ERR SER ORE EAE PE RARI 12 10 Q
67. t 5 Ei FUSIBLE IN EXPLOSIVE HAZARDOUS BEFORE OPENING THE CASING REMOVE LOCATIONS I MAIN PLUG 2 FAITES ATTENTION AU MODE L APPAREIL NE DOIT ETRE OUVERT QUE PAR o F 1 D EMPLOI t L APPAREIL NE DOIT DES SPECIALISTES AUTORISES 2 55 CO PAS MiG EN MAROHE EN IL EST NECESSAINE DEBRANCHER 20 E PRESENCE DE YAREURE L APPAREIL AVANT OE L OUYRIR I bal E m NAMEPLATE SIGA LAS INSTRUCCIONES EL APARATO 5010 PUEDE SER ABIERTO FOR m OPERACI N EL APARATO NO PERSONAL AUTORIZADO 3 u PUEDE SER UT L Z DO EN ANTES DE RETIRAR LA TAPA DESCONECTE 5 LUGARES CON RIESGO DE EXPLOSIONI EL CABLE DE LA LINEA 2 9 2 Description of the Analyzer Interfaces 7 3 25 pin female 2 COM 2 9 pin female x eee e COM 1 9 pin female Fig 2 12 Interface The standard bi directional interface RS232 C Submin D connector enables the user to connect the analyzer with a Host Computer an external printer or ticket printer In addition the unit is provided with an interface option for a Bar code scanner and for data link with an AVL Oximeter or an AVL Electrolyte Analyzer and or with an external service modem Gas Connections Gas 2 10 CO balanced Gas 1 5 5 95 CO 20 Ox balanced Fig 2 13 Gas connections Connections for gas tubing are located in
68. the display of measured pH PCO and PO and one of the calculated values for details please refer to chapter 8 section Settings Display and printout of the results COUHDITIOHIHG 7 482 PCO2 41 6 FOZ 96 9 BE 4 8 Edit Fatient data 7 On completion of the measurement the results are displayed and printed out and a gas conditioning is started As soon as the countdown reaches 20 seconds an asterisk 020 appears to indicate that the flap can now be opened for further measurement max 4 times before the end of the conditioning cycle is reached If the flap is not opened before completion of the countdown the analyzer returns to Fead and the display will read as follows READY lr z22 For measurement open the flar User Programs Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 3 4 Patient Testing Capillary or Microsampler Measurement 4 4 Before a measurement can be performed the analyzer must be in the FEAL mode Fig 4 3 Capillary measurement READY Far measurement aken Lhe flar Iser Fraodramz Open the flap Tad e Tei Press when HSFiratLiar 7 is indicated Carefully insert the capillary into the fill port NOTE At least 55ul sample volume is required If under Settings the function Mini sample was activated the following display appears MEASUREMENT Sample iz SSFirated Mini sample
69. the lower right corner of the rear panel 2 10 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 Description of the Analyzer Power Switch Module Fuses Power Switch Power Input Fig 2 14 Power switch module This module consists of a power switch power input fuses and a power line filter Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 11 2 Description of the Analyzer Operator Interface Display Keypad The display helps you to operate the analyzer When the unit is ready for measurement the display reads as follows READY 1 For measurement open the flar User Programs mu um mu un First line current status of the analyzer actual time Second and third line display instructions alarms and measuring values Fourth line indicates user programs and questions selection activation and data input The keypad in conjunction with the display provides control of all analyzer functions Keys Function Data input activates user programs confirms completes data YES answers indicated questions input confirms indicated values negates indicated questions selects next function negates indicated questions input of time date s selects previous function input time date interrupts the program sequence interrupts all actions exits user programs jumps to previous menu aborts data input 3 9 e
70. the stored values CV SD x 100 M 130 number measured value date of the measurement 132 133 137 140 142 145 157 2 3 4 5 6 Ji 8 9 Graphic chart of measured values concerning mean value X and standard deviation s in accordance with the insert mS mean value X 1 2 3 standard deviation s lt R 1 value is 2s below the mean value 2 value is 15 below the mean value es 3 value is 1s below the mean value Levey 4 value 15 15 more than the mean value Jennings Sines 5 value is 2s more than the mean value diagram 6 value is 2s more than the mean value pi 7 value is 3s more than the mean value HO 8 the measured value is out of the target range SPER the measured value is within the target range EA the measured value is out of the target range Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 11 12 Appendix If the AVL Multirules are ON the following characters are printed at the end of the report X out of control o k warning For activation of the AVL Multirules please refer to chapter 8 Settings section AVL Multirule For details about the function AVL Multirule please refer to page 12 15 Parameters and Equations 12 12 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix mV Report NOTE Necessary only for AVL customer support ere A EEG qo
71. 00 mmol l SO O2sat uiu 100 ctO O2cont 56 1 AaDO 742 mmHg cH 10 20 2 1000 nmol l AaDO secs 742 mmHg 0 1 6 0 mmol l PO Quse 742 mmHg PCO 0 soe 200 mmHg pH MAN 8 Shunt su 100 Printout Interface Gas Supply Calibration Gas 1 Calibration Gas 2 Admissible pressure Sample Data 20 96 O 5 5 CO balanced built in thermal printer 2x RS 232 9 pin SUBMIN D F 1x RS 232 25 pin SUBMIN D F 0 03 absolute 10 CO balanced N 0 03 absolute 3 4 bar 43 5 58 psi Sample media Sample input via Sample volume Measurement Data blood serum plasma for pH only AVL approved quality control materials syringe capillary Microsampler 255 ul capillary mode 60 ul Mini sample in capillary mode limitation by contact path 25 55 ul microsample in capillary mode Units Sample rate capillary mode 12 2 SI conventional up to 32 samples per hour with interruption of conditioning 1P recalibration up to 28 samples per hour without interruption of conditioning Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Temperature Humidity Ambient temperature Measuring chamber temperature Relative humidity Electrical Supply 15 C 32 C 59 F 89 6 F 37 C 0 1 C 98 6 F 0 18 F 20 90 Voltage range Frequency Power consumption max Classification Safety c
72. 09 7 437 7 430 0 010 Syringe 7 091 7 070 0 005 7 485 7 480 0 009 Capillary 7 087 7 071 0 006 7 480 7 477 0 010 Mini Sample 7 088 7 088 0 010 7 479 7 478 0 009 Micro Sample 7 087 7 088 0 012 7 479 7 480 0 005 Total 7 088 7 080 0 009 7 481 7478 0 008 Syringe 7 204 7 190 0 009 Capillary 7 202 7 191 0 009 Mini Sample 7 206 7 198 0 004 Micro Sample 7 203 7 197 0 008 Total 7 204 7 194 0 008 Syringe 7 308 7 285 0 013 Capillary 7 303 7 285 0 014 Mini Sample 7 301 7 290 0 012 Micro Sample 7 301 7 284 0 015 Total 7 303 7 286 0 013 Syringe 7 327 7 302 0 008 Capillary 7 329 7 304 0 007 Mini Sample 7 327 7 307 0 011 Micro Sample 7 325 7 309 0 006 Total 7 327 7 305 0 008 12 56 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Linearity of pH PCO and in Tonometered Whole Blood PH vs Expected 8 000 4 7 800 4 7 600 4 7400 4 COMPACT 3 pH 7 200 4 7 000 4 6 800 t i 6300 7000 7 200 7400 7 600 7 800 8000 Expected pH PCO vs Expected 1400 120 0 100 0 COMPACT 3 PCO mmHg 20 0 0 0 t t t t 0 0 20 0 40 0 60 0 30 0 100 0 120 0 140 0 Expected PCO mmHg PO vs Expected 600 0 500 0 400 0 300 0 200 0 COMPACT 3 PO mmHg 100 0 00 00 100 0 200 0 300 0 400 0 500 0 600 0 Expected PO mmHg Fig 12 39 Linearity of pH PCOz and in tonometer
73. 1 Interface Interface Test Note In certain cases the following signs are transmitted instead of measured values or calculated values Physiological range is activated value within out of limit TT Measured value out of range high limit Measured value of range low limit Electrode signal is out of range low limit gt gt gt gt gt Electrode signal is out of range high limit mE TE No calculation possible e g one electrode not calibrated ais SS a Electrode not calibrated Connect Pin 2 and Pin 3 of the standard interface COM 1 by a wire strap Activate User Programs ixA tor System test 2x NV Interface YES The following display appears USER PROGRAMS zt Interface error Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface Connection Cable AVL COMPACT 3 PC Terminal Printer COM 1 COM 2 COM 3 AVL COMPACT 3 Connection Cable 1 1 RxD 2 2 TxD 3 3 4 4 GND 5 5 6 6 7 7 8 8 9 9 F M PC Host or Printer Ticket printer Barcode PC Host or Printer Ticket printer Datalink ISE Datalink Oximeter PC Host or Printer Ticket printer Datalink ISE Datalink Oximeter Modem Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 ve 0 Interface parameters selectable Interface parameters selectable Interface parameters fixed Int
74. 11 No 13 Baro 723 A 155 Temp 37 0 pH 7 208 PCO2 16 9 BE BEecf BB HC03 P02 129 6 02sat l values 12 4 mmHg mmo mmo I mmo mmo mmHg 96 header patient data actual date time sample number air pressure input values measured parameter calculated parameter measured parameter calculated parameter operator identity Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Report with Patient Related Data AVL COMPACT 3 BLOOD GAS ACID BASE REPORT Pat Age 36 Pat no 18 Sample CAPILLARY Cap Th 04 Jul 96 15 No 30 Baro 724 t Hb A 1 5 Temp 37 0 38 pH 7 200 7 184 PCO2 17 0 17 9 mmHg BE 19 mmol BEecf 19 mmo BB 28 mmol HC03 6 mmol P02 12 0 3 133 mmHg 02sat 97 96 Op ID lnput values 12 Appendix For example Age xou 36 years Sex female Pat individual number max 10 digits Sample occiso Capillary Sample Type cap capillary Day of the week date month year hour minute TERR Sample Number Bateau actual air pressure mmHg total hemoglobin g dL A adult fp soe patient temperature C 37 0 C standard temp 38 2 C patient related temperature p Hisce ds value at standard temperature value at 38 2 C Pi 02 9 5 value mmHg at 37 C value
75. 11 14 The Datalink allows the AVL 9180 to be connected via interface to the AVL COMPACT 3 and convey the respective measurement data The connection of the different instruments is possible due to the built in interface in the AVL 9180 NOTE Please see that the connection takes place before the instruments are turned on Use the proper interface cable BV1812 for the connection to the COM 2 of the AVL COMPACT 3 or BV1815 for the connection to the COM 3 of the AVL COMPACT 3 on the right side back of the analyzer Pin 2 TxD transmit data Pid RED eus receive data Pin 7 GND signal ground 9600 baud standard 8 Data bits 1 Stop bit ASCII code no Parity The AVL 9180 sends Control G Hex 07 The AVL COMPACT 3 responds with Control F Hex 06 logical 1 12 3 V logical 0 3 12 V max cable length 3m Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface Software Report Transfer of Report Data Installation of the Units When the Datalink to the AVL COMPACT 3 is activated and the AVL 9180 has completed measurement it sends a BEL Hex 07 to signal the AVL COMPACT 3 that a datalink report is ready to be transmitted The AVL COMPACT 3 answers with a ACK Hex 06 to receive the datalink report If the AVL COMPACT 3 does not answer the BEL the AVL 9180 sends a further signal every 10 seconds If
76. 12 13 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 11 12 13 name of the electrodes mean value of Gas 1 value describes the shape of the curve for the tendency to set more than one number means an extension of the measuring time strict 1 monotonic flat 2 monotonic 3 not monotonic sample value mV number of artifacts 0 standard deviation predetermined value calculation of the sample values mV kind of predetermination 0 and standard deviation of the predetermination shape of the curve flat passing over to flat 2 steep 9 not exponential Tau tendency to set of the measuring signal time for filling during measurements buffer calibration 12 13 12 Appendix Datalink 12 14 This printout shows the results of the AVL COMPACT 3 and with datalink connected devices AVL COMPACT 3 BLOOD GAS ACID BASE REPORT Pat Age Pat No Sample CAPILLARY Th 04 Jul 96 13 11 No 13 Baro 723 t Hb A 15 Temp 37 0 pH 7 208 PCO2 16 9 mmHg BE 1 BEecf mmo BB mmol HC03 5 mmo P02 129 6 mmHg Ex OXI DATA Fd 0 4 22 CO Wor c AVL 988 3 ELECTROLYTE ISE NA K CA 04 96 11 46 SAMPLE SERUM NO 157 105 0MMOL L K 1 96MMOL L 7 4 2 56MMOL L 1 values results of the AVL COMPACT 3 measurement results of th
77. 2 P pump speed 2 Q dad J Vacuum pump A REF pump J UP DOWN x LER one PP bypass Valve Buffer 1 V J V4 Gas A V5 air V6 vacuum V7 water V8 MC bypass V9 MC valve V10 REF valve GV1 Gas valve UP DOWN GV2 Gas valve V11 Buffer2 V12 Cleaning 3 J f x f CH102 as _ J CH2CO2 A CH3 pH CH 4 Barometer CH 5 MC Temp CH 6 SP Temp CH7 ADC Ref CH 8 AGND CH9KI K0 UP DOWN CH 10 K Ref CH 11 Waste CH 12 Rinse CH 13 Ref CH 14 AGND CH 15 NC J C M X Display test Ke A P UP DOWN a ED Printer test C UP DOWN v TN Program version A UP DOWN v N Autom selftest M 2 UP DOWN v 3 _ 4 B YES d 5 Service gt Code xxx KY M 22 Vv 10 13 10 Troubleshooting Electrodes 10 14 Activate User programs Bx v tor lx AN3 Lem Lest YES TE The following system test functions are available Electrodes Contact Path Interfaces Pumps Valves ADC Display Printer Program Version Autom Selftest Service These functions are for use by AVL customer support For details please refer to the Service Manual or your local AVL representative To abort or to exit this test program press This will put the system into READY mode This test program allows the user to check the electrode voltages Electrodes 7 Confirm by pressing YES Press
78. 60 g L 1 0 g L 0 7 to 16 1 mmol L 10 01 mmol L Hemoglobin type adult or fetal P50 adult 15 to 40 mmHg 10 1 mmHg 2 0 to 5 33 kPa 10 01 P50 fetal 10 to 40 mmHg 0 1 mmHg 1 34 to 5 33 kPa 10 01 Respiratory Quotient 0 71 to 1 99 10 01 Fraction of Inspired Oxygen FIO 0 11 to 0 99 0 01 Patient number 0 to 9999999999 Patient age 0 to 99 years 1 year Patient sex Parameter male or female Range Display Resolution Actual Bicarbonate HCOy 1 to 100 mmol L mmol L 0 1 0 1 mmol L 0 1 Base Excess BE 40 to 40 mmol L Base Excess ecf BE 40 to 40 mmol L mmol L Base Excess at actual oxygen saturation BE 40 to 40 mmol L 0 1 mmol L Total 1 to 100 mmol L 0 1 mmol L Standard HCO st 1 to 100 mmol L 0 1 mmol L Bicarbonate Standard pH pH 6 5 to 8 0 0 001 pH units Hydrogen ion cH concentration 10 to 1000 nmol L 0 1 nmol L Functional Oxygen SO 0 to 100 0 1 saturation Oxygen content cto 0 to 56 mL dL 0 1 mL dL Alveolar arterial oxygen partial AaDO 0 to 742 mmHg 0 1 mmHg pressure difference Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Types of Calibration Quality Control Method Sheet Parameter Range Display Resolution Standardized ionized Calcium at Datalink with niCa 6 0 mmol L 0 1mmol L AVL 988 3 pH 7 4 at patient PO NT 742 mmHg 0 1 mmol L temp
79. 9 Peristaltic pump failure Call AVL customer support Sample detection contact 1 faulty Call AVL customer support Check meas Vacuum system leaky Screw on cap of waste bottle tight Path Check quad ring inside the waste cap Sample path clogged If an external waste container is present optional The back pressure valve in the cover possibly leaks Vacuum pump defective Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 See page 10 9 Activate Maintenance Wash or Maintenance lac Cleaning Check back pressure valve see chapter 12 Appendix section Options External Waste Container Call AVL customer support 10 Troubleshooting Error Messages Possible Cause Instructions for Elimination Gas 14 Gas cylinder empty Gas cylinder valve closed Gas path leaky PO Electrode defective Check gas pressure If necessary replace gas cylinder Check gas path Open gas cylinder valve Check gas supply and sample path for leaks Check Electrode Check Waste Dispose or empty the bottle If an external waste container is present optional a waste container with a fill level exceeding 80 Reinstall and insure the seal tight Press to confirm Haste empta Discard the external waste container exceeding 80 Ho Cleaning Bottle
80. 998 4 UP DOWN Password Password o k YES Measurement o k code 1 ON OFF ON OFF WN v ic Password Device lock siii code 1 ae UP DOWN Main cal report 9 report 5 YES mV report Report Report editor Comment Multirule 2 meas reports BE P DOWN SPD Shunt AaDO2 cH O2cont O2sat st pH st HCO3 TCO2 HCO3 BB BEecf UP DOWN BEact Mini sample ON OFF 8 1 8 System Functions 8 2 Activate User Programs eLLingds Sx NV YES This program allows you to specify the following settings e Manual Standby e Automatic Standby e Timings e Parameters e Language e Interface e Password e Device Lock e Report e Display e Mini sample Activates deactivates the economy standby mode The timetable for the economy standby mode can be programmed Sets date time calibration intervals and extended wash dry time Programs default parameters valid for the measurement Selects between two possible languages Programs the interface Activation of the AVL COMPACT 3 by authorized persons Access to analyzer is totally blocked Activates deactivates the print out of pH report mV report AVL Multirule Comment Activates deactivates the report editor Selects the fourth calculated value shown on the display During the measurement the question Mini sample appears on th
81. AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions USER PROGRAMS FOZ B 288 mmHa Phasis pange ok 7 The first value is blinking the displayed value may be varied with the numeric keypad Confirm the desired value by pressing The second value is blinking the displayed value may be decreased 1 by pressing Confirm the desired value by pressing NOTE If the physiological range is activated any additional information is printed on the report Flagging of the measured value At this point you may select another parameter by pressing or exit this program by pressing Esc Language With this function you can select the language to be used by your AVL COMPACT 3 in its displays and printouts Activate Settings adu Language For example LISER PROGRAMS english deutsch Languade ok 7 The activated language is blinking Switch between enlish and deutsch by pressing Nw A Activate the blinking selection by pressing YES At this point you may select another parameter by pressing or A or exit this program by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 13 8 System Functions Interface COM 1 8 14 This function allows to set the interface protocol definition for data transfer Activate Settings Sx NV Interface YES The following display appears USER PROGRAMS OH OFF COM 4 o k 7
82. AVL COMPACT 3 Rev 2 0 June 1998 13 1 13 Preanalytical Requirements for Blood Gas Analysis Sampling Procedures Sampling Devices Syringe Capillary AVL Microsampler 13 2 Syringe Capillary AVL Microsampler For arterial blood samples glass syringes with easily movable glass or metal plungers are traditionally used These guarantee that the gas exchange with ambient air and the resulting change in blood gas values remains negligible Recently syringes made from polymeric materials have also been used Before using these syringes their suitability for blood gas analysis will have to be established and or guaranteed by the manufacturer since certain plastic materials show significant permeability and solubility regarding oxygen and CO A change of the PO and PCO values in the sampling container caused by diffusion through the syringe walls would be the result Capillary blood sampling is usually performed using glass capillaries The capillary effect causes the sample to automatically flow from the puncture site into the capillary Use only capillaries with thin even layers of heparin on the inside We recommend AVL glass capillaries 250 pcs package heparinized Recently capillaries made from polymeric materials are also being used These are acceptable if testing has established that the solubility and permeability of the material with regard to gases see plastic syringes is sufficiently low To facil
83. AVL COMPACT 3 Rev 2 0 June 1998 15 Method Sheet Reference Interval Laboratory normal ranges for arterial carbon dioxide tension PaCO and pH are well documented and widely accepted Parameter Mean 2SD pH 7 40 7 35 7 45 mmHg 40 35 45 Arterial oxygen tension PaO is dependent upon the inspired oxygen tension as well as various physiologic variables and the administration of oxygen is common in the treatment of patients in need of blood gas analysis Hypoxemia is defined as an arterial PO below an acceptable range while breathing room air with about 21 oxygen at sea level Increasing altitudes above sea level will produce lower inspired oxygen tensions and therefore lower arterial PO values Below are listed acceptable arterial oxygen tensions at sea level while breathing room air PaO Adult and Child Normal 97 mmHg Acceptable range gt 80 mmHg Hypoxemia lt 80 mmHg Newborn Acceptable range 40 70 mm Hg Aged Acceptable range 60 years old gt 80 mmHg 70 years old gt 70 mmHg 80 years old gt 60 mmHg 90 years old gt 50 mmHg Each laboratory should establish its own reference interval for pH PCO PO as performed on the AVL COMPACT 3 Analyzer and at their laboratory altitude Shapiro BA Harrison RA Cane RD Kozlowski Templin R Clinical Application of Blood Gases 4th ed Chicago Year Bood Medical Publishers Inc 1991 pp 79 83 Operator s Manual AVL CO
84. Avoid vibrations use a solid surface Allow sufficient space at least 20 cm 8 Inch minimum around the analyzer for air circulation and electrical supply In the AVL COMPACT 3 analyzer relief clamps are inserted under the solenoid valves to prevent tube damage Before installing the analyzer remove the relief clamps and reinsert it during shutdown procedure NOTE Do not forget to remove the relief clamps otherwise no proper start up operation will occur The clamps designed for this purpose can easily be removed by lifting the solenoid fixtures Slightly pull the armature of the valves when removing the relief clamps Take care for the solenoid valve relief clamps you will need it for a possible later shutdown Open the cover of the analyzer to gain access to the solenoid valves relief clamps Six of them V3 V4 V5 V7 V11 V12 are located to the right of the measuring chamber see Fig 3 1 one to the right of the peristaltic pump see Fig 3 2 Open the bottle compartment cover transparent gray plastic and remove the three solenoid valve red relief clamps from the solenoid valves V6 V8 V10 in the bottle compartment see Fig 3 3 Fig 3 1 Solenoid valve relief clamps fill module Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 Installation Shutdown WASCHWASSE Fig 3 3 Solenoid valve relief clamps bottle compartment Peristaltic Pump Tube Fig 3 4 Peristaltic pump tubes
85. Buffer Type 1 and Buffer Type 2 will be measured in series for max 4 times every 12 hours Gas 2P calibration The analyzer performs a 2P calibration with Gas 1 and Gas 2 for the PO and PCO Electrode The analyzer performs pH 1P calibration with Buffer Type 1 This calibration can be programmed every 30 minutes or one hour fixed or drift dependent every 1 2 or 3 hours flexible For details please refer to chapter 8 Settings section Timings pH Calibration Interval A Gas 1P calibration will be performed in a time period of 3 5 minutes during standby mode and during READ Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 6 1 6 Calibration Conditioning To get READY the electrodes have to be conditioned with Gas There are two kinds of conditioning with Gas e interruptible after measurements e non interruptible after all actions which have influenced the measuring path Depending on the kind of action performed before the analyzer performs the corresponding conditioning The conditioning that can be interrupted is signaled by an asterisk in the right upper corner of the display When the asterisk appears the recalibration can be interrupted max 4 times in running for a measurement Operator Initiated Calibrations Main Calibration 6 2 All calibrations can also be initiated manually by the operator Activate User Programs 2x NV Calibrations YES Main calibration pH 2P calib
86. C Statistics dee to ese Eee ure te ede es d Te 12 11 ud M 12 13 IbriEW dq 12 14 Parameters and Equations ee Po ep ae open ea consosesonsccasssessasesaveceved costes sosevcdececesse 12 15 AVL Multirule QC Procedure eiusd Iud else ieri IR iD ede urb 12 15 Overview of AVL Multirules eed rm Rire Re REEF ERR ERE EROR RES PR RENTRER MERE KERN HM 12 15 shunt Parameters sevo E one NT Re te Ree tances Dee EE Ne 12 17 Requirements EISE A DE EEUU ERIS 12 18 Conversion of Unit scc RU Nr rs e E ORTU e ERE OR PU wae E eR PNE ERE 12 19 Temperature t itm tpe ER Re SR EROR SER Ebr EC epa E tee gebe t pee e EDEN coat 12 19 Default Values deest tero etse veles hee Cone aue ct UO Sape vt beo Cexut otto neat ba AER NES aue 12 19 Calculated Values tete exei ed sera EUR eee ve ER Re Ve Gouda V Eee Feu EON gue o Ese eei e ER ore 12 20 IR 12 21 Hydrogen Ion Concentration CH 12 21 Bicarbonate erc bare ca ere ee e ee eter d Sethe Lore esse os 12 21 Total COz1m Plasma 6 Og sick oo eiae ted et is da e Ma v Ee ORE LAN wt ve Rue ERE UAR IS Gees tet 12 21 Bas
87. DY The PO PCO and pH parameters can be chosen and measured individually according to the order of the electrodes in the measuring chamber NOTE The PO2 measurement begins immediately after a micro sample has been detected in this case the sample is properly positioned as a result of the defined minimum volume and the sample is then either disregarded or measured depending on the chosen variation If a parameter PCO or PO is chosen with the operator must position the sample by pressing AL over the desired sample The sensor must be completely covered by the sample Press to confirm the actual measurement If the parameter is in alarm this particular parameter cannot be selected and is automatically passed without appearing on the display The micro sample measurement is shown as MICRO on the display Procedure I mu READY 1 For measurement open the flar User Programs Open the flap Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing MEASUREMENT Inject zamrle ar Select aspiration HzrFiration Press when ASPIRATION is shown on the display The sample will be aspirated A micro sample measurement is automatically performed when the sample volume is less than 55 ul If the sample is greater than 25 ul the following appears on the display Remove carillaru close the flar Micro samplet Close the flap and
88. Data input Patient number The operator identification OP ID can only be read in with the barcode scanner during the READ mode Details pertaining to the use of password code cards can be found in chapter 8 Settings section Password Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 11 4 Patient Testing Parameter and Data Input Parameter Input During and after a measurement the user may enter or reset various parameters and patient related data e g the patient temperature This can be done only for the current measurement If a barcode scanner is installed it is possible to scan in the patient number during measurement from sample stop up to reaching READ as well as during the function Data input Patient number Further it is possible to scan in the OP ID before a measurement before the flap will be opened Standard values e g the patient s temperature FIO etc are default settings which may be modified if necessary The input of patient related and sample specific data overwrites the preset default values for the current measurement The data input is possible during measurement or immediately thereafter as long as the results are displayed During the measurement Parameterz input 7 Press Select the desired parameter with or A and confirm by pressing YES After the measurement COHDITIOHIHG aol 482 PCOS 41 6 Pie Shea s 4 8 Edit Fatien
89. E 2 5 Description of the Sample 2 6 INNO ENT EIE 2 6 Sample Inlet Paths o eet Rieti bn ised eroe Cui Nee Ut os Que ceo ut Der eu doe te Oe 2 6 Measuring Capillary ierosin eret Guedes e oec rte Doe carere sence PEE dete s e Ee pE soe ER PE RE dne 2 6 M as ring Chamber Valve et E EO ee EH Y SM rese etse 2 6 Measuring Chamber deste odes Arte ree Poe ia iie E aiT pa SPEC PR 2 7 Measuring Capillary oseon dieto ooi tree e e ue ro e reote 2 7 Measuring Chamber nai ee P Ente ti pus 2 8 Measuring Chamber Valves oec trees vor TIU exa cn e e pto ecoute PEE 2 8 Electtod6es oo dett P RR ER CE wien same DE toS CERES E ORC Ese HER pened Evo 2 8 Peristaltic Pumps ioi ode b RE er neni teens boa etui stood emule daw ado tes dee dide tease 2 8 Rear Panel EL 2 9 e UM 2 10 Gas Connection S xir erp REPERI EPI ade EI SR SERRE RR 2 10 Powe r Switch Module ope ven ene aee UNE e eoe y uxo beens teed Deeper tee cep eye a 2 11 Operator Interface sic ciciscciessseescescsen cess sewesscccsesscessavsaedseeeese seu edensdcescsecssseueesdsedaessesseensdssaese 2 12 IDEA M LLLI 2 12 SAQUE 2 12
90. June 1998 9 Maintenance Fig 9 10 O ring pH Reference Electrode Remove plastic protection cover and install a new pH Reference Electrode housing Fig 9 11 pH Reference Electrode housing Activate the automatic filling function User Programs Maintenance Ref electrode Fill electrode Sx Nw to fill the new pH Reference Electrode housing and remove air bubbles Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance Remembranable pH Blood Gas Electrodes Fig 9 12 Remembranable pH Blood Gas Electrode This electrodes require periodical checks and maintenance like replacement of electrode housing and cleaning NOTE The user program System test and Electrodes for example must be activated before performing the cleaning cycle so that the analyzer will not detect a measurement sample when the flap is opened This program can only be terminated by pressing and does not have a timeout function Check electrolyte levels of remembranable PCO and PO Electrodes Fig 9 13 Electrode check 1 Electrode Remove the electrodes from the measuring chamber block by lifting the corresponding clips and carefully pulling the electrodes towards the rear 9 16 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance Fig 9 14 Electrode Check 2 Electrode Hold the electrode with the tip downwards Gently ta
91. MPACT 3 Rev 2 0 June 1998 Method Sheet Specific Performance Characteristics All performance data in this section was generated on AVL COMPACT pH Blood Gas systems with default calibration frequencies continuous point gas calibration 1 point pH calibration at 1 2 or 3 hour intervals determined automatically by the instrument based on calibration drift and complete 2 point calibration every 12 hours and without any correlation factors The operating environment during the collection of this data was typical varying from 22 to 26 C 70 to 80 F Limitations The performance characteristics are affected by the following sample considerations The preferred test liquid is whole human blood for all parameters It is necessary to tonometer blood to obtain values to evaluate accuracy of PO and PCO because patient samples must be considered to be unknown Tonometry of blood introduces potential errors unrelated to the blood gas system being evaluated including accuracy of the gas values used temperature control and thermostatting of the tonometer humidification of the tonometry gases duration of tonometry and transfer of the sample from the tonometer to the instrument for analysis pH of blood cannot be predicted in tonometry All tonometered samples analyzed in these studies were analyzed in duplicate on an AVL 995 to establish correlation Precision of PO and PCO measurement as well as pH was evaluated over a 20 day period u
92. OMPACT 3 Rev 2 0 June 1998 5 Quality Control LISER PROGRAMS Level i Erase 0 values By pressing the stored QC data values date lot number expiration date default QC limits will be deleted If no new QC data will be entered confirm by pressing USER FROGRAMNS Lewel i Fos 7 By pressing or A you may now select PO PCO or pH Confirm the selected parameter by pressing USER PROGRAMS FOZ 151 147 mmHa GC Leusl 1 o k 7 Enter the correct range using the numeric keypad Press to confirm the correct value Press or A to select the ranges for and pH too Repeat operation for these parameters as described for PO If the lot number the expiration date and the target ranges for Level 1 are set correctly press twice to get the following display USER PROGRAMS QC Level 1 7 GC new lot At this point you may now select Level 2 and Level 3 by pressing or A Repeat operations as described for Level 1 At the end of the procedure press to return to the previous menu Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 5 5 Quality Control 5 6 Following QC target ranges are set according to standards Level Electrode Range PO 131 147 mmHg Level 1 PCO Ies 21 mmHg pH 7 18 7 24 PO 98 114 mmHg Level 2 PCO 35 ds 4 mmHg pH 7 37 7 43 PO 3 is 86 mmHg Level 3 PCO 61 5 69 mmHg pH 7 59 7 65
93. Operator s Manual AVL COMPACT 3 PH Bloodgas Analyzer CH3581 Rev 2 0 June 1998 Manufactured by AVL LIST GmbH MEDIZINTECHNIK Hans List Platz 1 8020 Graz Austria Distributed by AVL MEDICAL INSTRUMENTS AG StettemerstraDe 28 8207 Schaffhausen Switzerland AVL MEDIZINTECHNIK GMBH Norsk Data StraBe 1 Postfach 1142 61281 Bad Homburg Germany AVL LIST GmbH MEDIZINTECHNIK Hans List Platz 1 8020 Graz Austria AVL SCIENTIFIC CORPORATION Roswell GA 30077 USA Local AVL representative Copyright 1998 AVL List GmbH all rights reserved The contents of this document may not be reproduced in any form or communicated to any third party without the prior written consent of AVL While every effort is made to ensure its correctness AVL assumes no responsibility for errors or omissions which may occur in this document Subject to change without notice First Edition 17 Juli 1996 Important Information Important Information This Operator s Manual contains important warnings and safety instructions to be observed by the user This instrument is only intended for one area of application which is described in the instructions The most important prerequisites for application operation and safety are explained to ensure smooth operation No warranty or liability claims will be covered if the instrument is applied in areas other than those described or if the necessary prerequisites and
94. POS ese sese edente bees e qe 1 2 Handling the Analyzer scccscscssssscsscsceesscccescceeessesscceesceesesssesccesenseeescesesceesessesesceesesseeeeees 1 3 Location Shee be sede bene tet one cove vende vata 1 3 General Information 33 nee E rer RE T EEUU EE ERR SEA YN RUE ous 1 3 Handling Blood and Blood Products eee eee eese eee essen eene nennen sehn ennt nete tss 1 3 Hygienic Handling of eme Ie e en He me mee 1 3 Handling AVL Reagents ecce ecce esee eese eene eene eene etna sheath esse ss se sese thes sestas esee sn 1 4 PRECAUTION P M 1 4 Storage c IEEE 1 4 Decontamimation P 1 5 M EE 1 5 AME DepIrotetniZeE oe rur eer eod DOSE eg tee pereo ene ber eae ope ek 1 5 Disinfectant es sce Pre ER RR ase DR RR PI RA e TR UR ERREUR PRA ONE RE ERR ER PE UE 1 6 Fill pott afeas ye ete ng tenes he ete eee uere x dev eee 1 6 Sample anii e 1 6 e Rer E eL DE Pian dec ER de E odin A el eet Uae 1 6 oe otto tr e o eR e Ua E Eve Pe t E E Cox NOR UE PORE MORE
95. R barcode scanner the active scanning unit of the barcode scanner does not light red after being connected For further information about installation please refer to chapter 11 Interface Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 15 8 System Functions COM 2 COM 3 Activate USER PROGRANS OH COM 4 o k 7 or blinks Choose GH and confirm with The following display appears USER PROGRAMS COM 1 Mode Confirm by pressing By pressing 2 times the following is shown on the display USER PROGRAMS Barcode Hode ok 7 Confirm the selection by pressing YES Now the barcode scanner function is activated At this point it is possible to scan in a patient number with the barcode scanner during measurement from sample stop up to reaching FEAD as well as in the Data Input Patient Number function The operator identification OP ID can only be read in with the barcode scanner during the FEAD condition Now you can select another option PC Host Printer by pressing A or leave the program by pressing twice The following description is valid for both interfaces The following display will appear USER PROGRAMS OH OFF COM 2 a k 7 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions OH OFF is blinking Select either OH or OFF by pressing Nv A Activate the blinking symbol by p
96. R sega PRAES De 17 Precision and Linearity ee ede ge tea de dbe Rete 20 Precision and Recovery on Whole eee me ee mense he se he serene nennen 21 Correlation to Other Methods ere re USE uersu eot eee dese ree Dee eo doen 23 Precision of Measurement in Whole eee ene ne he he nenne hene rentrer ene 23 lilginpirjPCPP E M sete iescsces sceacsessctdscessadatebescbiusehsacscdesseadscsscscstuseses 26 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Intended Use Method Sheet The AVL COMPACT 3 pH Blood Gas Analyzer is intended to be used for the measurement of pH PCO and PO in samples of whole blood Clinical Significance pH The pH value of the blood serum or plasma be the single most valuable factor in the evaluation of the acid base status of a patient The pH value is an indicator of the balance between the buffer blood renal kidney and respiratory lung systems and one of the most tightly controlled parameters in the body The causes of abnormal blood pH values are generally classified as a primary bicarbonate deficit metabolic acidosis b primary bicarbonate excess metabolic alkalosis c primary hypoventilation respiratory acidosis d primary hyperventilation
97. Repeat this procedure until the code is correct INTERFACE Press YES to activate the interface INTERFACE ON The analyzer confirms activation for approximately 2 seconds The following display appears SERVICECODE Press YES until the following display appears PROGRAMMING Press YES to confirm Press i NO until the following display appears DATA LINK Press YES to confirm DATA LINK ON Press YES until the following display appears NA CL READY Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface In addition activate the interface of the AVL COMPACT 3 In this data system the measurement values of the AVL 988 3 and the AVL COMPACT 3 will be transferred together and printed with the results of the blood analysis With the necessary help program see Operator s Manual AVL 988 3 chapter 3 4 Printer Handling the results can also be printed parallel by the AVL 988 3 if desired NOTE In the case of the parameter combination NA K CA the Ca value from the data system is calculated from the pH value of the standardized Ca value from the AVL COMPACT 3 at pH 7 4 and is printed on the AVL COMPACT 3 11 13 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface AVL COMPACT 3 to AVL 9180 Description of the Interface AVL 9180 Baud Rate Transmission Format Controlling the Datalink Signal Level
98. SER FROGRAMNS Interface SIGMA By pressing you may select COM 2 or COM 3 The following display appears if you have selected COM 2 PROGRAMS Interface COM 2 7 Press to confirm USER FROGRAMNS OH OFF m OE Select OM and confirm by pressing YES USER FROGRAMNS 2 Mode 7 Select the interface by pressing NV Or A and confirm with ES USER FPROGRAMS Datalink 9 Mode o k 7 11 10 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface Select the datalink function by pressing or AL and confirm with YES The datalink is active now You may activate the datalink function on COM 3 in the same way Activating the datalinks on the AVL 988 3 Activate the service code DIL NA CL READY Press YES until following display appears INSTRUMENT TEST Press YES to confirm SPECIAL FUNCTIONS Press YES to confirm ADC TEST Press YES INTERFACE TEST Press YES PROGRAM VERSION Press YES SERVICECODE Press YES to confirm Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 11 11 Interface 11 12 SERVICECODE Press YES to confirm Enter code DIL The first character is blinking With NO select the correct character and confirm by pressing YES The next character is blinking
99. To evaluate calibration measurement and QC data a special software AVL DataComm 2 is available For detailed information about data transfer please refer to chapter 11 Interface AVL intruduces a breakthrough in critical care data management AVL DataComm 2 Designed for the Microsoft Windows operating environment the AVL Datacomm 2 s interface is simple and intuitive You can collect data from as many as eight different analzers in real time The AVL DataComm 2 is designed to meet your lab s existing and future requirements The AVL DataComm 2 is compatible with analyzers from several manufacturers not just ours so it s the most cost effective way to bring critical care data management to your lab Networking and connections to your LIS HIS provide even greater flexibility Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 7 1 7 Operating Principles 7 2 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions 8 SYSTEM FUNCTIONS Manual Stand Dy E siase 8 3 AUTOMATIC Stand p aaa ee aps 8 4 PAM 8 5 Date and Tame 8 6 pH Calibration Interval ited dane Des Den ine bee Ee UU ans camgenes ebd One Leu s 8 6 Main Calibration Interval
100. VL COMPACT 3 Rev 2 0 June 1998 12 59 12 Appendix External Waste Container In addition to the regular or reusable waste container an external waste container with a fill volume of 4 litres entire volume 5 litres is available Ve tube clamp N i the cover with valve function W B T AVL b Fig 12 42 External waste container Installing the external waste container Connect the tube to the nipple of the adapter of the waste collector Remove the cap from the waste collector Open the bottle compartment cover Screw the waste container cap onto the waste collector Insert the bottle into its socket in the bottle compartment e When placing the tube to exit the bottle compartment bottom right see arrow Fig 12 42a make sure it will not be pinched when the bottle compartment cover is closed e Feed the tube through the tube clamp Attention Do not pinch the tube e Remove the cap from the external waste container e Connect the other end of the tube to the nipple of the cover with valve function Fig 12 42b of the external waste container and screw the cover tight NOTE Place the external waste container on the ground 12 60 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Discarding external waste container At a fill level of 80 4 1 of the total volume the external waste container must be discarded e Close the tube by inserting it in the narrow o
101. age contains 3 ready to use containers with 90 mL each Potassium dihydrogen phosphate 25 0 mmol L Disodium hydrogen phosphate 25 0 mmol L Germicides Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each container label BP0134 For calibration of pH in AVL pH Blood Gas instruments 1 package contains 3 ready to use containers with 90 mL each Potassium chloride 600 mmol L Germicides Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each container label Method Sheet Rinse Cleaning Solution Deproteinizer Order number Use Contents Composition Additives Storage Stability Order number Use Contents Composition Storage Stability Order number Use Contents Composition Storage Stability BP1890 For calibration of pH in AVL pH Blood Gas instruments 1 package contains 6 ready to use containers with 430 mL each Dehydran 241 0 065 g L Dehydol 100 0 0065 g L Germicides Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each package BP1889 For the daily cleaning of the AVL COMPACT 3 measuring system 1 package contains 3 ready to use containers with 90 mL each Sodium bicarbonate 4 1 g L Sodium chloride 2 5 g L Antarox BL344 1 0 g L 2 phenylethanol 0 1 g L Hyamine 1622 0 05 g L Temperature 5 30 C 41 86 F Expiration date and lot
102. aintenance which helps to assure the liability and measurement quality of the analyzer The following maintenance should be performed at the specified intervals If needed maintenance can be performed between recommended periods NOTE AVL zero maintenance electrodes should not be removed for periodic checks Removal and reinsertion may cause damage AVL recommends the following decontamination procedures Decontamination should be performed in accordance with typical laboratory regulations This decontamination should be performed periodically to minimize the risk of infections incl hepatitis virus and HIV The purpose of this procedure is to minimize the risk when replacing items that were in direct contact with blood NOTE Always wear approved protective gloves The following parts of the device have to be decontaminated Daily e Fill port area e Keyboard e Surfaces As needed e Sample path NOTE Use liquid disinfectants only Do not use sprays Composition Aqueous solution of NaOCl containing lt 2 0 active chlorine Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 1 9 Maintenance Disinfectant Fill port area Sample drip tray 9 2 Hazards identification Due to the basic and oxidizing character of the reagent Deproteinizer local irritations after contact with eyes skin or mucous membranes cannot be excluded First aid measures After inhalation fresh air drink plenty of w
103. and will return to the READY screen Flap Decontaminate the inside and outside of the flap with a cloth or gauze pad saturated in disinfectant Procedure 1 Activate User programs lt m 22 m Susten best 7 YES Electrodes YES 2 Open flap 3 Decontaminate the inside and outside of the flap and wait until disinfectant has dried 4 Close flap only after disinfectant has dried completely to avoid damaging the lacquer when reopening the flap 5 Press the key twice upon completion of this maintenance procedure The system performs a washing drying procedure and will return to the READY screen Keyboard Decontaminate the keyboard with a cloth or gauze pad saturated in disinfectant NOTE Decontaminate with damp cloth only using a disinfectant Do not use sprays Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 3 9 Maintenance Surfaces Sample path Measuring chamber 9 4 Decontaminate all outside surfaces and cover with a cloth or gauze pad saturated in disinfectant Cleaning with AVL Deproteinizer should be performed only when the measuring capillary is contaminated protein residue or if components of the measuring path are being replaced Such cleaning process basically interferes with the measuring system and the electrodes They must be conditioned afterwards The decontamination agent is introduced via the fill port If necessary decontaminate the measuring chamber specially
104. at 38 2 C BE iones base excess mmol l uisi base excess of extra cellular fluid BB buffer base erret actual bicarbonate POD value mmHg at standard temp value at 38 2 oxygen saturation Other possible characters nes measured value out of range high limit EU E PUR measured value out of range low limit e edu cu amplifier is out of range low limit PSSS amplifier is of range high limit SEVERE een no calculation is possible qua S ete not calibrated MC Temp measuring chamber temperature over 37 C the analyzer is still ready for measurements but the values are no longer within the specifications Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 5 12 Appendix Calibration Report AVL COMPACT 3 BLOOD GAS CALI BRATION REPORT Main CAL 04 Last 2P CAL G Th 04 Jul 96 13 00 Last pH 2P CAL Th 04 Jul 96 13 00 Last pH 1P CAL CALIBRATION VALUES Cal 1 Cal 2 Slope pH 1250 592 658 PCO2 1236 242 pH 1P calibration 3h Omin next 2P calibration in I1 h 51 min 12 6 date time of the printout of the calibration report information when the last calibration was performed information about the status of the last calibration measured value Buffer Type 1 Buffer Type 2 measured value standardized to normal condition 740 mmHg
105. ategory Instrument type Operation type Protective system Ex protection Dimensions Weight 100 240 V AC self adapting 50 60 Hz typical 65 VA max 110 VA depending on actual operating mode I B following OVE MG EN 60 601 1 IEC 601 1 For continuous operation IP20 The device is not specified for operation inside explosion hazardous areas Width Depth Height Weight Acoustic Noise Level standby ready wash dry measurement Test Certificates 34 cm 13 4 inch 31 5 cm 12 4 inch 34 cm 13 4 inch 13 0 kg 28 7 pounds 28 dbA 28 dbA 60 dbA 43 dbA OVE TUV CSA CE Conformity Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 tested according to the standard EN60601 1 1991 tested according to the standard EN61010 1 1993 1995 NOTE According to the TUV standard only TUV tested pressure regulator and gas cylinder are allowed to be used tested according to the standard C22 2 Nr 151 M1986 The analyzer corresponds to the directive 89 336 EWG EMC directives tested according to the generic standard EN50081 1 and EN00081 2 as well as 73 23 EWG Low Voltage Directive with addition 93 68 EWG tested according to EN61010 1 and is allowed to be labeled with the CE marking 12 3 12 Appendix Description of Various Reports Standard Measurement Report AVL COMPACT 3 BLOOD GAS ACID BASE REPORT Pat Name Age Pat no Sample CAPILLARY Th 04 Jul 96 13
106. ater After skin contact rinse with plenty of water remove contaminated clothes After eye contact rinse with plenty of water consult a doctor If swallowed drink plenty of water avoid vomiting consult a doctor NOTE When Deproteinizer is handled and used properly no ecological problems are to be expected A commercially available alcoholic disinfectant containing aldehyde should be used Please refer to the product description of the surface disinfectant NOTE Do not use the disinfectant for internal decontamination of the sample path For decontamination AVL Deproteinizer is especially recommended You may also use a commercially available alcoholic disinfectant containing aldehyde The sample drip tray prevents contamination of the bottle compartment in case of improper sample introduction Decontaminate a dirty sample drip tray with a cloth or gauze pad saturated in disinfectant Procedure 1 Open bottle compartment cover 2 Pull sample drip tray out 3 Clean and decontaminate or replace it 4 Close bottle compartment cover Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance Fill port Decontaminate fill port with a cloth or gauze pad saturated in disinfectant Procedure 1 Activate User programs Yes amp x Sw Open flap Decontaminate fill port Close flap Press the key twice upon completion of this maintenance procedure The system performs a washing drying procedure
107. ates of reagents have been exceeded Reagents are not used according to AVL s recommendations e The procedures described in this manual are not followed Precaution AVL Deproteinizer contains sodium hypochlorite lt 2 0 active chlorine Do not swallow the solution avoid eyes and skin contact In case of contact wash the affected area with plenty of water In case of eye contact consult a physician as soon as possible Storage Store AVL reagents in accordance with the information displayed on the package label allow reagents to stabilize at ambient temperature before use 1 4 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Decontamination Reagents AVL Deproteinizer 1 Introduction AVL recommends the following decontamination procedures Decontamination should be performed in accordance with typical laboratory regulations This decontamination should be performed periodically to minimize the risk of infections incl hepatitis virus and HIV The purpose of this procedure is to minimize the risk when replacing items that were in direct contact with blood NOTE Always used approved protective gloves The following parts of the device have to be decontaminated Daily e Fill port area e Keyboard e Surfaces As needed e Sample path NOTE Use liquid disinfectants only Do not use sprays Composition Aqueous solution of NaOCl containing lt 2 0 active chlorine Hazards identification Due to
108. ave a minimum volume filled of 115 uL and are ideally suited for use with the AVL COMPACT 3 The AVL capillary tubes for pH and blood gas analysis should not be used for samples taken for the analysis of Lithium Samples may be collected in capillary tubes after warming the area or otherwise stimulating it to promote arterial circulation before the puncture The puncture should be made deeply enough to ensure a free and rapid flow of blood Do not use clay capped capillary tubes as the rough broken edge left when the capillary is cut may cause damage to the AVL COMPACT 3 fill port Use only capillary tubes with fire polished ends to prevent damage to the instrument If a mixing flea is used as required in some capillary tubes take care to remove the flea prior to sample introduction to avoid damage to the AVL COMPACT 3 Specimens collected in capillary tubes are stable at room temperature for up to 30 minutes after collection because of the rapid cooling of the sample accomplished during filling Blood may be collected for analysis on the AVL COMPACT 3 with the AVL Microsampler to provide two filled capillary tubes which may be used for analysis on separate instruments for split sampling for CO Oximetry measurement or for the analysis of electrolytes other than Lithium After collection the AVL Microsampler should be capped and transported in a horizontal position to the instrument for analysis within 30 minutes as with all specimens c
109. bleshooting Fig 10 3 Remove glass splinters 3 If it was possible to remove the glass splinters loosen fixing knob 1 move the measuring chamber block carefully to the right 2 so that it docks with the preheating tube When it fits tightly with the preheating tube secure the measuring chamber by pushing the knob to the correct position Fig 10 4 Remove glass splinters 4 NOTE Make sure that the quad ring between the measuring chamber and the preheating tube is in correct place to allow for a trouble free operation cycle 10 12 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Test Programs sS test Ko YES v f YES Elektrodes ______ Gas 1 internal lt 22 UP DOWN a M Contact paths UP DOWN N Interface UP DOWN f 2 1 2 2 M J UP DOWN C S Gas 2 internal UP DOWN C Gas external IN UP DOWN C Buffer 1 i A 2 UP DOWN Buffer 2 M A 27 UP DOWN 3 gt Probe extern M A 2 UP DOWN o p ltoggle UP DOWN 1 N Wash 8 A Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 This chapter describes various test programs Most of these test programs are to be used by AVL customer support only but some of these test procedures can also be performed by the user oq v VES fp pump speed 1 2
110. by pressing VES Exit this program by pressing 8 22 Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions PH Report mV Report This function allows to activate or deactivate the pH 1P calibration report Activate Settings Bx NV tor 3x AN3 EsrPorL 7 YES Rerort YES LISER PROGRAMS Eerort o k 7 OH is blinking Switch between OH and OFF by pressing Nv or A When you activate the blinking selection by pressing the display will fade out Exit this program by pressing With this function you can activate the printout of electrode voltages which are used for the determination of the measuring values With this mV report you can analyze calibration measuring problems e g drift values out of range etc Activate Settings axy tar Sx YA Esport IVA mi Rerort T USER PROGRAMS OH OFF ml REerort ok 7 or is blinking you can activate the printout of the electrode mV after each calibration cycle for example main calibration pH 1P calibration Conditioning by pressing Confirm by pressing For details please refer to chapter 12 section Description of Various Reports Exit this program by pressing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 23 8 System Functions Report Editor 8 24 This function enables the user to activate standard report ed
111. clinically invalid thereafter For this purpose the sample must be cooled in ice In some laboratories cups filled with ice are being used Immediately after the sample has been drawn it must be completely submerged in ice The sample container should be completely covered with ice With modern blood gas analyzers it is not necessary to warm up the sample before analysis With older models this may be necessary roll the sample container in your hands for a few minutes e Samples in glass capillaries can be stored for at least one hour at room temperature without significant value changes Treatment of Syringe Samples Before Analysis The following steps must be performed before analysis Before analysis the operator must ensure that no blood cell sedimentation occurred in the syringe For this purpose the operator must roll the syringe in his her hands for thorough mixing of the sample Before each analysis the dead space volume of the syringe is discharged onto a gauze pad e Then the sample is injected into the device Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 9 13 Preanalytical Requirements for Blood Gas Analysis Summary Preparation of Puncture Site Anticoagulation Arterial Blood Sampling Syringe Sampling Microsampler Sampling 13 10 Following above procedures will minimize preanalytical influences on the sample This ensures that the measurement values of the blood gas analyzer corres
112. concentrations certified to 0 03 absolute by the manufacturer Expected and observed values for PCO and PO were corrected to 760 mmHg For each tonometered level 10 replicates were run on two AVL COMPACT pH Blood Gas Analyzers PCO Analyte type n Expected Observed S Recovery 1 00 CO syringe 20 59 0 06 90 capillary 20 7 1 6 4 0 07 86 1 50 CO syringe 20 10 7 10 8 0 14 101 capillary 20 10 7 10 6 0 23 99 2 97 CO syringe 20 19 5 19 2 0 16 98 capillary 20 19 5 19 1 0 11 98 4 00 CO syringe 20 28 5 28 7 0 12 101 capillary 20 28 5 28 2 0 19 99 6 00 CO syringe 20 42 8 42 8 0 22 100 capillary 20 42 8 42 7 0 35 100 8 00 CO syringe 20 57 0 575 028 101 capillary 20 57 0 570 0 60 100 10 00 CO syringe 20 71 3 72 1 0 52 101 capillary 20 71 3 72 5 0 19 102 14 00 syringe 20 99 8 100 9 0 45 101 capillary 20 99 8 100 7 0 63 101 18 00 CO syringe 20 128 3 131 1 0 89 102 capillary 20 128 3 129 7 0 55 101 Linearity Number of pairs n 180 slope m y intercept b correlation coefficient r Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 0205 0 0010 0 7408 0 0637 0 9999 21 Method Sheet PO Analyte type n Expected Observed Sur Recovery 293460 syringe 20 209 209 100 capillary 20 209 208 043 99 4 00 syringe 20 28 5
113. de is filled Check permeability of the pH Reference Electrode The permeability of the pH Reference Electrode diaphragm should be tested Carefully touch the electrode tip with a clean dry tissue USER FROGRAMS electrode Check rFermeabilitu Press Check whether a small droplet of pH Reference Solution forms at the electrode tip If no droplet is visible repeat this procedure If again no droplet is visible replace the pH Reference Electrode housing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 13 9 Maintenance 9 14 droplet Fig 9 8 pH Reference Electrode If the droplet has formed wipe it off carefully insert the electrode into the measuring chamber and secure with the clip Exit this program by pressing Replacing the pH Reference Electrode housing Leave the analyzer switched on Do not interrupt a calibration or a measurement Remove the pH Reference Electrode clip leaving the electrode cable and reference solution tubes attached see Fig 9 7 NOTE Use gloves while removing the pH Reference Electrode housing Carefully remove the pH Reference Electrode housing catching any slight spillage of solution in a tissue Dispose of the old electrode housing according to applicable safety regulations or procedures Fig 9 9 Remove pH Reference Electrode housing Replace the electrode O ring if necessary e g if brittle or worn Operator s Manual AVL COMPACT 3 Rev 2 0
114. dix Oxygen Content Cio Standard pH pHs Standard Bicarbonate CHCO351 Oxygen content is the sum of oxygen bound to hemoglobin as O Hb and the amount of oxygen dissolved in the plasma This value is calculated from the measured O Hb and ctHb if available and is estimated from the calculated SO if the measured O5Hb is not available and if the calculation of oxygen saturation is selected The oxygen content of the CO Oximeter does not contain the physical dissolved part and has to be completed With COOX data AVL 912 O ct 0 00314 PO ml dL 15 No COOX data 21 39 c SO 0 00314 PO ml dL 15 for SO see above SO f PO pH P5 a f BE 13 Standard pH of the blood is defined as the pH value of a blood sample which has been equilibrated at 37 C with a gas mixture having a PCO 40 mmHg pH unit 17 pH st 0 8262 0 01296 ctHb 0 006942 Ig 0 025 PCO pH Standard bicarbonate of the blood defined as the plasma bicarbonate concentration in blood which has been equilibrated at 37 C with a gas mixture having a PCO 40 mmHg cHCO s 1 Q PHst 6 022 mmol L 18 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 23 12 Appendix Relative Shunt volume 12 24 Qs The value is the fraction of venous blood that remains unoxygenated after traveling from the right side of the heart to the left side of the heart This fraction inc
115. e membrane is reduced through a series of reactions producing current between the cathode and anode proportionate to the oxygen tension 2 4 4OH Cathode Reaction 4NaCl 40H 4NaOH 4 7 Electrolyte Reaction 4Ag gt 4Ag 4e gt 4ACI 4Ag A4AgCl 4e Anode Reaction The electrons in the initial reaction are supplied by a constant voltage of 0 7 V In this series of equations it is apparent that for the reduction of each oxygen molecule 4 electrons are consumed Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Reagents and Accessories Buffer Type 1 pH 7 383 Buffer Type 2 pH 6 841 Reference Solution Order number Use Contents Composition Additives Storage Stability Order number Use Contents Composition Additives Storage Stability Order number Use Contents Composition Additives Storage Stability Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet BP0136 For calibration of pH in AVL pH Blood Gas instruments 1 package contains 3 ready to use containers with 90 mL each Potassium dihydrogen phosphate 13 619 mmol L Disodium hydrogen phosphate 53 14 mmol L Lithium carbonate 0 25 mmol L Germicides Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each container label BP0137 For calibration of pH in AVL pH Blood Gas instruments 1 pack
116. e of closed not waterproof type Do not operate the instrument in an explosive environment or in the vicinity of explosive anesthetic mixtures containing oxygen or nitrous oxide e The instrument is suitable for continous operation CAUTION The mains plug may be plugged only into a grounded socket When using an extension cord make sure it is properly grounded e Any rupture of the ground lead inside or outside the instrument or a loose ground connection can render hazardous operation of the instrument Intentional disconnection of the grounding is not permitted While changing the fuses make sure that the fuses used are of the specified type and rating in every case Never use repaired fuses or short circuit the fuse holders Operating Safety Information Contents Contents METHOD SHEET icr 1 Clinical Significance eI 1 Principles Of Procedure cccscscssscccsescecscsceesceesesceescceeeescessccesesceesscesescessesseesccesessesseccesensesesceees 2 R agents ans OUT iD UIS TT C 5 Specimen Collection and 9 Handling and Storage of Samples eese eee eese ee enne eene nne t hne sees e nnns 11 Materials Needed eee eerie ciere cedet eee oc ordeo ET EUR Ceu MED RR EU MEER REDDE 12 Test Conditl0ons iieeee ero eere enr ene vn e eee np aee en e en va uoa av va Neo e vu EUM ao a
117. e performed at regular intervals Overview Sample type Sampling site Sampling Sampling Sampling Procedure device preparation technique heparin hygienic conditions are pre requisite Arterial blood Artery Syringe Check puncture Macro puncture Needle is gt brachial site for uninter completely rupted circulation inserted in blood radial ulnar femoral dorsalis pedis AVL Check puncture Micro puncture Only surface Microsampler site for uninter penetration of rupted circulation blood vessel Catheter Rinse dead space volume Capillary digital pulp Capillary Hyper Capillary Pierce puncture blood emization puncture site with lancet eat tone then draw sample adult heel 13 8 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 Preanalytical Requirements for Blood Gas Analysis Treatment of Sample Before Analysis Transport and Storage Both blood gas analysis and acid base analysis are acute analyses i e the sample should be analyzed as soon as possible after sampling Furthermore it must be considered that due to heparinization sedimentation of the sample is much faster than the blood sedimentation rate If immediate analysis is not possible the following measures have to performed e Immediately after sampling using a syringe the air must be pushed out and the syringe must be sealed e If storage of the sample cannot be avoided it should not exceed one hour since the results will be
118. e CO Oximeter connected with AVL COMPACT 3 results of the ISE analyzer connected with AVL COMPACT 3 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Parameters and Equations AVL Multirule QC Procedure Overview of AVL Multirules AVL recommends QC measurement is performed at least once a day to evaluate the reliability and performance of the analyzer The QC Software of the AVL COMPACT 3 therefore uses the AVL Multirule procedure a special QC concept which is based on the Westgard Rules This procedure allows to detect as early as possible random or systematic errors of the instrument and of the operation NOTE The AVL Multirule procedure for AVL COMPACT 3 can be used only in connection with a QC material recommended by AVL e g AVL CONFITEST Valid for the measured parameters PCO and pH Run Measurement within two 2 Point Calibrations X Mean value Within run Observation period between two 2 Point Calibrations Rule Interpretation Remark 126 QC value exceeds X 2 o limits Warning 136 QC value exceeds X 3 limits Out of Control 2 of 3 2 Two of three QC values exceed the same Out of Control X 2oor X 2 6 limit Across run Observation period more than three 2 point calibrations Rule Interpretation Remark 226 Two QC values of one level exceed the Out of Control same X 2 oor X 2 limit same side of deviation Observation period is two runs 616 Six QC values level I
119. e Excess 1n blood BE Er e ene a ne e Er EE EN esee ceux 12 21 Bu tter base A Phd 12 22 Oxygen Saturation 5 Os cisci iate E dt estos duisi fe oet desee ee tes od 12 22 Oxygen Content Zo Oo 12 23 Standard pH pH esc e tech d tas re ope e gae EE fee dne dep 12 23 standard Bicarbonate RH bana des ERA MIR amaia i 12 23 Relative SHUN VOLUME os dece der eer eere ere etui ty ede one eee ee eo exe tpe eux UU ege xe Tore oes en Oe pupa TO E vet 12 24 Standardized Ionized Calcium niCagu 4 eese He e Henne 12 25 pH at Patient Temperature pcne opes na pdt duni tus odes ad ru UE 12 25 PCO at Patient Temperature 12 25 PO at Patient Temperature 12 25 Alveolar Arterial Oxygen Tension Difference AaDO 12 26 Base Excess 1n blood BE iine ID e e er E dii 12 26 luiteratutez oe PR 12 27 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 1 12 Appendix Care and Maintenance of Remembranable Blood Gas 12 28 PH Electrodes rote ret desire dee pelts dye pese ee tae Ub e Ro PERS 12 29 Replacement of the pH Electrode Housing Im HH HI HII en rene 12 29 Cleaning the pH Blectrodez EN RU ex der
120. e chamois leather of the electrode cleaning box with a few drops of distilled water Squeeze a small amount of electrode cleaning paste on to the moistened chamois leather 12 38 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Fig 12 22 PO Electrode cleaning procedure 1 Hold the electrode between your thumb and forefinger polish it with the chamois leather for about 15 seconds in circular movement applying slight pressure Fig 12 23 PO Electrode cleaning procedure 2 Remove any remaining cleaning paste from the electrode with distilled water and a clean moistened tissue Fig 12 24 PO Electrode cleaning procedure 3 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 39 12 Appendix Dry the complete inner shaft with a clean tissue Attach new PO Electrode housing filled with PO Filling Solution Reinstall PO Electrode into the measuring chamber block fit the electrode clip and reconnect the electrode plug Close the cover Initiate the corresponding calibration 12 40 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Replacing the Membrane Housing of PCO and PO Electrodes NOTE Before replacing the electrode housing of the PCO Electrode a special cleaning procedure is necessary for details please refer to page 12 34 Take a new electrode housing for PCO Electrode green or PO Electrode blue Remove its white protecti
121. e eset estes sesso etse stesse esset 12 4 Parameters and Equations 12 15 Care and Maintenance of Remembranable Blood Gas Electrodes eee 12 28 Operating Principles tee tm 12 44 Analytical C 12 4 ODD PP H 12 59 User TH CAISSE TIMIDI IUOITICECIS LISSE 12 63 12 64 13 PREANALYTICAL REQUIREMENTS FOR BLOOD GAS ANALYSIS luni M 13 1 Sample BATTERIE TUTTI III TUE IEE 13 1 Sampling Proc d res oe eun b eo avra Cer a Eee ap ea eee neos Fore vh 13 2 Treatment of Sample before 1 esee ee eese eene 13 9 SUMIMALY ZO TI D TTE 13 10 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents Figures CHAPTER 2 1 2 1 D d E D OE 2 2 Fig 222 Thermal printer m 2 2 Fig 2 3 View with open top cover esse senses enses sense nenne 2 3 Fig 2 4 Reagents WD YT IDIOT CLE CLOS 2 3 Fig 2 5 Sample mod le 5er neo En eo eu Eee uo nee ao RET oe uoa e Ego nae ua Po aae aao eae 2 5 Fig 2 6 Measuring chamber module cccssssccscscesssscsscccsesccssscccescesesssesccssesses
122. e filling of the measuring chamber It also prevents electrode damage from excessive pressure Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 Description of the Analyzer Measuring Chamber Module Measuring Capillary The measuring chamber module consists of the following parts _ Fig 2 6 Measuring chamber module measuring capillary measuring chamber block C measuring chamber valve D electrodes Fig 2 7 Measuring capillary In the measuring capillary the Blood Gas Electrodes and the pH Electrode are in direct contact with the sample to measure the Blood Gas parameters and the pH value The measuring capillary is permanently illuminated so that the entire aspiration cycle can be observed Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 7 2 Description of the Analyzer Measuring Chamber Block Measuring Chamber Valve Electrodes Peristaltic Pump 2 8 The entire module is thermostated at 37 C The measuring chamber solenoid valve is located at the right end of the measuring chamber block This valve prevents direct access from the pre induction tube i e syringe injection to the measuring chamber module to avoid damage of the electrodes The electrodes are inserted into the measuring chamber block from the rear The electrode tips project into the measuring capillary thus come into contact with the sample material The electrodes are color coded for
123. e housing as this could create difficulties inserting the electrode clip When the inner part is inserted into the electrode housing silicon grease is extruded Em Fig 12 31 Silicon grease of the tip of the electrodes Remove this grease with a cotton swab or tissue When using a tissue double it to be able to remove the silicon grease in the space between O ring and membrane with the tip of the tissue Reinstall PCO Electrode or PO Electrode into the measuring chamber block fit the electrode tip and reconnect electrode plug Close the cover Initiate the corresponding calibration NOTE If a warning or a alarm is displayed during calibration try to recalibrate once again then repeat replacement of the membrane Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 43 12 Appendix Operating Principles A detailed description of analytical principles and individual component functions is described in this chapter Principle of pH Measurement When pH sensitive glass is dipped into an aqueous solution water molecules may diffuse into the structure of the glass and form a hydrated swell layer This layer is able to absorb hydrogen ions protons This creates an electrical potential which depends on the degree of acidity or on the activity of the hydrogen ions respectively and thus on the pH value of the solution ACID Substance that is able to release H ions proton donor BASE Substance that is able to
124. e numeric keypad the correct start time hour minutes and confirm by pressing Uus ER PROGRAMS e rur Dic End time ok 7 Enter the correct end time in the same way as the start time Confirm by pressing i The next display will read as follows USER PROGRAMS Saturday reada Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions NOTE Press if the analyzer should be ready for measurements on Saturday That means that only the standby mode activated for the days during the week is valid e g 08 00 p m to 06 30 am The analyzer is READY for the whole day Confirm this question by pressing if for the whole weekend the standby mode should be valid from Saturday 00 00 to Sunday 12 00 p m If you have confirmed the question by the following display appears USER PROGRAMS Sunde reada If you have confirmed by pressing the analyzer is as FEAL as during the week only the standby mode activated for the days during the week is valid Confirm this question by the standby mode is valid for the whole Sunday At any time you are able to deactivate the standby mode in the same way as you have activated or exit by pressing ESC Exit this program by pressing Timings This function allows to set date and time calibration intervals and wash and drying cycles Activate Settings YES 2x Nw Timings YES Operator s Manua
125. e screen Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions Manual Standby Whenever the AVL COMPACT 3 is not used for a longer period it is possible to activate the economy standby mode During this period the analyzer consumes no Buffer 1 and Buffer 2 Activate Settings YES Man Standby YES USER PROGRAMS Man standby o k 7 or OFF is blinking By pressing A Or you can switch between ON and OFF Activate the blinking selection by pressing Exit this program by pressing twice The display reads as follows STHHDEM MODE 9 41 User programs Deactivate the entered standby mode in the same way it was activated or exit by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 3 8 System Functions Automatic Standby 8 4 In this mode it is possible to program a specific timetable when the AVL COMPACT 3 automatically enters or leaves the economy standby mode Activate Settings YE ix Autom YES LISER PROGRAMS Autom standby o k 7 or OFF is blinking By pressing A or you can switch between and Activate the blinking selection by pressing Now the start and end time of the automatic standby periods can be programmed It is also possible to select if the AVL COMPACT 3 should stay in the economy standby mode on Saturday and Sunday too Enter with th
126. e sehe 9 15 Fig 9 11 pH Reference Electrode 9 15 Fig 9 12 Remembranable pH Blood Gas 9 16 Fig 9 13 Electrode check 1 PCO PO 1 9 16 Fig 9 14 Electrode Check 2 PCO PO e eee eene ente ate nn e 9 17 CHAPTER 10 Fig 10 1 Remove glass splinters 1 eee eeee ecce eese eene eene nennen nennen een eese stesse tette et sees eene 10 11 Fig 10 2 Remove glass splinters 2 10 11 Fig 10 3 Remove glass splinters 3 10 12 Fig 10 4 Remove glass splinters 4 nnne nnn nete santa ness ann tesa nenne essent 10 12 CHAPTER 11 Fig 11 1 COM 1 COM 2 pinning 11 1 Figs 11 2 COM 3 pinning sae Te Pe PNE ario aA iS 11 2 Fig 11 3 Barcode scanner 5 5 1 ccr sa aereo b voa era a ae baden P edge dead aepo De gb 11 6 Fig 11 4 9 pin SUBMIN D eene nennen enhn nns h nannten annee se sanus tees annee essa nn etse nenne een anon 11 6 Fig 11 5 Types of barcodes ossee esseisti eee ee esee e eee r sE E tesa sets stehe 11 7 Fig 11 6 Interface AVL 988 11 8 Fig 11 7 Interface A VI 9180
127. e to the corresponding calculation steps for Shunt Alveolar arterial oxygen PAO PaO AaDO yes NCCLS formulas 16 and 17 partial pressure difference Hydrogen ion concentration cH not defined in NCCLS Standardized ionized Calcium nCapy 7 4 not defined in NCCLS PO at patient temperature 2 NCCLS formula 25 PCO at patient temperature PCO PCO2T yes NCCLS formula 24 pH at patient temperature pH pHt yes NCCLS formula 23 relative Shunt volume Qs Shunt partly NCCLS formula 19 if P 0O gt 150mmHg Qt 12 20 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Equations Hydrogen lon Concentration cH Bicarbonate HCO Total CO in Plasma ctCO Base Excess in blood BE Base Excess extracellular BE ect Concentration activity of hydrogen ions 2 100795 nmol L 5 H Bicarbonate concentration in plasma PCO T9999 mmol L 6 Total concentration of CO in plasma the sum of dissolved CO and bicarbonate ctCO P cHCO 0 0307 PCO mmol L 7 The base excess of the blood results from a calculation to determine the titratable base of the blood which in principle is measured by titration of the blood with a strong acid or base to a pH of 7 4 with PCO 40 mmHg at 37 C mmol L 10 BE 1 0 014 ctHb L43 ctHb 7 7 pH 7 4 24 8 cHCO The base excess of ex
128. e varied with the numeric keypad Available input range 1 0 26 0 g dL Preset value 15 g dL When you confirm the selected tHb value with the display will fade out At this point you may select another parameter with or A or exit the program by pressing Esc Activate amp input 2x Adult lt fetal Hb YES The analyzer calculates the oxygen saturation values on the basis of a standard ODC Oxygen Dissociation Curve This ODC is however different for normal adult blood and for children s blood On the display appears adult and fetal the selected parameter is blinking Select either adult or fetal by pressing or A When you activate the blinking parameter with the display will fade out At this point you may select another parameter with or A or exit the program by pressing Esc Activate Parameters inrut Sx NV This parameter is used to calculate the alveolar arterial oxygen partial pressure difference AaDO The displayed FIO value may now be varied with the numeric keypad Available input range 0 11 0 99 Preset value 0 21 When you confirm the selected FIO value with the display will fade out At this point you may select another parameter with or A or exit the program by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing Modification of Respiratory Quotient RQ Modification P50 Value Ac
129. e vp Et eb 9 2 Sample ALi css I 9 2 rg 9 3 eese soe A eset 9 3 Keyboard iode Ud sad casa P eR Pete ER RARI PO MEC MEER gs DO RENE HERE 9 3 SUPLACES eR 9 4 Sample path Measuring e eee e mee mee hen he he hen nennen 9 4 OLD D LCLCLILILLLLOLLLLCOLOIDLOLILDLIDOEOT 9 5 REM 9 5 Wast Bottle e e 9 5 uH MEE 9 6 Gas SUppl T 9 6 loda Kerri pum 9 7 Analyzer ge PR REIR Ie Eu 9 7 oc ctp EHE EP ERR eoe Dette ve EROR unte rss eic 9 7 Quality Control 55 haces casa testet oet ee tole Sea tah hank hanes Lo COS See duet bas Ren e Eten SE aes awa Sees CENT ERE n 9 7 Weekly Maintendale eee peso aeneae suco eese s s sees neas aeneo ese ao eee aae auo luno 9 8 pH Reference Blectrode pede PO SERI Re Ele ERR ge EPEa gab Pep Ei TRPE sagem ages 9 8 Replace sample Drip ee eere diete eo dase ute ae pee dude ee o Pere deed dn 9 8 6 SEET I UOI SEa
130. eau ve Ee ovd eo Ree n Se To doas 12 45 Fig 12 34 pH Reference Electrode esee esee eese eee ee eene eene tenete eset 12 45 Fig 12 35 Operating principles PCO esee esee e eene 12 46 Fig 12 36 PCO Electrode oor er eee ere ERE oen eno Dep Up 12 46 Fig 12 37 Operating principles PO Electrode eene eene 12 47 Fig 12 38 PO Electrode seen senes ennt esse esse nenne ii 12 47 Fig 12 39 Linearity of pH PCO and PO in tonometered whole blood 12 57 Fig 12 40 Comparison study with AVL 995 12 58 Fig 12 41 Barcode scanner eee nn nennt snnt a 12 59 Fig 12 42 External waste container 12 60 Fig 12 43 User programs AVL COMPACT 12 63 Big E ESI 12 64 13 Fig 13 1 AVE Microsample r sasare enean Ue ed saeua ea sese ona saine so Va as aaa a aureae udo 13 2 Fig 13 2 Main arteries in the
131. ecdacsceescdedetteseeacetecsecss Automatic Standby 2 ride e enr een era oro ne odo sra ne ro eee eor ees Se area panda TAM GS PM S Jgqe iE WATS U AG Cio E Interface en eene saec aee ea snsaes NU NE PASS WOP PST Device LOGK ao dae e nee S eo ea eoe eura ces eee eoa ea aes aen higiene IIb Mini Sample p Hed ep 9 MAINTENANCE Decontamination ssescessesscsosscesessossesseseesosssosssssscessessesssoessssesssssosses Daily se ease o coves ecessacesesevess Weekly Maintenance ssie roseus eoo ee ee ena pe nae aao EE ee neo Eua ed SR RENE Va n R eaa Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents Every Modi err EESO ES ESTEEN EE SSIES 9 9 Yearly Maimtenane csccccesscicessesteveesscsdevesecsvesesseccesnssedecetsesssetevsseeaveeseascestebessdessoedeseus eeseessses 9 10 AS NECUO IR 9 11 10 TROUBLESHOOTING Displayed and Printed Warning sorses oense seostes oisinn onii sE ea 10 1 Displayed and Printed Alarms cccscccssscccsssccsscccescesssccesceesesssessccsenseeesccesesceseesssscessesseeeees 10 1 Error Messages and Instructions for Elimination ccccssscssscccsesc
132. eck BARO Characteristic value of Baro is Call AVL customer support out of range Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 7 10 Troubleshooting Printed Warnings and Error Messages Error Messages Possible Cause Instructions for Elimination Check Sample inlet path soiled Measuring chamber soiled Clean measuring chamber Vacuum system leak Screw Waste cap on tight Check quad ring of the waste cap If an external waste container is present optional The back pressure valve in the cover possibly leaks Check back pressure valve see chapter 12 Appendix section Options External Waste Container Sample path clogged See page 10 9 Activate Maintenance Wash or Maintenance lac cleaning Vacuum pump defective Call AVL customer support Warning QC material not defined Define QC material Out of Range QCmaterial not correct defined Repeat QC measurement QC range s not inserted correct Enter QC range s Repeat QC measurement Sample position not o k Repeat QC measurement observe aspiration procedure Calibration not o k Check gas pressure and Buffer Type Activate calibration and repeat QC measurement Electrode s not o k For further procedure see Check Electrodes Insufficient Wash and Dry Cycle Possible Cause Remedy Insufficient drying of measuring chambe
133. ecsscccescessesseessceeesseesssseons 10 3 Printed Warnings and Error 10 8 Insufficient Wash and Dry 10 8 Clogged Sample 10 9 Test TL 10 13 11 INTERFACE General D scription s NC eden scevesin 11 1 Coe EE RV Eee EXE SON DE Pa opo YER REESE Ne E STOSO EE ENTRY 11 1 ICI C M MS 11 2 Transmission Format PR 11 2 Transmission 2 20 eoa inet de Soy aae sees ibo ee eu 4 rac dese poss es sasea ee deos e se arae e laa aao ca 11 3 vieles Seere iaeo sess eases dsten dead oaen ed dee oe 11 3 Connection Cable AVL COMPACT 3 PC Terminal Printer ee eee eee eee ee eene eee eenne 11 5 Barcode Scanner sescicescs sci ccsessdecccsueddusedee aossen opa d eee dee o ds scdacsdueSects sSeasece eos e cea eun Paga do Ree o TREE 11 6 Datalink qoe P HS 11 8 POG eme 11 23 IV Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents 12 APPENDIX Specification of the Analyzer 12 1 Description of Various Reports eee eeeeeeeee eese eene eene nene eese est ee nett
134. ectrode performance is one of the most important factors influencing the quality of analytical results Proper care and maintenance is required at regular intervals ATTENTION No electrodes should be removed during calibration or measurement Please wait until the process has been completed Maintenance is only necessary when an alarm occurs Before beginning with maintenance the program function System test and Electrodes for example must be activated This program can only be terminated by pressing and does not have a timeout function NOTE Before performing electrode maintenance disconnect the electrode cable and remove the electrode clip Handle the electrodes with care ensuring that electrode tips do not contact any hard surface In the following section the maintenance procedures for the different types of electrodes PCO PO are described Fig 12 1 Remembranable pH Blood Gas Electrode 12 28 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix PH Electrode Replacement of the pH Electrode Housing The pH Electrode consists of the inner electrode and the housing and is marked with a gray grip The pH Electrode requires only little maintenance To perform maintenance of the pH Electrode do not interrupt a calibration or measurement Black O Ring Connection Shaft E Electrode Housing Inner Part Fig 12 2 pH Electrode In case of a pH Electrode alarm or any other
135. ed whole blood Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 57 12 Appendix Comparison Study with AVL 995 pH vs AVL 995 7 600 4 7 500 T 7 400 T 7 300 T 7200 T 7 100 COMPACT 3 pH 7 000 6 900 6 800 6 800 6900 7 000 7 100 7 200 7 300 7400 7 500 7 600 AVL 95 pH PCO vs AVL 995 80 0 4 70 0 50 0 COMPACT 3 PCO mmHg 40 0 30 0 20 0 20 0 300 40 0 50 0 60 0 70 0 80 0 AVL 995 PCO mmHg vs AVL 995 400 0 350 0 300 0 9 2 E E 2 e E x a o o 50 0 0 0 n 0 0 500 1000 1500 2000 2500 3000 3500 4000 AVL 995 mmHg Fig 12 40 Comparison study with AVL 995 12 58 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Options Barcode Scanner Fig 12 41 Barcode scanner A bar code scanner which scans in the patient number during measurement can be installed optionally in the AVL COMPACT 3 In addition the operators identification Op ID can be scanned in with the barcode scanner however only in the READ condition When the barcode scanner is installed the password and locking of the analyzer can be activated The reading units are pre programmed for the code types e 2byS5 Interleaved Codabar e Code 128 e Code 39 For details please refer to chapter 8 Settings and chapter 11 Interfaces Operator s Manual A
136. eed os deh Veet Shy ecg A ru aati dela gs cael v m eat wo 13 4 Microsampler Sampling ine tet RR REC et ER ORO HR Ere besa ipie Per Ree EUR DRESSER 13 6 5 tici Iain thas GEO e Meu aes Dd 13 6 Sampling from Catheter seuss 13 8 TIAE 13 8 Treatment of Sample Before Analysis 13 9 Transport and dL ET 13 9 Treatment of Syringe Samples Before 1 1 memento nenne 13 9 Y b AEE O 13 10 Preparation of Puncture SIE oo vec tebe e CE eee uae lin ius Eee eet 13 10 Anticoagulation i eet rhe rhe DU edge Pee PERIERE feng ERE eA PR REEL eR VER PEOR 13 10 Arterial Blood Sampling 3 eoe tere eite te edet 13 10 Syringe Sampling eve ES 13 10 Microsampler de er Mati Tee e ag E Pg e S ERAT E 13 10 NEunl pM E EEUU 13 10 Capillary ostii titt beret stout alt tens bec pedet eot jos SOR ses qe RET 13 11 Storage and Transport of Samples 0 0 cee cece cece nee ee e me He mee hen men he eren 13 11 Sample Analy8s18z eu ER e FEN DIUI Uo nM e 13 11 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 1 13 Preanalytical Requirements for Blood Gas Analysis 13 Preanalytical Requirements for Blood Gas Analysi
137. eet GaU ku 1 7 KeyboO td s itt eU doit tete bi Quoi ciet T eem deo th eth T tust 1 7 HE 1 7 Sample path Measuring ence e Ie He mee me hen he ere hee hen 1 8 Handling the eene eene e snnt nete shes than eth nsns esse eene nennen 1 8 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 1 1 Introduction 1 Introduction Analyzer Description AVE Besa paeem Fig 1 1 AVL COMPACT 3 Intended Use The AVL COMPACT 3 is an automatic microprocessor controlled pH Blood Gas Analyzer with an integral thermal printer High safety zero risk sample port and waste level control eliminate contamination and infection hazard A complete pH Blood Gas analysis is performed on only 55 ul of whole blood with obvious benefits in neonatology pediatrics and geriatrics An optimized user interface reduces the requirement for extensive user training AVL zero maintenance electrodes fit perfectly to the low maintenance concept of the AVL COMPACT 3 Quick and precise analysis is completed within 20 seconds from sample introduction to results Lowest consumables and calibration gas requirement of any comparable analyzer ensures continued cost savings Product design and AVL quality combine to ensure ultimate performance reliability and economy Extensive self diagnostic software as
138. em Functions Display This function allows to set the fourth calculated value e G BE in the following display on the display CONDITIONING 7 482 PCOS 41 6 POZ 98 9 BE 4 4 Edit Patient data 7 Activate Settings Gx v tor 2x AN3 DizrFlau4 YES USER PROGRAMS BE Dizrlas o k 7 By pressing or A you can select between the following parameters BE AaDO cH Oscont Ossat st pH st HCO TCO HCO BB BEecf Shunt BEact Activate your selection by pressing VES Exit this program by pressing Operator s Manual AVL 3 Rev 2 0 June 1998 8 27 8 System Functions Mini Sample 8 28 Activate Mini same IH lt m 22 dent xNv far 1 A lt wn E USER PROGRAMS Man standby o k or OFF is blinking By pressing A Or you can switch between ON and OFF Activate the blinking selection by pressing ES and during a capillary measurement the question Mini sample will appear on the display For details please refer to chapter 4 section Patient Testing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance 9 MAINTENANCE VET OG COLON m 9 1 lr iruuuc 9 1 RAS CNIS EE 9 1 LWABIBI Iri EDIT 9 1 INCID DU 9 2 Fill portareazcs e ede e e m e RES ea ach Oe some ese op
139. equired the sample should be stored cooled in an ice slurry 1 to 4 C prior to analysis Plasma samples should be obtained by immediately centrifuging heparinized whole blood separating the plasma from red cells and capping the sample tube Analyze as soon as possible If storage is required the samples should be capped and refrigerated at 4 to 8 C Refrigerated samples should be allowed to warm to room temperature 15 to 32 50 to 90 F prior to analysis Plasma samples more than one hour old must be centrifuged again to remove additional fibrin clots Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Method Sheet Serum Materials Needed Reagents Serum samples should be obtained by collecting blood in an untreated blood collecting tube The sample should stand for 30 minutes to allow the clot to form prior to centrifugation After centrifugation remove the serum from the clot and cap or seal the sample tube If storage is required the sample should be stored tightly capped under refrigeration at 4 to 8 39 to 46 F and allowed to return to room temperature 15 to 32 C 59 to 90 F prior to analysis Each laboratory should determine the acceptability of its own blood collection syringes capillaries and tubes and the serum or plasma separation products Variations in these products exist between manufacturers and at times from lot to lot Description Part Number pH Buff
140. er 12 Appendix section Description of Various Reports AVL COMPACT 3 BLOOD GAS header ACID BASE REPORT Pat Age 36 Pat no 18 patient data Sample CAPILLARY cap Mo 17 Nov 97 15 54 actual date time No 30 sample number Baro 124 8 air pressure tHb A 15 2 Temp 37 0 38 2 input values pH 7 200 7 184 PCO2 17 0 17 9 mmHg measured values BE 19 mmol BEecf 19 mmol BB 28 7 mmol l calculated values HC03 6 mmol P02 126 3 133 4 mmHg measured value 02sat 97 4 9b calculated value Op ID operator identity 1 values NOTE For details please refer to chapter 8 Settings To set the layout of this report activate the program Settings Report Report Editor Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 9 4 Patient Testing Password Option Password OFF Password ON Measurement ON If the function Password is activated in the program function Settings for details see chapter 8 section Barcode Scanner or Password the following condition for measurement is given READY Far measurement Lhe flare lizer Programs mu The measurement can be performed as usual If a barcode scanner is installed it is possible to scan in the patient number during measurement within the sample stop time and before the measurement and calculated values appear on the display as well as during the Data input functi
141. er Type 1 BP0136 pH Buffer Type 2 BP0137 pH Reference Solution BP0134 Rinse BP1890 Cleaning Solution BP1887 Deproteinizer BP0521 Calibration Gas 1 HL0020 Calibration Gas 2 HL0021 Printer Paper HP0070 The AVL COMPACT 3 pH Blood Gas Analyzer automatically processes the sample through the necessary steps then prints and displays the results For details of this operation please refer to the Operator s Manual Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Test Conditions Sample Size Sample Type Sample Application Ambient Temperature Relative Humidity Type of Measurement Measured Values 50 uL capillary 100 uL syringe 25 uL microsample mode whole blood syringe capillary or AVL Microsampler 15 32 C 59 89 6 F 20 to 90 non condensing pH PCO PO Parameter galvenometric polarographic Range Display Resolution pH 6 0 to 8 0 pH units 0 001 pH units PCO 0 to 200 mmHg 0 1 mmHg 0 5 26 7 kPa 0 01 kPa PO 10 to 742 mmHg 0 1 mmHg 1 33 to 98 7 kPa 0 01 kPa Barometric Pressure 300 to 800 mmHg 0 1 mmHg 0 0 to 106 0 kPa 0 01 kPa Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Input Values Calculated Values Parameter Range Display Resolution Patient temperature T 14 0 to 44 0 C o 1 57 1 to 111 2 F 10 1 F Total Hemoglobin tHb 1 to 26 g dL 0 1 g dL 10 to 2
142. erature PCO at patient PCO ass 200 mmHg 0 1 mmol L temperature pH at patient pH 8 0 1 mmol L temperature Shunt Qs 0 to 100 0 1 Qt The AVL COMPACT 3 automatically performs a one point gas calibration with each sample measurement In addition the AVL COMPACT 3 automatically performs a one point pH calibration based upon user programmed intervals either fixed at every half hour or one hour intervals or flexible at 1 2 or 3 hour intervals based on the drift of the pH Electrode The programmed interval may vary from site to site depending on usage and regulatory requirements A two point main calibration can be programmed to occur automatically at intervals from 2 to 12 hours in normal operation if no analysis is in progress Automatic calibration also occurs shortly after power on or reset A calibration cycle can also be manually initiated any time a sample measurement is not being performed At least once daily or according to local regulations run solutions at three levels low normal high of a quality control solution with known pH PCO and PO values For further details review the Quality Control Section of the Operator s Manual The result obtained should fall within limits defined by the day to day variability of the system as measured in the user s laboratory If the results fall outside the laboratory s acceptable limits refer to the Troubleshooting Section of the Operator s Manual Operator s Manual
143. erface parameters selectable Interface parameters selectable Interface parameters fixed Interface parameters fixed Interface parameters selectable Interface parameters selectable Interface parameters fixed Interface parameters fixed Interface parameters selectable 0 Oo RxD TxD GND CHOIAMEBWNE 11 Interface Barcode Scanner Specifications For the AVL COMPACT 3 there is a barcode scanner optionally available During measurement the patient number can be scanned in In addition the operators identification OP ID can be scanned in with the barcode scanner however only in the HEADY mode When the barcode scanner is installed the password and locking of the analyzer can be activated Fig 11 3 Barcode scanner NOTE The active reading unit of the barcode scanner does not light red after being connected Fix settings e Baudrate 1200 Baud e Data bits 8 e Stop bit 1 e Parity No Plug 9 pin SUBMIN D M please refer to description of COM 1 9 Fig 11 4 9 pin SUBMIN D M Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface Installation Types of bar code Connect and fix the barcode scanner to COM 1 For details please refer to chapter 8 Settings section Interface All types of bar codes are preset and are put out with a header PREFIX STX and a trailer SUFFIX ETX Types of Barcode Presentation
144. es The back pressure valve in the cover possibly leaks e Close the tube by inserting it in the narrow opening of the tube clamp e If this eliminate the error replace the cover e If this does not eliminate the error please call AVL customer support Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix User Programs epooJeg Aq ejqejreAe Ajuo jAuo yuljeyeq eAnoe Aq 1 ty ty A Vv amp 30IAH3S amp 314dIAVS ININ A x Y y 1531135 y SHIJA HOOUd 1HOd3H A Vv Y amp 08 isa YaLLNIHd 2 SONG a A xi
145. essure Measurement PCO Electrode 12 46 The construction of the PCO measuring system is shown in the Fig 12 35 The direct PCO measurement used in the AVL COMPACT 3 is a modification of the galvanic pH measurement A pH glass electrode and an Ag AgCl Reference Electrode form the outer part that is surrounded by a common electrolyte solution They are separated from the blood sample or calibration gas by a CO permeable but not ion permeable membrane CO diffuses in both directions through the membrane until an equilibrium is established between CO partial pressure of sample and CO partial pressure of the very thin electrolyte layer between membrane and glass electrode At this time the pH value of the electrolyte solution has been changed by chemical reaction This pH change is measured amplified and indicated as PCO value CO H O H CO HCO amplifier ine reference electrode Ag AgCl electrolyte KCI NaHCO pH sensitive glass electrode CO permeable membrane blood sample or calibration gas Fig 12 35 Operating principles PCOz Electrode The PCO Electrode consists of Electrode body the electrode body is a pH glass electrode provided with a silver silver chloride coated anode Electrode housing the tip of the housing is covered by a CO permeable membrane Membrane the two foil membrane is sealed with silicon grease Electrolyte
146. et o V eei 11 23 Product Description iiem m ERR tene ERE Ree EN a ERE Se ERR PERS IRR C 11 23 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 1 11 Interface 11 Interface General Description Hardware Pinning COM 1 RS 232 COM 2 RS 232 The AVL COMPACT 3 is fitted standard with three serial interfaces for data transfer COM 1 COM 2 COM 3 All printed data are automatically sent to each serial interface where PC Host is activated All three ports can be programmed in the user program Settings 9 pin SUBMIN D F CEFET tases 9 8 7 6 Fig 11 1 4 2 pinning Pin 1 MEE 5V Pin 2 RAD receive data Pin 3 transmit data Pin 5 GND signal ground Pin 9 RI exem ring indicator Pin 4 6 8 Not connected RxD receive data TXD idee transmit data Pin 4 DTR data terminal ready Pin 5 signal ground DSR data set ready RES asesi request to send Pin 8 CTS uites clear to send Pin 1 9 Not connected Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 1 11 Interface COM 3 RS 232 Baud Rate 25 pin SUBMIN D F Pin 2 TxD uus transmit data Pin 3 ses RxD receive data Pin 4 RTS
147. exit the program by pressing Esc If the modification is finished press ESC the corrected report is automatically printed NOTE It is possible to select the corresponding parameter with and For example instead of pressing 6x press at the beginning 1x A for details please refer to chapter 12 section User Programs 4 16 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing Input of Patient Related Data This patient related data input is possible during measurement or immediately thereafter as long as the results are displayed During the measurement gis EL ct tu 1 Edit Fatient Confirm by pressing and activate Parameters inrut Edit patient data YES Select the desired parameter with or A and confirm with YES After the measurement CONDITIONING Hui FH 7 482 PCOZ 4i 8 FOZ 98 BE 4 8 Edit 4 Fabient data Confirm by pressing and activate Parameters input Edit ratient data YES Select the desired parameter with or A and confirm with ES The following patient related data can be entered Patient number Patient s sex Patient s age Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 17 4 Patient Testing Entering Patient s Number Manual Entering Patient s Number Barcode Entering Patient s Sex Entering Patient s Age Activate Parameters
148. f the display during the measurement ends with the display of measured pH PCO and PO and one of the calculated values for details please refer to chapter 8 Settings section Display and printout of the results 891 FH 7 482 PCOZ 41 8 FOZ 28 9 BE 4 8 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 5 4 Patient Testing Micro sample 4 6 On completion of the measurement the results are displayed and printed out and a gas conditioning is activated As soon as the countdown reaches 20 seconds an asterisk 020 appears to indicate that the flap can now be opened for further measurement max 4 times before the end of the conditioning cycle is reached If the flap is not opened before completion of the countdown the analyzer returns to Fead and the display will read as follows READY lrv zz Far measurement Lhe flar lizer Programs The micro sample is only offered as a measurement variation for capillary samples smaller than 55ul and with a minimal volume of 25 ul The micro sample will automatically be identified during aspiration of the capillary sample If the sample volume is greater than 25 ul the operator can choose micro sample measurement If the question MICRO SAMPLE is answered with or the time out has expired the sample will be rejected with the error signal Ha Samrle Thereafter the analyzer carries out a wash dry cycle and conditioning process and returns to REA
149. featured on all AVL analyzers The AVL COMPACT 3 pH Blood Gas Analyzer is intended to be used for the measurement of pH PCO and PO in samples of whole blood Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 1 1 Introduction Clinical Significance pH PCO 1 2 The pH value of the blood serum or plasma may be the single most valuable factor in the evaluation of the acid base status of a patient The pH value is an indicator of the balance between the buffer blood renal kidney and respiratory lung systems and one of the most tightly controlled parameters in the body The causes of abnormal blood pH values are generally classified as lt 7 4 e primary bicarbonate deficit metabolic acidosis e primary hypoventilation respiratory acidosis pH gt 7 4 primary bicarbonate excess metabolic alkalosis primary hyperventilation respiratory alkalosis An increase in blood serum or plasma pH alkalemia may be due to increased plasma bicarbonate or a feature of respiratory alkalosis due to an increased elimination of CO due to hyperventilation A decreased pH value acidemia in blood serum or plasma may occur due to an increased formation of organic acids an increased excretion of H ions in certain renal disorders an increased acid intake such as in salicylate poisoning or loss of alkaline body fluids Respiratory acidosis is the result of a decreased alveolar ventilation and may
150. form your AVL representative In case of damage inform your carrier immediately Keep analyzer and packing material until any queries have been addressed NOTE Packing may vary by country and slight variation from the accessories list Contact your AVL representative for your specific list Description 1 set dummy electrodes four pieces 1 pes lamp 28 V 1 pes 80 mAT 250 V 1 2 1 pes 1 6 AT 250 V F3 mains fuse 2 pes 3 2 AT 250 V F4 lpcs nozzle cleaning needle pcs tubing set for peristaltic pump lpcs fill port l pcs quad ring seal for pH Reference Solution bottle 28 17 x 3 53 mm l pcs quad ring seal for measuring chamber 1 06 x 1 25 mm l pcs quad ring seal for waste 50 4 x 3 53 mm l pcs leak proof adapter measuring chamber valve 1 pcs power cable 1 5 mm length approx 2 m l pcs sample drip tray 1 pcs operator s manual Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 1 3 Installation Shutdown Location Solenoid Valve Relief Clamps 3 2 For correct trouble free operation the following environmental specifications must be observed Ambient temperature 15 C to 32 C 50 F to 90 F Avoid direct sunlight Avoid hazardous gases and vapors Relative humidity 20 90 Avoid locations beside strong electromagnetic fields electric motors transformers X ray apparatus etc Avoid the use of cellular telephones near the device
151. h blood in consideration of the actual oxygen saturation This extended equation permits an exact determination of the BE from venous and mixed venous blood mmol L 43 1 0 0143 ctHb 1 63 ctHb 9 5 pH 7 4 24 26 cHCO 0 2 ctHb 2 100 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Units of Measuring and Input Values of the Following Equations Conversion of Units Short Term Literature Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 pH unit 50 mmHg mmHg ee ee PO a mmHg RQ CtHb g dL FIO SOdcont 1 vol 0 4464 mmol l tHb 1 g dL 10 g l 0 6206 mmol l 1 mmHg 1 3333 mbar 0 1333 kPa arterial Ve venous Aui alveolar Ti ae eise patient temperature 3 NCCLS Definitions of Quantities and Conventions Related to Blood pH and Gas Analysis Approved Standard NCCLS Document C12 A Vol 14 No 11 September 1994 Zander R Correct determination of blood base excess BE mmol l in Blood Anastesiol Intensivmed Notfallmed Schmerzther Germany Oct 1995 30 Suppl 1 p41 42 Marsoner HJ Acid base and oxygenation algorithms Mediquip 1 1982 1 12 27 12 Appendix Care and Maintenance of Remembranable pH Blood Gas Electrodes This section describes the care and maintenance required for optimal electrode performance El
152. h or the measuring chamber are clogged activate a vacuum cleaning cycle Activate E m 22 m Maintenance lt m wn Wacuum cleaning USER PROGRAMS Vacuum cleaning Please wait At this point a vacuum cleaning cycle of the sample path and the measuring chamber is performed On completion of the cycle the following display will appear LISER PROGRAMS Maintenance Hacdan cleanind Press to repeat the process Exit this program by pressing 10 10 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Glass Splinters NOTE Risk of contamination Under any circumstances wear protective gloves NOTE If there are splinters of glass in the measuring chamber call the AVL customer support Should the sample path contain splinters from a broken capillary remove them as follows Open the cover of the analyzer Loosen the knob that secures the measuring chamber Move the measuring chamber block carefully all the way to the left Fig 10 1 Remove glass splinters 1 Put a cellulose tissue at the outlet of the preheating tube Pump the piston of a syringe filled with water to flush the fill tube Cellulose tissue Fig 10 2 Remove glass splinters 2 If this does not help use an appropriate sized stiletto to push the splinters through the pre induction tube Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 11 10 Trou
153. hole blood coagulation during sampling must be prevented We recommend the use of special syringes which contain 0 05mL concentration of approx 1000 IU mL of lyophilized heparin After sampling the syringe is shaken carefully to mix the heparin contained in the dead space of the syringe and the sample thoroughly contains glass or steel globule for this purpose AVL blood gas glass capillaries for sampling of capillary blood have an even heparin coating on the inside When the sample is aspirated the heparin is automatically absorbed by the sample and causes the desired anticoagulation effect Caution Should the same sample be used for the measurement of blood gas and electrolyte values or other parameters carefully select the heparin used in the syringe and capillary tube For blood gas analysis sodium heparin is used for the determination of electrolytes this type of heparin is undesirable In this case a mixture of sodium lithium or sodium ammonium heparin AVL No MG0023 should be used The capillaries in the AVL Microsampler are likewise evenly coated with the required amount of lyophilized heparin and suitable for simultaneous blood gas and electrolyte testing In AVL glass capillaries the selection of heparin substances and their concentrations is such that changes to the measurement values can be excluded When other heparin salts are used slight deviations in the values are possible Significant changes to measurement va
154. housing with pH Reference Solution see chapter 9 Maintenance Clean see chapter 12 Care and Maintenance of Remembranable pH Blood Gas Electrodes or replace electrode Call AVL customer support Replace Buffer Type 1 Buffer Type 2 and run a 2 Point Calibration Replace Buffer Type 1 Buffer Type 2 run a cleaning cycle with Deproteinizer Rinse the tubes with distilled water for several times install new Buffer Type 1 Buffer Type 2 bottle and rinse the tubes with the new Buffer Type 1 Buffer Type 2 for several times Perform a main calibration Check fill port Check wash nipple Check seal adapter Check electrode support 10 Troubleshooting Error Messages Possible Cause Instructions for Elimination PCO Voltage too high too low Replace PCO Electrode Perform QC measurement Excessive insufficient slope Repeat measurement Excessive electrode drift Call AVL customer support PCO Electrode plug Connect plug disconnected PCO Electrode Replace electrode housing or electrode Gas bottle exchanged or empty Check gas supply and tubing see chapter 9 Maintenance Connect properly Leaks Activate Sustem Test Electrodes Gas 1 2 internal Check quad ring between preheating tube and measuring chamber On the left side of the measuring chamber place a tube reaching into a cup of
155. i de aee ptr dae obs bee Eee sy om bet abate ee ons o eeu olet cies eade 12 49 Verification of Performance ieren oaii dra 12 51 Comparison of PCO2 Measurement between Sample Types ssssesesseee e 12 54 Comparison of PO2 Measurement between Sample Types ssssssseseeem mee 12 55 Comparison of pH Measurement between Sample HH 12 56 Udine M 12 59 Barcode Scanner oec ct RERO EE eV tie E Eu RES RUE Ee ce ERU Ur ERE RE VER KE ERE 12 59 External Waste Container srera beceeeo eee teet oee sexi bea Cu od ee ep ep DERE TU bee on ORA S 12 60 User Prosrams eisccscccsscscscsiscedssaccwccssccsseSacscasencesabseesdcesseed scan seen scecdescsscecdsescsddsescgeieensdcdcsseSessensdescses 12 63 CUR 12 64 12 1 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix 12 Appendix Specification of the Analyzer Measured Value Displayed Range Resolution PO 10 742 mmHg 0 1 mmHg PCO 4 sss 200 mmHg 0 1 mmHg pH 6 000 8 000 0 001 Barometer 300 800 mmHg 0 1 mmHg 375 1058 mbar 0 1 mbar Normal Sample gt 55 ul Mini sample 60 ul limitation of volume by contact path and Microsample 25 55 pl Specification for whole blood Stand Deviation PO 0 0 143 mmHg lt 1 2 mmHg 143 742 mmHg 1 25 15 0 mmHg PCO 4 0 40 mmHg 0 2 0 8 mmHg 40
156. iCapn 7 4 at Patient Temperature pH PCO at Patient Temperature PCO PO at Patient Temperature The ionized Calcium value is standardized to pH 7 4 niCa 10 74 0 22 for blood ee 0 24 serum plasma F5 In the AVL COMPACT 3 only the blood parameter will be calculated pH value corrected to patient temperature other than 37 C pH 0 0147 0 0065 pH 7 4 t 37 pH unit 30 PCO value corrected to patient temperature other than 37 C PCOS PCO 109996757 mmHg 32 PO value corrected to patient temperature other than 37 5 4910711 023 88 40 071 mmHg 33 t 9 7210 9 p053 88 2 30 PO 10 2 2 7 2 t 37 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 25 12 Appendix Alveolar Arterial Oxygen Tension Difference AaDO Base Excess in blood BEaci 12 26 If measured values are reported after correction to patient temperature these temperature corrected values should also be used for the further calculation of parameters dependent on these variables The alveolar to arterial oxygen tension gradient PAO PaO is the difference between the alveolar oxygen tension estimated above and the measured oxygen tension of arterial blood AaDO P O P O with P O Baro PH 0 FIO P CO 0 580 ate os and PH O 47 10 39900237 000016 37 PCO PCO The base excess of t
157. ion factor for the second unit Pa 3 line 3 result is the equation p bar 1 000E 05 p Pa NOTE 1 bar 100 kPa 14 5 psi Temperature 9 32 5 gt 2 9 Default Values T 37 C 98 6 F RQ 0 84 FIO 0 21 tHb 15 g dL 9 3087 mmol l adult fetal adult P5 adult 26 7 mmHg 3 578 kPa Ps fetal 21 5 mmHg 2 881 kPa Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 19 12 Appendix Calculated Values The calculated values are as far as possible and meaningful accorded to the NCCLS standard Following calculated values are available in the AVL COMPACT 3 Calculated values term term NCCLS Remark NCCLS COMPACT conform Bicarbonate HCO3 yes NCCLS formula 8 Total CO in plasma ctCO TCO2 yes NCCLS formula 7 Base excess blood BE yes NCCLS formula 15 Base excess blood with SO BE no not defined in NCCLS correction Base excess extracellular BE 5 NCCLS formula 14 Buffer base not defined in NCCLS Standard pH value st pH not defined in NCCLS Standard Bicarbonate st HCO3 no defined in NCCLS section 5 10 without formula Oxygen saturation SO O2sat partly NCCLS conforming only with datalink to oximeter Oxygen content ctO O2cont yes in NCCLS not special defined but is in accordanc
158. itate arterial blood sampling AVL developed the Microsampler kit It allows sampling at the radial brachial and femoral arteries in a very simple way causing only minor trauma to the punctured blood vessel Fig 13 1 AVL Microsampler The AVL Microsampler consists of a very thin needle 26 gauge approx 0 45 mm at the tip of the kit which is connected to two glass capillaries inside a holder The inside of each capillary is coated with an even layer of lyophilized highly soluble heparin to prevent coagulation of the sample in the sampling container During normal puncture the needle is completely inserted into the vessel with the AVL Microsampler only the tip penetrates the vessel Immediately after penetration the user can see the pulsating flow of blood into the capillary and thus verify that the tip of the needle is inside an arterial vessel if the blood flow into the capillary is not pulsating a vein was punctured Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 Preanalytical Requirements for Blood Gas Analysis Anticoagulation Effect of Heparin on Measurement Para meters Use of EDTA The thin needle causes only minor trauma at the puncture site the puncture lesion closes very quickly after the needle is retracted Furthermore the inner lumen of the needle reduces the arterial pressure thus creating a slow blood flow into the capillary that can be observed by the user In the analysis of w
159. itor Activate Settings 8x Report 3x Report editor USER PROGRAMS standard individual Report o k AVL COMPACT 3 BLOOD GAS ACID BASE REPORT Pat Name Age Pat no Sample CAPILLARY Th 04 Jul 96 13 No 13 Baro mmHg tHb A 0 g dL Temp 37 0 AC pH 7 208 PCO2 16 9 mmHg BE mmol l BEecf mmol BB mmol l HCO3 mmol l P02 129 6 mmHg O2sat Op ID lnput values or deactivate an i ndi vi dual fixed lines of the standard measurement report these lines can be increased up to 30 lines with the individual report editor standard ori ndi vi dual is blinking Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions standard or individual is blinking Press A to select the other one Press to activate the blinking report Activate by pressing YES Example how to program an individual report LISER PROGRAMS Line FH Parameters ok 7 Press to activate pH in the first line By pressing you can select one of the following parameters for the first line FH SPACE Shunt cH 02 cont 2 sat steH Teo HEOZ BEect FOS FCO BE act Confirm the selected parameter by pressing YES Repeat the selection for the following lines in the same way With SPACE you insert such a blank line With EHD you determine the end of the report Comment This function allows to set a comment line up
160. ix Accuracy and Repeatability of PCO Parameters 12 52 The results of the measured data are compiled in the following table Accuracy in Whole Blood Expected X SD R n mmHg mmHg mmHg 40 10 2 10 4 0 24 98 20 28 9 28 7 0 32 101 20 35 5 35 4 0 46 100 20 41 8 41 3 0 36 101 20 54 9 55 2 0 63 99 20 67 7 69 0 0 38 98 20 75 5 76 0 0 71 99 20 82 1 82 7 1 20 99 20 94 1 96 6 1 08 97 20 119 1 124 2 1 24 96 20 AVL CONFITEST X SD TotSD n mmHg mmHg mmHg Level 1 18 780 0 2 0 3 40 Level 2 37 370 0 2 0 4 40 Level 3 63 360 0 2 0 5 40 Level 4 44 160 0 2 0 4 40 RNA Medical EQUIL X SD TotSD n mmHg mmHg mmHg Level 1 74 220 0 6 1 1 40 Level 2 34 550 0 3 0 4 40 Level 3 11 020 0 1 0 2 40 RNA Medical QUALIDATA X SD TotSD n mmHg mmHg mmHg Level 1 70 320 0 5 0 9 40 Level 2 44 490 0 2 0 2 40 Level 3 23 000 0 2 0 4 40 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Accuracy and Repeatability of PO Parameters Accuracy in Whole Blood Expected X SD R n mmHg mmHg mmHg 40 20 1 20 1 0 43 100 20 42 0 41 4 1 45 101 20 58 4 55 2 0 83 106 20 96 7 96 1 0 61 101 20 116 2 110 4 1 88 105 20 127 9 126 1 2 79 101 20 141 9 138 0 1 41 103 20 145 3 144 4 1 53 101 20 204 2 206 7 2 08 99 20 309 8 310 5 6 20 100 20 AVL CONFITEST X SD TotSD n mmHg mmHg mmHg Level 1 148 710 0 9 1 7 40
161. l AVL COMPACT 3 Rev 2 0 June 1998 8 5 8 System Functions Date and Time PH Calibration Interval 8 6 This function allows to set date and time Activate 24S Timings YES Time Date YES USER PROGRAMS Th Bd Tul 96 14 18 Time Date On the display the day is blinking You may change the day shown by pressing or A Confirm the selected day by pressing The date is blinking Enter the selected date month year and time hour minute step by step As soon as the last character is confirmed by pressing the display will fade out At this point you may either select another time setting by pressing or A and activate the selected setting by pressing or exit from the user program by pressing Esc Activate Settings YES 2x Nw Timings ix Cal interval YES USER PROGRAMS fixec flexible Cal interval FH 7 Fixed or flexible is blinking You may now select whether the pH 1P calibration should recur at a fixed interval or be dependent on the pH electrode drift f pH Switch between fixed and flexible by pressing or A If fixed is activated by pressing YES the following display will appear Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions Main Calibration Interval Extending the Wash Cycle USER PROGRAMS 8 5 Hours Hours 1 Cal 7 HH 5 or 1 i
162. lap MEASUREMENT Inject zamrle ar zelect aspiration HzrFiration 7 Fig 4 2 Syringe measurement As soon as the requisite sample volume is injected an acoustic signal will sound and the following display appears Bg Remove syringe close the flare Remove the syringe from the fill port and close the flap Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing NOTE If the flap is opened again while the sample is being aspirated and not closed before the countdown reaches 000 a continuous beep will sound until the flap is closed If the flap is opened during the measurement the measurement will be aborted NOTE Do not open the cover during measurements gis Edit Fatient data 7 The analyzer performs a fully automatic measurement The transparent illuminated measuring channel enables the user to observe the movement of a sample and to identify blockages or air bubbles During measurement data input input patient or sample related data is possible If a barcode scanner is installed it is possible to scan in the patient number during measurement from sample stop up to reaching READ as well as during the function Data input Patient number Please refer to chapter 8 Settings section Interfaces for further information The countdown running in the upper right corner of the display during the measurement ends with
163. lass capillaries can be stored at room temperature for a minimum of one hour without significant value changes Certain analyzers may require warming of the sample before input into the analyzer For a description of this procedure please refer to the respective operator s manuals Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 11 13 Preanalytical Requirements for Blood Gas Analysis 13 12 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998
164. ld be used to avoid needle stick injury Mix the specimen collected in a syringe thoroughly with anticoagulant by gentle inversion or by rolling the syringe between both hands Properly identify the specimen following usual procedures for such documentation Place the syringe containing the specimen in an ice slurry Blood gases and pH will change if the specimen remains at room temperature in a syringe for more than 5 minutes due to cellular metabolism PO changes due to oxygen consumption may be influenced by several factors including white blood cell count reticulocyte count storage temperature and initial PO value At a storage temperature of 1 to 5 C the results obtained are valid up to 2 hours Samples expected to have high white blood cell count reticulocyte count or high values initially should be analyzed as soon as possible after collection Errors in blood gas analysis on properly collected samples may result from improper mixing of the sample after collection and before measurement contamination with room air resulting from failure to expel trapped bubbles after collection and from metabolic changes in the sample Venous Specimens Whole blood samples should be collected in a heparinized syringe vacuum tube or capillary and analyzed as soon as possible after collection The sample container should be filled as much as possible leaving minimal residual air space If storage for more than 5 minutes or up to 1 hour is r
165. le ee Gan Sgt 4 16 Input of Patient Related 4 17 Entering Patient s Number he hehe hehehe he sehen 4 18 Entering Patient s Number Barcode nern rendre tare ree eR RR RE ER PER e EROR ER 4 18 Entering Patients SOX eio diced pte tee fet iit i e eto prose eee Te Eyes dee este 4 18 Entering Patient s Age csetera ven eR SERERE ER EHE DRESS E eri E B nh Os 4 18 4 19 Measurement Reports certe ie eter ete coeoch us Sycesivacucgsvabtcuccsvsbescodeasecgsduasepesdesepergedess 4 20 o Ei uio Oe re ae o 4 20 EC IE 4 20 Cali bratiOns REP Orts C 4 21 Error Reporte M P eles 4 21 System Status xe eR Trece e RI ei ER e 4 22 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 4 Patient Testing 4 Patient Testing Sample Preparation Important when Storing Blood This chapter describes routines used to operate of AVL COMPACT 3 NOTE Always observe the laboratory regulations when collecting blood For capillary blood samples it is advisable to use AVL capillary tubes which contain a special Heparin coating The most advanced and use
166. le Blood Specimens were collected for blood gas analysis by traditional operators of blood gas equipment The specimens were analyzed on existing instrumentation operated and controlled by hospital procedures If any specimen remained after the initial run on the hospital system the remainder was then run on the AVL COMPACT The results of the AVL COMPACT analysis follows Comparative Method AVL 995 Blood Gas Analyzer Correlation Parameter Slope Intercept Coefficient Range pH 0 9862 0 108 0 9920 16 96 7 63 141 normalized pH 7 4 0 006 PCO 0 9886 0 516 0 9967 18 90 1 PO 0 9712 3 453 0 9976 11 7 376 141 Measurement in Whole Blood Following is the summary of the expected performance specifications for the Normal Capillary Mini sample and Micro sample modes Measuring Range mmHg SD pH 6 000 8 000 lt 0 005 PCO 0 40 0 0 8 mmHg 40 200 0 8 3 0 mmHg PO 0 143 lt 1 2 mmHg 143 742 1 2 15 0 mmHg Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 23 Method Sheet Precision on Whole Blood PCO Measurements The standard deviation for pH in whole blood is not easily specified because the pH value in vitro can either be controlled or kept constant The following data was obtained through timed recording of the pH values the curve was fitted with a straight line and the mean deviation from this line was calculated pH Standard Deviation 1 Syx pH 6
167. lever Pull pump spool off and remove clip from motorshaft if necessary Position spoolhole on motorshaft and turn spool until flat sides match and push spool all the way up the shaft to the pump plate do not hold shaft Place the new tube around pump spool and press the tube plate into tension lever until it locks Push end of tension lever to the right and slightly against the pump plate until it locks with a click NOTE During the maintenance take care that the pump tubes are not overstretched Risk of material damage This section describes the care and maintenance required for optimal electrode performance Electrode performance is the most important factor influencing the quality of analytical results Proper care and maintenance is required at regular intervals CAUTION No electrodes should be removed during calibration or measurement Please wait until the process has been completed Maintenance is only necessary when an alarm occurs Before beginning with maintenance the user program System test and Electrodes for example must be activated This program can only be terminated by pressing and does not have a timeout function NOTE Before performing electrode maintenance disconnect the electrode cable and remove the electrode clip Handle the electrodes with care ensuring that electrode tips do not contact any hard surface Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 11 9 Maintenance pH Blood Ga
168. ludes the effects of true shunts i e anatomic shunts and true capillary shunts along with the effects of a ventilation perfusion mismatch The extent of shunting is assessed after having the patient breath pure oxygen for about 15 minutes until there is adequate washout The resulting high PAO value allows the assumption that the end capillary blood contains an amount of oxygen equal to the oxygen carrying capacity of hemoglobin plus the maximum amount of oxygen soluble in plasma Qs Cro Ci9 4 25 Qt Cig Cio V with Cro V 9 15 ml dL Co C Cio A Calculation of A Cio A 1 39c 0 0 00314 P O ml dL for PaO see equation 35 Calculation of c a see equation 13 p 12 22 and equation 15 p 12 23 Calculation of c v With COOX data AVL 912 V Cima Can V 0 co V 0 00314 P O ml dL V Without COOX data and with measured mixed venous PO value the equations 13 and 15 are used for the calculation of Cro V value Without COOX data and without measured mixed venous PO value the equation 15 is used for the calculation of Cio V value The above described relations are only available for a body temperature of 37 C Is the patient temperature other than 37 C the numerical results are senseless and therefore are not printed Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Standardized lonized Calcium n
169. lues may occur when EDTA or citrates are used Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 3 13 Preanalytical Requirements for Blood Gas Analysis Sampling Procedure Preparation of Puncture Site Syringe Sampling The puncture site is being cleaned and disinfected with alcohol e g isopropyl alcohol ethanol etc in the usual manner The ideal artery for puncture should be easily accessible have a sufficient lumen be at the surface and at a sufficient distance from veins or nerves Supply by collateral vessels should also be sufficient so that in case of an emergency a sufficient supply remains Above all it should be easily accessible during puncture Selection of the artery will be governed by the expertise of the operator and patient comfort In the past the femoral artery was the preferred puncture site but over the years the brachial artery caution insufficient collateral supply and especially the radial artery were also being used brachial artery humeru radius ulna radial artery ulcers radial artery ulnar artery Fig 13 2 Main arteries in the arm Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 Preanalytical Requirements for Blood Gas Analysis arteria axillaris arteria brachialis arteria radialis arteria ulnaris arteria femoralis arteria dorsalis pedis Fig 13 3 Main arteries in the body Traditional arterial puncture is perfo
170. mission Format 11 2 Transmission apio s va DU Neue 11 3 RepOFts os Deua eo ona Deo ee 11 3 Interface Test ei RII ED E M Ue 11 4 Connection Cable AVL COMPACT 3 PC Terminal Printer eee ee eee eee ee eee eene tenen n 11 5 COM e SINIT nU RD iE EIE S 11 5 COM 2t sete oA IM AL d E bMS MU Ras colt 11 5 etn dx enituit ee WE dietus 11 5 Barcode Scarner EU Dee deste tese ce copa sess toco eo deoa ee Es Dae aeta o Doe andae 11 6 SpeCIfIcations ions ep teret E ER TI E Sr Seg a e ER Oe Se Cosa aaa seas ga CER REPERI IS ZR ONSE Sedans 11 6 Installation ee ede eee eoe eerte dee pee dee eut 11 7 IBI ROI m L 11 7 rici dicts oc cds isat oan cauecesstiabuv ces cssdaesscs ou ste T 11 8 to AVL 98823 nte eve ek 11 8 AVL COMPACT 3 to AVL 9180 iiie tete Ese piod eed UR Pe Rd RE V E ERI dees 11 14 AVL COMPACT 3 O12 p ON REA BRE RIEN IE HERES US 11 20 11 23 Technical Specifications ose RR ee Sous ea eae err
171. n date and lot number are printed on each container label HL0020 For the calibration of PO and PCO in the AVL COMPACT 3 pH Blood Gas Analyzer Each disposable cylinder contains 3 15 L at 2200 PSI at 70 F 150 bar at 21 C Oxygen 20 0 0 03 Carbon Dioxide 5 5 0 03 Nitrogen balance Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each container label Method Sheet Calibration Gas 2 Capillary Tubes Order number Use Contents Composition Storage Stability Order number Use Contents Composition Storage Stability Precautions HL0021 For the calibration of PO and PCO in the AVL COMPACT 3 pH Blood Gas Analyzer Each disposable cylinder contains 3 15 L at 2200 PSI at 70 F 150 bar at 21 C Carbon Dioxide 10 0 0 03 Nitrogen balance Temperature 5 30 C 41 86 F Expiration date and lot number are printed on each container label MG0002 For collection and transport of capillary blood specimens for pH Blood Gas and Electrolyte analysis Not to be used for collection of samples for analysis of Lithium Each package contains 250 capillary tubes Each tube is coated to contain 6 I U Sodium heparin and 9 I U Lithium heparin per 100 uL tube volume Each tube has a minimum volume of 115uL Temperature 5 30 C 41 86 F Expiration date and lot number are labeled on the bottom of each container U
172. nd Data Input page 4 12 Activate User programs 3x NV Printout ix Nw EsrFoart 7 YES USER PROGRAMS Eeraort Last report Select either Last rerort Lazt 3 rerortz or Scroll results with Nv or A and confirm the selection by pressing YES When the selection Last reraort orthe Last 3 rerartz is confirmed the corresponding printout of the last report or the last 3 reports will be started Selecting Soroll results by pressing enables to scroll the results on the display USER PROGRAMS FH IER Press A to scroll the results If all the results are scrolled press YES Exit from the program by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing Calibration Reports Error Report It is possible to print out the report of the most recent calibration Activate User Programs 3x Printout YES 2x v Calibration repart 7YES USER PR GREHHMS Pleaze wait At this point the calibration report is printed out On completion of the printout the following display appears USER PROGRAMS Printout Calibration report 7 You may now select another parameter with or A and activate it by pressing or exit the program by pressing ESC This printout shows the last 20 error messages issued Activate User Fraodgrams lt ES 3x NV ES 3x Nv ES lt Printout lt Error Report
173. ne 1998 11 Interface Activating the datalinks on the AVL 9180 Activate the service code KEY NA CL READY Press No PRINT FUNCTIONS Press No URINE SAMPLE QC STANDARD DIALYSAT Press No DAILY MAINTENANCE Press No OPERATOR FUNCTIONS Press No PROGRAM INSTRUMENT Press YES Enter Code AAA Enter code KEY The first character is blinking With No select the correct character and confirm by pressing YES The next character is blinking Repeat this procedure until the code is correct Level 1 Ranges Program QC Press No Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 17 11 Interface 11 18 Program QC Level 2 Ranges Press No Program QC Level 3 Ranges Press No Program Normal Ranges Press No Program Corr Factors Press No Program Bicarb Corr Factors Press No Program Acetate Corr Factors Press No Program Printer Setup Press No Program Interface Press YES Activate Data Link Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface Press YES to activate the data link between AVL 9180 and AVL COMPACT 3 In addition activate the interface of the AVL COMPACT 3 In this data system the measurement values of the AVL 9180 and the AVL COMPACT 3 will be transferred
174. ne of the parameters is blinking Select either SI or conventional by pressing A Activate the blinking unit by pressing As soon as the unit is entered the display shows USER PROGRAMS Units Slconvent ions Press to get the next display LISER PROGRAMS Units tHe SIJON 7 Confirm by pressing YES The display shows SI and canventiona one of which is blinking If SI was selected before 5 is blinking Select conventional by pressing or A for tHb if the tHb value should be indicated in conventional units Activate the blinking selection by pressing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions As soon as the selection is entered the display shows USER PROGRAMS Units Slconvent ions Press to get the next display The display shows and F for entering the correct temperature unit one of the temperature units is blinking Select either or F by pressing y or A Activate the blinking temperature by pressing the display will fade out At this point you may select another parameter by pressing or A or exit this program by pressing Esc Default Values This function enables you to adjust the default parameter values Parameter Unit Default Selectable Range Values g dL 15 1 0 26 0 Total hemoglobin tHb g 1 150 260 mmol l 9 3 0 6
175. net bus deena nce bac pend PEE 12 Materials Needed tri triere evis iinet tas PE KASESE EEES ENEE EE ESEE E 12 R agentsa stie es SEO secon E T hae derek a E 12 Test Conditions P es 13 Sample m OE Rate p V UE E ber ie Ee E EHE SERRE ER EROR 13 Sample e RIDE Erst SERE beads DE EORR RE RP ERU 13 Sample Applications rer e P e OR eia US e o ud 13 Ambient Temperatures ssockevocs EE 13 Relative Humidity PEE 13 Type of Measurement e ER CORE eee IRR ORE e EE bens ER TERR EE NESSE et etg edd 13 Measured Values SERA es vies Deo CER 13 Input Ox eret Ra eere EE ERE RR RR EE ex E OE QE ee Se EU EM VN RE oe 14 Calculated Values ei C rper REESE PREX ER ER ORE Ra PA PREMIER RIPE I NER 14 Types of Calibration ise tee eret eoo edi qe o Er io Ree e Ea eor ME Teik 15 Quality Control e CSS NUES 15 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Specific Performance Characteristics ccccscccscssscccsccesccesccesceescesscesccssccssccesceeseesceesceesceescessseees 17 ons Ee o Fe ie RYE RR 17 Reproducibility ES NER RI ERE ERE PIE RE TERI asa teasbnagas oda bdesedea UAR Pande TERES ERE daa ETE TO
176. nfirm by pressing VES USER FROGRAMNS 2 Mode 7 Select the interface by pressing or A and confirm with YES USERE FPROGRAMS Datalink Mode o k 7 Select the datalink function by pressing or A and confirm with ES The datalink is active now You may activate the datalink function on COM 3 in the same way Activating the Datalinks on the AVL 912 There is no activation of the datalink function necessary at the AVL 912 The datalink function is automatically activated 11 22 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface Telelink A modem and PC are needed to perform tele maintenance by AVL customer support This option can only be performed with COM 3 Technical Specifications RS232 Interface 8 Data bits 1 Stop bit no Parity 1200 baud default NONE HARDWARE Handshake HW Handshake CTS DTR ANSI terminal standard COM 3 PC Terminal Fig 11 9 Telelink Product Description After login by Telelink all AVL COMPACT 3 display and printer information is transmitted to the ANSI terminal Now the AVL COMPACT 3 display is deactivated TELEL IHE is on the AVL COMPACT 3 display AVL COMPACT 3 display information is transmitted to the ANSI terminal the AVL COMPACT 3 printer information is also transferred to the ANSI terminal e The buttons on the AVL COMPACT 3 are
177. nts eO e dE e e EA E eee tes 2 1 Calibration rie i s PR EORR TR NS MERE ERU E Na ana RERO MM APR 2 1 Analyzer Components ETT 2 2 Display Keys GEO Ue E e NW Urge ere ER Ve eR MORE re PR Er Ee rp SS 2 2 Thermal Printer cess UR MERE deans RUE e tome CH ER OE AE XV Ebr M ERE UAE RR VERO VERTI 2 2 GOV Cf M TC E M ID A NI 2 3 Bottle Compartment iire eee sore Ede coe ebur order Re Dee Eee abt ede eda te Ede E e ER Petr vun 2 3 tee uer e cose Rue eR tee 2 4 5 sansa E Hi IRE vehe ERR ERR PIRA e ER adeeb SER RACE A age beds NS ER ERE Qoa 2 4 Butter Type PH 7 383 secet de et y teneor e peas 2 4 Buffer Type 2 pH 26 841 it tee eee evene ue ete PER te ERREUR UR ag 2 4 PH Reference Solution uou eoe I ede Vt rere e eder pe ax ee be ee e ee Ed 2 4 Cleanins Solutions m n eH ep PR ete e m Decii bo teda peste etr 2 4 Sample Module erii tt OR SE te oak eer Ree Si EE aber thea Oeo sob dee dives tates 2 5 ue eee eei eee Rt poe Ret ep oe 2 5 Fill Port and eio ERU eto ve M ERO QN MN PRU Dede sy CERE 2 5 Sample Drip Tra e aee aaee raae U
178. ollected in capillary tubes Venous specimens collected in vacuum tubes containing Lithium or Sodium heparin may be used Ensure that the tube is completely filled and that the sample is thoroughly mixed immediately after collection by gentle inversion Blood gas values reported from venous specimens should be clearly identified as such to allow for correct interpretation Each laboratory should determine the acceptability of its own blood collection syringes and capillaries Variations in these products exist between manufacturers and at times from lot to lot Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Handling and Storage of Samples Whole Blood Plasma Please refer to NCCLS Document C27 A Blood Gas Pre Analytical Considerations Specimen Collection Calibration and Controls Approved Guideline April 1993 for a detailed discussion of guidelines for the collection of acceptable specimens instrument calibration and quality control in pH and blood gas analysis including details of many potential sources of error which may cause inaccurate results Arterial Specimens Whole blood samples should be collected in a heparinized syringe AVL Microsampler or capillary and analyzed as soon as possible after collection Immediately after collection check the syringe or other device for air bubbles and carefully expel any trapped bubbles following the manufacturer s recommended procedure Extreme caution shou
179. on Please refer to chapter 8 Settings section Interfaces for further information Hei sn For measurement oren the flare The measurement be performed without scanning in the password In order to activate the program functions either password code 1 or password code 2 must be scanned in The operator identification OP ID can only be scanned in during the FEAL mode with the use of the barcode scanner Details pertaining to the use of password codecards can be found in chapter 8 Settings section Password Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing Password ON Measurement OFF READY 55 Input Password Password A measurement can only be started if a password codecard is scanned in Scanning in the password codecard 3 READY For measurement Lhe flare Password a 1 The operator is only able to perform a measurement but has no access to the program functions Scanning in the password codecard 1 and 2 READY For measurement open the flar User Programs mu 1 ea The operator is able to perform measurements and can also activate program functions CAUTION If a barcode scanner is installed it is possible to scan in the patient number during measurement from sample stop up to reaching REALY as well as during the function
180. or s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 Preanalytical Requirements for Blood Gas Analysis Performing capillary sampling For capillary sampling a careful selection of the puncture site is very important Suitable sites are the earlobe Fig 14 6 the digital pulp and in case of newborn sampling the heel Fig 14 5 Fig 13 5 Puncture of the heel newborn Uninterrupted capillary circulation at the puncture site must be ensured to achieve results that correspond to those obtained with arterial blood sampling The puncture site for capillary sampling should be hyperemized For capillary sampling at the earlobe adults hyperemia will be created by medication Hyperemia becomes apparent through skin discoloration red and the occurrence of itching or stinging On the digital pulp hyperemia is created through mechanical pressure or heat application In newborns the puncture site at the heel is usually not hyperemized The puncture itself is performed using sterile disposable lancets The puncture should be deep enough but no deeper than 3 mm The first drop should be wiped off With proper hyperemia a second drop will appear immediately The end of the capillary is held close to the incision and the blood will flow into the capillary until it is filled The opening of the capillary should be covered by blood to prevent gas exchange fA 2 9 Fig 13 6 Capillary puncture at the earlobe Do not squeeze blood o
181. orm a hydrated layer A potential difference develops between the solution inside the glass electrode and the solution being measured for H The magnitude of this difference depends solely on the concentration of Hydrogen ions in the solution This difference is measured by combining the glass electrode with standard calomel reference electrode and measuring the voltage of the system Calibration of the system is accomplished by using buffer solutions with known pH values traceable to buffers with values assigned by the National Institute of Standard Technology The pH of the unknown solution is compared to known buffer solution by electric potential measurement by the instrument using specially designed electrodes arranged as a special type of concentration cell which is described by a modification of the Nernst equation RT E E lIna mv o Ina mv where Eo standard potential in mV R gas constant 8 3143 joule x mol T temperature degrees Kelvin 310 15 K 37 C n number of electrons in electrochemical reaction value of the Faraday constant 96487 coulomb x mol ay Hydrogen ion activity Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 PH Electrode PH Reference Electrode PO2 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet The pH Electrode consists of a single glass tube with a special pH sensitive glass membrane at its tip Hydrogen ions
182. ow or low pressure of the external calibration gases No vacuum pressure for a wash and dry cycle Temperature of the sample inlet path is too high or too low Temperature of the measuring chamber is too high or too low Soiling Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Error Messages and Instructions for Elimination The following tables contain all possible errors causes and remedial action Error Messages Possible Cause Instructions for Elimination Ho Sample No sample available Insert new sample Capillary fed sample less than 25 ul Insert new sample more than 25 ul Activate Micro sample Sample transport error Check pH Reference Electrode Sample path leak Check quad ring of the measuring capillary Check O rings at electrode tips Check membrane of measuring chamber valve Check inlet path Check all accessible tubes especially peristaltic pump tubing Wrong sample material Insert new sample Ho Buffer 1 Buffer transport error Check sample path for leaks Ho Buffer 2 Sample path leak Check quad ring of the waste cap Check O rings at electrode tips Check membrane of measuring chamber valve Check inlet path Check all accessible tubes especially peristaltic pump tubing No Buffer Type 1 Buffer Type 2 Replace Buffer Type 1 Buffer Type 2 available Sample path clogged See page 10
183. p plate and pull the tube plate out of tension lever Place the new tube around pump spool and press the tube plate into tension lever until it locks Push end of tension lever to the right and slightly against the pump plate until it locks with a click NOTE During the maintenance take care that the pump tubes are not overstretched Risk of material damage NOTE The user program System test and Electrodes for example must be activated before performing the cleaning cycle so that the analyzer will not detect a measurement sample when the flap is opened This program can only be terminated by pressing and does not have a timeout function Procedure e Open the flap of the AVL COMPACT 3 e Grasp the fill port at the lower edge and pull it out e Moisten the new fill port with distilled water and press it carefully into its place Close the flap Press as often as necessary to get NOTE During the replacement of the fill port wear protective gloves to avoid any risk because the fill port can be contaminated Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance Preventive Maintenance As needed Pump Spool Care and Maintenance of Electrodes Replace all tubes and expendable parts Please contact your local AVL customer support Fig 9 5 Pump spool Unlock tension lever and disconnect pump tube Press tension lever against pump plate and pull the tube plate out of tension
184. p it with your finger If no electrolyte solution is visible regenerate the electrode according to the instructions respectively If electrolyte solution is visible reinstall electrode in its position in the measuring chamber block and secure with the clip For details please refer to chapter 12 section Care and Maintenance of Remembranable pH Blood Gas Electrodes Cleaning NOTE The user program System test and Electrodes for example must be activated before performing the cleaning cycle so that the analyzer will not detect a measurement sample when the flap is opened This program can only be terminated by pressing and does not have a timeout function Measuring Capillary If the measuring capillary is heavily soiled the user has to insert Cleaning Solution like a sample into the fill port Activate User programs YE 3x Nw Maintenance YES 2x Nw Cleaning YES Perform the cleaning procedure according to the displayed instructions Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 17 9 Maintenance Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting 10 TROUBLESHOOTING Displayed and Printed Warning cccsscccscscssssccsssceesssceescccsescesssceescesseesssesccesesssescssoscessesesees 10 1 Displayed and Printed Alarms cccscscssssccssscccsesceesscccesceesescesscceeesceeessssescessesesesccesessenseceees 10 1 Alarmi C aus OS asi os coast cco sane
185. pen the valve of the gas cylinder Activate User Programs 7 YE 3x Nw Maintenance 7 YES A Gas Purge 7 YES NOTE Do not mix up bottles and tubes Clean analyzer surface with a mild soap solution if necessary Do not use strong polishing material If soiled the fill port must be cleaned with a moist cotton swab NOTE The user program System test and Electrodes for example must be activated before performing the cleaning cycle so that the analyzer will not detect a measurement sample when the flap is opened This program can only be terminated by pressing and does not have a timeout function Perform at least one daily quality control with recommended AVL control material in accordance with your current laboratory regulations Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 7 9 Maintenance Weekly Maintenance Reference Electrode Replace Sample Drip Tray 9 8 Check the filling of the pH Reference Solution and the permeability The permeability of the pH Reference Electrode diaphragm can be tested by touching the electrode tip with a clean dry tissue Activate Maintenance YES Fef electrode YES Fill electrode IVA USER PROGRAMS Ref electrode Check Permeability Press Check whether small droplet of pH Reference Solution forms at the electrode tip If no droplet is visible repeat this procedure If again no droplet is visible replace the pH Reference
186. pening of the tube clamp e e Remove the cover close the external waste container with a sealing cap and discard in accordance with local regulations for biohazardous waste e Screw the cover onto new external waste container e Open the tube clamp Discarding a waste container with a fill level exceeding 80 NOTE The external waste container should not be filled above the marking Discard the external waste container together with the cap in accordance with local regulations for biohazardous waste Decontamination Cleaning Decontaminate clean the external waste container using a disinfectant in accordance with local regulations NOTE Substances for odour control should be added only to the external waste container Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 61 12 Appendix 12 62 Troubleshooting Check Waste see Chapter 10 Troubleshooting Section Error Messages and Instructions for Elimination An external waste container with a fluid level exceeding 80 has also filled the regular waste container The warning Check Waste is displayed Elimination see Discarding a waste container with a fill level exceeding 80 06 Meas Fath filled Check meas Path see Chapter 10 Troubleshooting Section Error Messages and Instructions for Elimination Check see Chapter 10 Troubleshooting Section Printed Warnings and Error Messag
187. pond to clinically relevant patient values In conclusion a summary of the most important preanalytical factors in blood gas analysis Check puncture site for collateral circulation Hygienic procedures disinfection Hyperemization in case of capillary puncture Recommended anticoagulant heparin Recommended dosage 1000 IU mL Ensure even mixture of sample and heparin in syringes Use glass or plastic syringes with even heparin coating e g AVL glass capillaries AVL Microsampler meets all requirements Preferably use artery with collateral supply Small needle lumen reduces arterial trauma Fill dead space of syringe with heparin solution 1000 IU mL Avoid strong suctioning of sample Compress puncture site Use AVL Microsampler Palpation of artery Introduce needle almost vertically with slight incline towards proximal Observe lightly pulsating blood flow Pull needle back after complete filling Compress puncture site Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 Preanalytical Requirements for Blood Gas Analysis Capillary Sampling Storage and Transport of Samples Sample Analysis Wipe off first drops of blood Collect blood close to puncture site Work fast to avoid air contact Apply bandage to puncture site Analyze blood gas samples as soon as possible Close sample container for transport avoid air contact Cool syringe samples in ice sample cools faster in thin syringes Samples taken with g
188. possible to activate or deactivate the peristaltic pump speed 1 Repeat the operation until all speeds were selected Exit this test program by pressing This test is used to check all valves opening and closing them Press YES By pressing or A you can now select see also chapter 12 Fluidics diagram V7 Water sexes MC bypass V9 MC valve V10 REF valve GV1 Gas valve GV2 Gas valve V11 Buffer Type 2 V12 Cleaning lt Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Confirm the selected valve with USER PROGRAMS Val ves CLOSE V2 PP Bypass By pressing you can now open and close the selected valve NOTE Short opening of gas valve GVI and GV2 only to avoid overpressure inside the device Repeat this procedure in the same way as often as necessary Exit this program by pressing Display Test This test checks all dots of the display USER PROGRAMS System test Display test Press and you get the following display This display is correct when all dots have the same intensity If not the LCD display is faulty Printer Test This test program checks the printer by printing all available Latin characters USER PROGRAMS System test Printer test Press and you get the following printout THE QUI CK BROWN FOX JUMPS OVER THE LAZY DOG the quick brown fox jumps o
189. prox 5 mm in this solution for 12 hours before reinstalling the electrode in the measuring chamber Place a soft cloth at the bottom of the glass cup in which the pH Electrode or its inner part is stored Fig 12 8 pH Electrode immerse into Buffer 1 Cleaning the pH Electrode NOTE This cleaning should be performed only in case of heavy soiling of the electrode tip This procedure should be carried out no more than two or three times a year Carefully remove the pH Electrode as described before Remove and dispose of the electrode housing according to applicable safety regulations or procedures Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 31 12 Appendix Replace the electrode O ring if necessary e g if brittle or worn Moisten the chamois leather of the electrode cleaning box with a few drops of distilled water Squeeze a small amount of electrode cleaning paste onto the moistened chamois leather Fig 12 9 pH Electrode cleaning procedure 1 Hold the electrode vertically between thumb and forefinger and polish it in circular movements with the chamois leather for about 15 seconds Fig 12 10 pH Electrode cleaning procedure 2 Remove any remaining cleaning paste from the electrode with distilled water and a clean moistened tissue applying slight pressure 12 32 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Fig 12 11 pH Electrode cleaning procedure 3
190. pu c at esu e eg n y 12 31 POCO Electtodez ox onere blu eg eem uA A A Pi MH tea ac Econ We LL DER 12 34 Cleaning before Replacing the 51 eee 12 34 Cleaning of the Glass rie deer e re 12 36 POS I B IRE 12 38 Et 12 38 Replacing the Membrane Housing of PCO2 and PO 1 12 41 Operating Prin Ci Plessis ee eee eue va eo eo eau ea hee ea o un 12 44 Principle of pH Measurement ote rrr te ERE RAE eU EE E eR te betes 12 44 pH Electrode and pH Reference 1 He eee ee eere 12 45 Principle of CO Partial Pressure PCO eee eee nennen 12 46 Principle of O Partial Pressure eene rennen 12 47 Analytical P rformarnce eere dee eek eee cen ese ede ores Se ee o eo ease ages oa Suec ao eoe e aee oe seo esoe SEs tIS resa 12 48 Introductionoauu sio Rode e e dE T rq PLA EE ERE E ERAT Re gets 12 48 Definitions cor Rte E RSEN RYE ERI Si UE CHAT URDU aa oN E RESI EVER CERE 12 48 COmparisOf c cocos tet
191. r Extend drying by 10 seconds see chapter 8 Settings section Extending the Drying Cycle Insufficient wetting through use of abrasive Perform two blood or serum measurements cleaning agents too much Deproteinizer Vacuum system leak Check waste bottle cap for tight seal Check quad ring of the waste cap Check all accessible tubes Sample path clogged See page 10 9 Vacuum pump failure Call AVL customer support 10 8 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Clogged Sample Path Blockage Activate vacuum cleaning Sample path YES unclogged Insert dummy electrodes Fill syringe with distilled water Activate System test Electrode Gas1 intern Open the flap Flush sample path Activate System test Electrode Wash Sample path unclogged Insert Y gt electrodes Call AVL customer support Y Clean with Cleaning Solution Stabilize by two blood or serum measurements If electrodes have been changed perform a Main Calibration ATTENTION To protect against spillage protective glasses should be worn when attempting to flush a blockage in the sample path with a syringe injection Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Activating a Vacuum Cleaning Cycle If the sample pat
192. r friendly device for collecting arterial blood is the AVL Microsampler Fig 4 1 AVL Microsampler The use of very thin needles prevents common complications such as hematoma thrombosis etc which may occur after an arterial puncture NOTE When the Microsampler needle punctures an artery a pulsating blood flow filling of the capillary tube can be observed Continuous flow indicates that a vein has been punctured CAUTION The higher the temperature of a sample the faster and more intensive its metabolism means change of Blood Gas and pH values The ideal temperature for long term storing of blood is approx 4 C 39 F At this temperature the metabolism of a sample and as a consequence its oxygen consumption are lowest At a temperature of 4 C a sample may be kept for up to two hours without significant changes of its Blood Gas and pH values When using an AVL Microsampler the sample does not require icing for up to 30 min For details please refer to chapter 13 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 1 4 Patient Testing Sample Measurement Syringe Measurement 4 2 Before a measurement can be performed the analyzer must be in FEAL mode READY ir z 8 For measurement open the flar User Programs 7 NOTE Before measurement turn the syringe in your hand for about 10 seconds to mix the sample and remove any air by injecting it onto a cotton swab Open the f
193. ran ooo de Deodasades e essesi 4 2 Fig 4 3 Capillary measurement ecce eese eese eese seoses isase e eet nest nest asese rosno seori as sbr sasos 4 4 CHAPTER 8 Fig 8 1 Password codecards with different access codes eese 8 20 Fig 8 22 Bass WOE BI E EE 8 21 CHAPTER 9 Fig Fig Fig Fig Fig Fig Fig 9 1 9 2 9 3 9 4 9 5 9 6 9 7 LI 9 6 Position of the gas cylinders 9 6 pH Reference Electrode ied 9 8 Peristaltic pump t bes eee ee esee eee ae eate k o aero eu seo baeo a eoo e Ern eaae PR Eee ea Va PER EP S Nee e ap Sad doe 9 10 5 M 9 11 Zero maintenance pH Blood Gas Electrodes 9 12 pH Reference Electrode 1 esee e eese esee eese eese eene nete nee nnet tht eese 9 12 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 VII Contents Fig 9 8 pH Reference Electrode sscscssssccsescessssccsscccescessccceescessssssesccsseesesesccesessesessssosceses 9 14 Fig 9 9 Remove pH Reference Electrode housing eeeeeeee eee eee eee eee eene nnne nennen nnne tenen 9 14 Fig 9 10 O ring pH Reference Electrode ceeeeeeee eee esee ee eese senes een
194. ration pH 1P calibration Gas 2P calibrations BOIS When this calibration is activated the following prompt can appear MAIN CAL Electrodes changed 7 Press if one or more electrodes have been changed otherwise press to go on This prompt does not appear if any electrode has been in alarm NOTE After one or more electrodes have been changed a main calibration always has to be performed Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 6 Calibration PH 1P Calibration Gas 2P Calibration NOTE If during the pH IP calibration the display Electrode changed is confirmed by pressing the analyzer performs automatically a pH 2P calibration If no electrodes have been changed respond to iF CAL Electrodes changed 7 by pressing NO The Gas 2P calibration is identical for the PO and PCO Electrode The display GAS CAL Electrodes changed 7 is confirmed by pressing YES if one ore both electrodes have been changed otherwise press Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 6 3 6 Calibration 6 4 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 7 Data Manager 7 DATA MANAGER AVe DataComm 2 eee 7 1 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 7 l 7 Data Manager 7 Data Manager AVL DataComm 2
195. recommended AVL control material Activate User Programs ix ac ix Nw GC new lot lt m 77 Entering New Lot Number USER PROGRAMS QC Level 1 GC new lot You may select Level 1 Level 2 or Level 3 by pressing A and confirm the selected level by pressing USER PROGRAMS GC new lot data 7 Level 1 Press USER PROGRAMS Lewel 1 By pressing the stored QC data values date lot number expiration date default QC limits will be deleted If no new QC data will be entered confirm by pressing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 5 3 5 Quality Control Entering Expiration Date Entering Target Ranges 5 4 USER PROGRAMS Level 4 5142 QC new lot number The first digit is blinking You may enter or vary the number with the numeric keypad If the lot number was entered correctly press to confirm Further you can enter the expiration date USER PR GEH Lewel 4 mc QC exrir date ok The first digit 00 2 month is blinking You may now enter the digits With the numeric keypad month and year can now be entered take care of the correct sequence If the expiration date is entered correctly press to confirm The next display appears USER PROGRAMS BC new lot data 7 Level 1 Press LISER PROGRAMS Level i Press to confirm Operator s Manual AVL C
196. ressing YES If OH is activated the following display appears USER PROGRAMS COM 2 Mode Confirm by pressing By pressing or A the following connections can be selected COM 2 1 PC Host Printer Ticket printer Datalink AVL 988 3 or AVL 9180 Datalink 912 A UO N COM 3 1 PC Host Printer Ticket printer Datalink AVL 988 3 or AVL 9180 Datalink 912 Modem A U N Confirm the selection by pressing YES the display will fade out By pressing or A select the following display USER PROGRAMS COM Baucdrate 7 Confirm by pressing YES USER PROGRAMS HE Baud rate ok 7 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 17 8 System Functions Activate the corresponding baud rate by pressing or select an other baud rate by pressing Available are 1200 2400 4800 7200 and 9600 baud Confirm the selection by pressing ES the display will fade out By pressing or select the next display LISER PROGRAMS COM 2 Handshake 7 Confirm by pressing i LISER PROGRAMS Handshake o k 7 By pressing or you can select between COM 2 COM 3 1 None 2 XON XOFF Software Handshake 3 CTS DTR Hardware Handshake Confirm the selection by pressing ES For details please refer to chapter 11 Interface Exit this program by pressing Esc Operator
197. rm e Both measurements must have been successfully performed with the oximeter Otherwise all oximeter data is canceled and the procedure takes place as without datalink NOTES FOR OPERATION At air breathing FIO 0 21 it is better to measure only with an AVL COMPACT 3 without datalink At oxygen breathing FIO gt 0 4 a measurement with datalink is better Bibliography 1 Breuer H B ttner D Stamm Hrsg O Miiller Plathe Sdure Basen Haushalt und Blutgase 2 Auflage Thieme 1982 2 W D Keidel Hrsg Kurzgefaftes Lehrbuch der Physiologie 4 Auflage Thieme 1975 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Conversion of Unit kPa Pa N m bar mbar mmHg atm at psi kPa 1 1000 0 010 10 7 501 9 869E 03 1 020E 02 0 145 1 000 03 1 1 000E 05 1 000 02 7 500E 03 9 870E 06 1 020E 05 1 450E 04 N m bar 100 1 000E 05 1 1000 750 0 987 1 020 14 504 mbar 0 100 100 1 000E 03 1 0 750 9 869E 04 1 020E 03 1 450E 02 mmHg 0 133 133 330 1 330E 03 1 333 1 1 316E 03 1 360E 03 1 934E 02 atm 101 325 1 013E 05 1 013 1013 250 760 1 1 033 14 696 at 98 068 9 807E 04 0 981 980 680 735 294 0 968 1 14 228 psi 6 895 6 895E 03 6 895E 02 68 948 51 715 6 805E 02 7 029E 02 1 To convert e g Pa to bar proceed as follows 1 look for the unit bar in the 1 line 4 column in the 1 line 2 step down the column until you find the convers
198. rmed using a syringe In most cases arterial pressure is sufficient to push back the syringe plunger automatically If necessary light retraction may support this procedure Active suctioning as is performed with venous blood sampling should be avoided if possible After removal of the needle compression of the puncture site is required to prevent hematoma Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 5 13 Preanalytical Requirements for Blood Gas Analysis Microsampler Sampling Capillary Sampling 13 6 This type of blood sampling can also be performed at all sites described for syringe sampling using the AVL Microsampler Sampling is particularly easy at the radial artery see Fig 13 2 and Fig 13 3 The artery is located by palpation with index and middle finger The two fingers are being applied to the left and the right of the artery in parallel to its flow direction The fine needle is inserted into the vessel almost vertically between the two palpating fingers with a slight incline to proximal The needle is not fully inserted into the blood vessel as is the case with syringe sampling but only penetrates the surface Successful penetration is indicated by a lightly pulsating blood flow into the capillaries which also indicates that an artery was punctured not a vein and that the incision did not go completely through the artery If that is the case pull the needle back lightly until blood starts flowing in
199. rtment NOTE Before screwing on the cap of the pH Reference Solution bottle ensure that the ring seal is properly in place Ensure that the cap is screwed on finger tight otherwise the DH Reference Electrode will not function properly After installing the pH Reference Solution do not switch on the analyzer before a pH Reference Electrode has been installed Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 Installation Shutdown Calibration Gas Connection The AVL COMPACT 3 needs two different calibration gases Gas 2 10 95 COs balanced Gas 1 5 5 95 20 95 Os balanced Calibration Gas 2 Calibration Gas 1 Fig 3 6 Position of calibration gas cylinder Procedure e Install the pressure regulators on the new gas cylinders e Insert the new cylinders in the holder and secure them e Connect the tubes to the outlet of the gas reduction valve Connect the tubes to the connector nipples the rear panel of the AVL COMPACT 3 e Open the valves of the gas cylinders again NOTE Do not mix up bottles and tubes NOTE The length of the gas tube is limited at Im 3 ft Avoid large distances between analyzer and gas cylinder Please contact your AVL customer support if larger distances are necessary Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 5 3 Installation Shutdown Electrodes pH Reference Electrode white 3 6 NOTE Zero maintenance pH Blood Gas Elec
200. s Introduction Sample Types Arterial Blood Venous Blood Arterialized Capillary Blood Blood gas and pH analysis is performed to obtain accurate measurement parameters indicating oxygenation and acid base status of the patient Known parameters are PO partial oxygen pressure PCO partial pressure of dissolved CO and the pH value as a measure of acidity or alkalinity The measurement values depend on sampling procedures sampling containers transport and storage as well as on the measurement itself In most cases arterial blood obtained through arterial puncture is used for blood gas analysis Regulations in various countries require the exclusive use of arterial blood for blood gas analysis The advantage of this type of sample lies in the homogeneity of the arterial blood from aorta to peripheral circulation Samples taken at the radial brachial and femoral arteries yield identical results independent of the puncture site For examining oxygenation venous blood is suitable only as an additional component i e for determining the difference of the oxygen content between arterial and venous blood With an appropriate tissue puncture site with proper preparation and taking into consideration contraindications the values for pH and PCO are not significantly different from those obtained with arterial blood The values for the PO however may be lower by up to 10 depending on the puncture site Operator s Manual
201. s Electrodes Zero Maintenance pH Blood Gas Electrodes pH Reference Electrode 9 12 Fig 9 6 Zero maintenance pH Blood Gas Electrodes The upkeep of the zero maintenance pH Blood Gas is limited to regular checks of electrode voltages and the occasional replacement of an electrode whose service life has expired See attached page for zero maintenance pH Blood Gas Electrode information NOTE Zero maintenance pH Blood Gas Electrodes do not require any maintenance The pH Reference Electrode is located on the extreme left hand side of the measuring chamber To perform maintenance procedures on the pH Reference Electrode do not interrupt calibration procedures or measurements and leave the analyzer switched on Remove the pH Reference Electrode from the measuring chamber block and hold the electrode with the tip downwards Do not disconnect the tubes Fig 9 7 pH Reference Electrode 1 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance Filling of the pH Reference Electrode If the pH Reference Solution in the pH Reference Electrode housing is low activate Maintenance YES kef 1 ect rac m YES USER PROGRAMS Ref electrode Press YES This function activates the automatic filling procedure of the pH Reference Electrode housing On completion of the filling the following display appears USER PROGRAMS Ref electrode Press when the electro
202. s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 System Functions Password This function only allows the AVL COMPACT 3 to be activated by authorized persons The barcode scanner including Password codecards Fig 8 1 with printed barcode is used to activate the analyzer First the COM 1 in mode Barcode must be activated in the user programs Settings Interface Activate Settings Nw for AQ LISER PROGRAMS zettindsz Password NOTE The password can only be activated with the password codecard I USER PROGRAMS OH OFF oak or blinks Select either OH by pressing v AX Confirm the selected condition by pressing The following appears the display USER PROGRANS OFF Measurement ok or OFF blinks Confirm the selected condition by pressing If Measurement o k 7 OW was selected each measurement can be performed without reading the password codecard The user programs are only with password available You can leave the program e g timeout after 2 minutes by pressing The following is shown the display READY 16 5 For measurement open the flar zzumpbd 7 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 19 8 System Functions 8 20 There are 3 access codes for the password Each of these passwords are coded as barcode on the password codecard
203. s blinking You may now set a pH calibration to recur either every 30 minutes or every hour Switch between 0 5 and 1 0 by pressing or A Activate the blinking selection by pressing YES As soon as your selection is entered the display will fade out Activate Settings YES 2x Nw Timings YES 2x ww Interv main calib YES USER PROGRAMS Main cal Lach Cal interval ok 7 You may now set an interval between 2 and 12 hours with the numeric keypad and confirm your selection by pressing VES This function allows to activate or deactivate an extended wash cycle 6 seconds Activate Settings 2x NV Timings Sx NV Extend wash time YES USER PROGRAMS OFF Ext wash time 7 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 7 8 System Functions Extending the Drying Cycle 8 8 or OW is blinking Switch between OH and OFF by pressing Nv AX Activate the blinking selection by pressing ES As soon as your selection is entered the display will fade out This function enables you to activate or deactivate an extended drying cycle 10 seconds Activate Settings YES 2x NV Timings YES dx SV Extend drew time YES LISER PROGRAMS Ext dry time Oaka 7 or OH are blinking Switch between OH and by pressing Nz or Activate the blinking selection by pressing YES As soon as your selection is entered
204. s of identical samples during a longer time period e g days weeks done by some persons using different devices The following should be taken into account kind of preanalytical preparations and handling of reagents and devices e stability of the samples and the QC materials e carry over drift The purpose of a correlation study is to evaluate the typical performance of the instrument in comparison to a legally marketed predicate device in order to demonstrate equivalence to existing methodology The stated situations must be granted by the operator Correct set up and installation on site of the AVL COMPACT 3 see chapter 3 Use device only under correct environmental operating conditions Use only AVL reagents with valid expiration date Correct handling of reagents and samples please refer to the package insert sheet and chapter 3 n same cases tonometered samples must be used For accuracy and imprecision of this device the samples and procedures please refer to the recommendations of the tonometer manufacturer The operator must be trained for using this devices and methods pH measuring values are obtained using AVL QC calibration materials AVL recommends to use only reagents gases and calibration materials with the same lot number to avoid additional uncertainties Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 49 12 Appendix Measuring Conditions 12 50 Ambient temperature
205. safety measures are not observed The instrument is only to be operated by qualified personnel capable of observing these prerequisites Only accessories and supplies either delivered by or approved by AVL are to be used with the instrument Due to this instrument operating principle analytical accuracy not only depends on correct operation and function but also upon a variety of external influences beyond manufacturers control Therefore the test results from this instrument must be carefully examined by expert before further measures are taken based on the analytical results Instrument adjustment and maintenance with removed covers and connected power mains are only to be performed by a qualified technician who is aware of the dangers involved Instrument repairs are only to be performed by the manufacturer or qualified service personnel Explanation A This symbol is located on the inside of the instrument Refer to the Operator s Manual Service Manuals e Symbol for instrument type B An instrument of the B type falls under safety categories I II or III or has an internal power supply providing the required insulation against discharge current and reliable ground connections Important Information Important Information Operating Safety Information e The instrument falls under Safety Category I e The instrument belongs to Type B e The instrument is designed as a conventional devic
206. sampler Measurement 4 4 Micro sample 5 Speer ee e teet sai ot ere Ee Re ROME REOR OE RE Seit Uer Ee E re d reet aae 4 6 Printout of ResultSsi le dise EE ee v bas ARR ERE RE DI torio tu T e Eoi E e OC oe AR UR Oeo oe rp 4 9 Password Option iii tese es decc eto secu tess esae osea es aeneo tenses 4 10 PassWord OFF vc eere reed tet ce se un ie k ee eder ete e eet ose exe eee ore de E te dtque 4 10 Password ON Measurement eme eene mete ee eee ene se essere sese ens 4 10 Password ON Measurement 4 11 Parameter and Data Input eese eeee eese esee esent e eset naso sa 4 12 Parameter Input o Aen i ote ote EUR Reve SOUS Rose 4 12 Modification of Patient s emen enint hen entren 4 13 Modification of tHb PIS RESET SERERE RAP 4 14 Modification of tHb Type for Fetal and Adult Blood seeseee 4 14 Modification of Fraction of Inspired Oxygen em eee eene 4 14 Modification of Respiratory Quotient RQ sess 4 15 Modification of Half Saturation Pressure 4 15 Modification of Samp
207. se of calibration solutions or electrodes not manufactured for AVL could void the warranty A waste container is provided Once used the waste container holds human body fluids which may be potentially infectious handle with appropriate care to avoid skin contact or ingestion For in vitro diagnostic use Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Method Sheet Specimen Collection and Handling Safety Sample Requirements Anticoagulants Sample Collection Devices Syringes Universal precautions must be observed when collecting blood specimens It is recommended that all blood specimens be handled as if capable of transmitting human immunodeficiency virus HIV hepatitis B virus HBV or other bloodborne pathogens Proper blood collection techniques must be followed in order to minimize risk to the laboratory staff and gloves should be worn Please refer to NCCLS document M29 T2 Protection of Laboratory Workers from Infectious Disease Transmitted by Blood Body Fluids and Tissue Second Edition Tentative Guideline for further information on safe handling of these specimens Refer to NCCLS document H11 A2 Percutaneous Collection of Arterial Blood for Laboratory Analysis Second Edition Approved Standard May 1992 for detailed information of sample collection storage and handling Blood sampling for analysis must be performed under proper medical supervision with details of collection including sampling de
208. sing 2 AVL COMPACT pH Blood Gas Analyzers with 2 replicates per run and 2 runs per day using a commercially available solution of reduced bovine hemoglobin which has been demonstrated to be comparable to tonometered whole blood Precision and accuracy of pH was evaluated using commercially available precision pH buffer solutions with values traceable to N I S T and precision of pH PCO and PO was evaluated using aqueous control materials Reproducibility Typical Within Run S and Total S imprecision data was collected from 2 runs per day with 2 replicates per run on three AVL COMPACT pH Blood Gas Analyzers over twenty days following the protocol of NCCLS document number EP5 T2 Material AVL CONFITEST Aqueous pH Blood Gas Control Level 1 Parameter n Mean Swr St pH 240 7 207 0 0020 0 0043 PCO 240 18 8 0 20 0 27 PO 240 148 7 0 92 1 72 3 Mahoney JJ Wong RJ Van Kessel AL Reduced Bovine Hemoglobin Solution Evaluated for Use as a Blood Gas Quality Control Material Clin Chem 39 5 874 879 1993 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 17 Method Sheet Material AVL CONFITEST Aqueous pH Blood Gas Control Level 2 Parameter n Mean Swr St pH 240 7410 10 0017 0 0047 PCO 240 37 4 0 23 0 42 PO 240 1109 0 93 1 38 Material AVL CONFITEST Ill Aqueous pH Blood Gas Control Level 3 Parameter n Mean Swr ST pH 240 17 630 0 0021 0 0051 PCO 240 63
209. ssccesessessesssenes 2 7 Fig 2 7 Measuring capillary ecce eese eese esee nennen enne esent nnne sante sns sans 2 7 Fig 2 8 El cttodes 1 ioiioo relin Ioz Ide peer io Poo eoo dedo dae 2 8 Fig 2 9 Peristaltic PUMP tese e aere pov eese aod epa eoo e eva ex ee i EPA E SN Te AVE EY Pa el e ovy Ro VY a Pru o EE seen 2 8 19 2 10 oec Ree peor oee open aeo ge Peso v de aee e ne ev rase ee ea etos 2 9 Fig 2 11 Warning and identification plates esee eee eese ee eese eene enhn enhn sehn sete sees annees nene 2 9 Figs 2 122 Inter lace 2 10 Fig 2 13 Gas connections 2 10 Fig 2 14 Power switch module eee eese esee eee esee eene 2 11 CHAPTER 3 Fig 3 1 Solenoid valve relief clamps fill module ee eee eene enne nennen nnn ten 3 2 Fig 3 2 Solenoid valve relief clamps peristaltic pump 3 3 Fig 3 3 Solenoid valve relief clamps bottle 3 3 Fig 3 4 Peristaltic pump
210. standby mode can be canceled at any time After performing the necessary calibration the analyzer is READY If your AVL COMPACT 3 is to be shut down completely for more than 3 days you have to empty the tubes remove the electrodes from the measuring chamber and secure some of the tube valves with the relief clamps Procedure READY For measurement open the flar User Programs 1 Take both tubes off the pH Reference Electrode and connect them with each other by means of a nipple Close the two nipples of the pH Reference Electrode with the two supplied red stoppers NOTE A capillary tube may also be used instead of a nipple Do not insert the ends of the capillary into the tubes deeper than 10 mm 2 Empty Buffer Type 1 Buffer Type 2 pH Reference Solution and Cleaning Solution rinse them fill them with distilled water and put them back into the analyzer 3 Activate User Programs dx NV Maintenance dx NV Shutdown YES USERE PROGRAMS Shubdowr Rinse 7 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 11 3 Installation Shutdown Electrode Care 3 12 Press YES A rinsing cycle is now activated during which the entire reagent inlet and outlet tubing system is rinsed Empty the bottles of Buffer Type 1 Buffer Type 2 pH Reference Solution Cleaning Solution and Rinse USER FROGRAMS Shutdown Dru 7 Press YES USER PROGRAMS Shutdown Dry
211. t cloth at the bottom of the glass cup in which the PCO Electrode or its inner part is stored To replace the membrane housing see page 12 41 The PCO Electrode is marked with a green grip Disconnect the cable from the PCO Electrode pull out its clip and remove the electrode from the measuring chamber Carefully remove the inner element from the housing avoiding spillage of electrolyte solution Dispose of the old electrode housing according to applicable safety regulations or procedures Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Fig 12 14 Electrode remove Inner element Replace the inner O ring if necessary e g if brittle or worn Fig 12 15 Electrode Inner element Clean shaft of the inner part glass tip and Ag AgCl ring with a tissue moistened with distilled water Fig 12 16 PCO Electrode cleaning shaft Check whether the Ag AgCl ring displays a uniform dark brown color If the Ag AgCl ring displays white spots contact your service office Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 35 12 Appendix Cleaning of the Glass Tip 12 36 AgCI Fig 12 17 PCO Electrode inner shaft Rinse glass tip Ag AgCl ring and shaft very carefully with distilled water Dry the complete inner shaft with a clean tissue NOTE Perform only 2 or 3 times a year if the glass tip of the electrode is heavily soiled The
212. t data Press Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing NOTE If none of the following parameters is selected before the measurement is finished the analyzer automatically returns to the highest menu level COHDI TIOHIHG or READY USER PROGRAMS Edit Patient data Parameters input Press and select the desired parameter with A and confirm the selected parameter by pressing ES The following parameters can be modified Patient s temperature value Hb type for fetal and adult blood Fraction of inspired oxygen FIO Respiratory quotient RQ Half saturation pressure P50 e Sample Type cap art venous Modification of Patient s Temperature Activate Parameterz input YES Fat Temperature YES The displayed temperature may now be varied with the numeric keypad Available input range 14 C 44 C 57 2 F 111 2 F Preset value 37 C When you confirm the selected temperature with the display will fade out At this point you may select another parameter with or A exit from the program by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 13 4 Patient Testing Modification of tHb Value Modification of tHb Type for Fetal and Adult Blood Modification of Fraction of Inspired Oxygen FIO Activate Parameters input ix Nv tHb YES The displayed tHb value may now b
213. that forms the outer part that is surrounded by a common electrolyte solution They are separated from the sample or calibration gas by a CO permeable but not ion permeable membrane Carbon dioxide diffuses in both directions through the membrane until an equilibrium is established between the CO partial pressure of the sample and the CO partial pressure of the very thin electrolyte layer between the membrane and the glass electrode At this time the pH value of the electrolyte solution has been changed by a chemical reaction which occurs as carbon dioxide gas dissolves in the electrolyte and produces hydrogen ions CO 6 H CO H This pH change is measured and amplified and is indicated as the PCO value Methodology is a modification of the galvanometric pH measurement The PO Electrode consists of a glass electrode body containing the cathode 4 platinum wires and a silver anode an electrode housing containing an O3 permeable membrane and inner electrolyte that enables the chemical reaction and transports the charges The O diffuses through the membrane depending on the O partial pressure of the sample and continuously replaces the O Method Sheet molecules of the electrolyte layer consumed during the cathode reaction A very small constant current representing the oxygen partial pressure PO of the samples passes through the electrode Methodology is polarographic At the cathode oxygen diffused through th
214. the basic and oxidizing character of the reagent Deproteinizer local irritations after contact with eyes skin or mucous membranes cannot be excluded First aid measures After inhalation fresh air drink plenty of water After skin contact rinse with plenty of water remove contaminated clothes After eye contact rinse with plenty of water consult a doctor If swallowed drink plenty of water avoid vomiting and consult a doctor NOTE When Deproteinizer is handled and used properly no ecological problems are to be expected Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 5 1 Introduction Disinfectant Fill port area Sample drip tray Fill port A commercially available alcoholic disinfectant containing aldehyde should be used e g Meliseptol Please refer to the product description of the surface disinfectant NOTE Do not use the disinfectant for internal decontamination of the sample path For decontamination AVL Deproteinizer is especially recommended You may also use a commercially available alcoholic disinfectant containing aldehyde The sample drip tray prevents contamination of the bottle compartment in case of improper sample introduction Decontaminate a dirty sample drip tray with a cloth or gauze pad saturated in disinfectant Procedure 1 Open bottle compartment cover 2 Pull sample drip tray out 3 Clean and decontaminate or replace it 4 Close bottle compartment cover
215. the connecting pieces with a cloth saturated in disinfectant Procedure Activate User programs 7 YE 3x Nw Maintenance 7 2 Cleaning F YES Perform cleaning according instructions on the display NOTE After reinstalling of the decontaminated electrodes at a later time or a new electrode perform two measurements with a wetting agent e g whole blood to moisten the system Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance Daily Maintenance Liquid Levels Check level and expiration date Rinse Buffer Type 1 Buffer Type 2 pH Reference Solution Cleaning Solution NOTE Never refill Rinse Buffer Type 1 Buffer Type 2 Cleaning Solution and pH Reference Solution bottle always replace Contamination could occur NOTE If you do not use the prefilled Rinse solution refill with distilled water only and add one ampoule of Rinse Additive If the liquid level is too low the measuring chamber can become soiled and this can lead to incorrect measuring values Waste Bottle Dispose of or empty and decontaminate the bottle NOTE The waste bottle contains biohazardous substances Waste liquids should be capped and disposed of according to local regulations Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 5 9 Maintenance Printer Gas Supply 9 6 Paper check quantity and replace if necessary NOTE The paper is heat sensitive on one side only Please insert correc
216. the cover Initiate the corresponding calibration Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 37 12 Appendix Electrode The PO Electrode consists of the inner electrode the housing with the membrane and the electrolyte solution and is marked with a blue grip The membrane housing should be replaced periodically Membrane replacement can be easily performed by the operator Glass with Black O ring jamen Adenode P di Glass tip Plastics Jacket Cable Holder Fig 12 21 Electrode NOTE Do not use abrasive cleaning solutions which may damage the inner element The inner element or the entire electrode should be stored in PO electrolyte solution NOTE Never allow the tip of the glass electrode to touch any hard surface e g glass Place a soft cloth at the bottom of the glass cup in which the Electrode or its inner part is stored To replace the membrane housing see page 12 41 Cleaning Carefully disconnect the PO Electrode cable by pulling the plug gently Release its clip and remove the electrode from the measuring chamber block Carefully remove the inner electrode from the housing avoiding spillage of electrolyte solution Dispose of the old electrode housing according to applicable safety regulations or procedures Replace the inner O ring if necessary e g if brittle or worn Moisten th
217. the following display with the correct temperature appears WARM UP a SB ZP temr ai o IG During the warm up there is a conditioning of the PO and PCO electrode WARM LP 299 4 Check the automatic filling function of the pH Reference Electrode housing see chapter 9 If the pH Reference Electrode is filled continue with item 5 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 7 3 Installation Shutdown 3 8 If the pH Reference Electrode was not filled Take pH Reference Electrode out of the measuring chamber NOTE Do NOT disconnect cable and tubes Activate Maintenance YES ix w Electrode YES USER FROGRAMS Ref electrode Fill electrode 7 Press This function activates the automatic filling of the pH Reference Electrode housing On completion of the filling procedure the following display appears USER FROGRAMS Ref electrode Press when the electrode is filled The permeability of the pH Reference Electrode diaphragm should be tested Carefully touch the electrode tip with a clean dry tissue Press to confirm Observe the electrode tip for the formation of a small droplet of pH Reference Solution USER FROGRAMS Ref electrode Check Permeability 7 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 Installation Shutdown If no droplet has formed on the tip press to confirm and repeat this proced
218. the following is shown MEASUREMEMT Confirm with If is pressed or after conclusion of time out the sample will be washed out and the analyzer returns to the READY mode Biz POS measurement Press to perform the PO measurement If the PO measurement is not selected the already scanned in values will also be canceled After the PO measurement or when this is not selected by pressing the following appears on the display MHEASUREMEHT Bag PCOS measurement Press to perform the PCO measurement Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 7 4 Patient Testing 4 8 E os with UF Positioned By pressing A you can position the sample The sample should be positioned uninterrupted The sample should reach at least to the middle of the connecting capillary between the pH and PCO electrodes Confirm the correct position and start the measurement by pressing After completion of the PCO measurement the pH measurement will be offered At the pH measurement the pH reference electrode as well as the pH electrode have to be completely covered by the sample Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing Printout of Results Immediately after the results are displayed the results are printed on the thermal printer For a detailed description of reports see chapt
219. this does not occur until the start of a new measurement Data not transmitted will be shown If the AVL 9180 receives an ACK from the AVL COMPACT 3 an entire datalink report will be transmitted The single lines of the protocol whose sequence corresponds to the printed protocol are separated by CR Hex 07 and LF Hex 0A The first transmitted sign is Control G the last transmitted sign is EOT Hex 04 Connect the AVL COMPACT 3 and the AVL 9180 with the connecting cable to the provided interfaces Turn the analyzers on and wait for the READ mode Activating the datalink on the AVL COMPACT 3 User Programs 5x Settings Sx Nw Interface VES USER FROGRAMNS Interface Ema d uw By pressing you may select 2 or COM 3 The following display appears if you have selected COM 2 USER FROGRAMNS Interface SER mm m Press to confirm Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 15 11 Interface USER FROGRAMNS OH OFF m 7 Select and confirm by pressing VES USER FROGRAMS COM z Mode 7 Select the interface by pressing or A and confirm with YES USER Datalink 933 Mode o k 7 Select the datalink function by pressing or A and confirm with YES The datalink is active now You may activate the datalink function on COM 3 in the same way 11 16 Operator s Manual AVL COMPACT 3 Rev 2 0 Ju
220. tivate Parameters input 4xNV far 3x AN3 This parameter is also used to calculate the alveolar arterial oxygen partial pressure difference AaDO The displayed RQ value may now varied with the numeric keypad Available input range 0 71 1 99 Preset value 0 84 When you confirm the selected RQ value with the display will fade out At this point you may select another parameter with or A or exit the program by pressing Esc Activate Parameters inrut Sx Nvw far 2 32 YES The P5 value is defined as the oxygen partial pressure at which the hemoglobin is half saturated with oxygen The displayed P50 value may now be varied with the numeric keypad 50 adult Available input range 15 40 mmHg 2 0 5 3 kPa Preset value 26 7 mmHg 50 fetal Available input range 10 40 mmHg 1 3 5 3 kPa Preset value 21 5 mmHg When you confirm the selected P50 value with the display will fade out At this point you may select another parameter with or A or exit the program by pressing Esc Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 15 4 Patient Testing Modification of Sample Type Activate Parameters input Bx v far ix AX 1 Lure YES By pressing or A you can select between arterial capillary and venous Confirm the selected sample type by pressing At this point you may select another parameter with or A or
221. tly Correct paper insertion 1 Push the paper roll holder slightly to the side and remove the empty roll 2 Insert a new roll of paper 3 Insert the paper in the feeder 4 Press the paper feed black button until the paper appears on the outside of the cover Fig 9 1 Paper insertion Check primary pressure of the precision gas cylinder min 10 bar or 150 psi if necessary replace the gas cylinder Check secondary pressure of the precision gas cylinder min 3 4 bar or 45 60 psi If necessary call AVL customer support NOTE To guarantee the specification it is required to use AVL Precision Gases Gas Cylinder Seal Calibration Gas 2 Calibration Gas 1 10 CO 5 5 balanced N5 20 O5 balanced N5 Fig 9 2 Position of the gas cylinders Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Maintenance External Cleaning Analyzer Fill Port Quality Control Replacing the calibration gas cylinders e Disconnect the tubes e Empty the cylinder completely Release the clasps of the pressure regulator and take off the cylinder e Take the empty cylinder out of its holder e Dispose of the empty gas cylinder in accordance with local regulations e Insert the new cylinder in the holder and secure it e Install the pressure regulator on the new gas cylinder use new gas cylinder seals e Connect the tube with the connector nipple on the rear panel of the AVL COMPACT 3 e O
222. to 20 characters on the printout e g name of the hospital Activate Settings BxNV tor 3x AQ Rerart dx NV Comment YES Available are capital letters small letters numbers and special characters USER PROGRAMS The first character is blinking Press or A until the required character appears on the display Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 25 8 System Functions AVL Multirule 2 Measurement Reports 8 26 Confirm your selection by pressing YES The next character is blinking Repeat the operation to enter the required comment Exit this program by pressing Activate Settings Bx NV far 3x AN Eerart Sx NV Multirule7 YES USER PROGRAMS OFF Multirule ok 7 OFF or is blinking by pressing Nv AX you can now activate or deactivate the AVL Multirules These Multirules are valid for the QC Statistics Confirm by pressing For details please refer to chapter 11 section Parameters and Equations Activate m ce ct er in lt ES xNw far Ex AQ zu Ti lt m 22 T z meaz YES LISER PROGRAMS 2 peas rerportz 7 or OH is blinking Switch between OH and by pressing Nz A Activate the blinking section by pressing and 2 measurement reports running will be printed Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 Syst
223. to the capillaries When both capillaries are filled quickly pull the needle out of the tissue and briefly compress the puncture site The minute incision closes quickly and leaves no lesions or hematoma Fig 13 4 Use of AVL Microsampler When circumstances do not allow arterial sampling or if repeated arterial puncture is not desirable or dangerous arterialized capillary blood sampling may be selected as an alternative method When properly performed this type of sampling can be a substitute for arterial sampling and gives a true picture of the acid base status When sampling is performed on a hyperemized earlobe the PO value is also reliable The validity of capillary sampling depends mainly on two factors e Good vasodilatation through hyperemization of the puncture site e Elimination of all contamination risks by ambient air can be difficult in some cases Use of capillary blood samples is contraindicated in the following cases e Patient in shock with centralized circulation In this case arterialized blood cannot be drawn from the capillary bed due to the opening of the subcutaneous capillary shunts Increased central vein pressure which causes an increase of venous blood in the capillary blood Peripheral and local circulation problems which affect the puncture site e Cases in which the PO values have to be very exact for shunt determination or in case of precise determination of high PO values Operat
224. together and printed with the results of the blood analysis NOTE In the case of the parameter combination NA K CA the Ca value from the data system is calculated from the pH value of the standardized Ca value from the AVL COMPACT 3 at pH 7 4 and is printed on the AVL COMPACT 3 After completion of data link the following display appears on the AVL 9180 Remain in Program Func Press No the analyzer returns to READY Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 19 11 Interface AVL COMPACT 3 to AVL 912 Description of the Interface Baud Rate Transmission Format 11 20 Datalink can be used to connect the AVL 912 and the AVL COMPACT 3 and convey the respective measurement data NOTE Please make sure that the proper connections are made prior to turning the instruments on Use the proper interface cable BV1810 for the connection to the COM 2 of the AVL COMPACT 3 or BV1813 for the connection to the COM 3 of the AVL COMPACT 3 NOTE In the mode Microsample the measurement of all desired parameters has to be finished before starting a measurement on the AVL 912 Pin Occupancy The 9 pin SUBMIN D F interface socket is located on the back of the analyzer above the power supply plug 51 C AVLC 3 eJ X Pru c sied um P wa t 0 8 7 6 S5 56 NT Modem Centronics Fig 11 8 Interface AVL 912 Pin 2 uus
225. tor Initiated Calibrations ecce eese eese eese eene eene sesso etse esse esse seen 6 2 Main Calibration OI UM dec Me M I DU E us 6 2 PH AP Caltbration EE 6 3 Gas 2P Cali eer tese does ete ded reed 6 3 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 6 1 6 Calibration 6 Calibration All calibrations are automatically performed by the AVL COMPACT 3 analyzer Automatic Calibrations Main Calibration PH 1P Calibration Gas 1P calibration The following calibrations are automatically initiated and performed by the analyzer This calibration is performed periodically every 12 hours or at a user programmable interval 2 12 hours The main calibration is performed by e Gas calibration point Gas 2 calibration point Cleaning Solution an internal counter checks if more than 20 samples have been measured If that is the case a cleaning cycle will be performed during the next main calibration Buffer Type 2 calibration point Buffer Type 1 calibration point Buffer Type 1 and Buffer Type 2 will be measured for max 3 times 4 times if one aspiration cycle was not detected The number of cycles is dependent on the reproducibility of the values the selected calibration interval and the quality of the electrodes pH 2P calibration
226. tored e The patient measurement data will not be influenced in any way by using this AVL Multirule procedure e The lab supervisor or the physician is responsible to decide if sample data marked with Warning or Out of Control should be rejected or not and which further actions have to take place Bibliography Elsa F Quam BS Lorene K Haessig BS Marlene J Koch BS A Comprehensive Statistical Quality Control Program for Blood Gas Analyzers Journal of Medical Technology 2 1 January 1985 2 James O Westgard et al A Multi Rule Shewhart Chart for Quality Control in Clinical Chemistry Clinical Chemistry Vol 27 No 3 1981 12 16 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Shunt Parameter The Shunt parameter is a measure for the direct mixture of venous blood in the oxygenated circulatory system The Shunt parameter gives the short circuit volume relating to the total volume value Activate User programs 5x Settings 8x or 2x Report 2x Report editor Select the Individual report editor and the Shunt parameter If the Shunt parameter was selected the Shunt should always be calculated and given The Shunt volume can be determined with one sample however better with two sample measurements The SI and the conventional unit for Shunt volume is 9b The output on the report can appear as follows AVL COMPACT 3 BLOOD GAS ACID BASE REPORT Name
227. tracellular fluid is a quantity that reflects only the non respiratory components of acid base balance ctHb 5 g dL 16 2 pH 7 4 24 8 cHCO mmol L 11 refer Rechenwerte HM HR Rev 8 29 April 1997 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 21 12 Appendix Buffer base BB The buffer base is the concentration of buffering anions which is available in whole blood to buffer strong acids and consists mainly of protein anions and bicarbonate Of the protein anions hemoglobin is the most significant BE 417 0 42 ctHb mmol L 12 Oxygen Saturation 50 The amount of oxyhemoglobin in blood expressed as a fraction of the amount of hemoglobin able to bind oxygen oxyhemoglobin plus deoxyhemoglobin is termed hemoglobin oxygen saturation cO Hb cHHb SO 00 9 13 If not calculated or from a direct measurement available SO 96 2 100 1 Adult lgQ 2 9 1gPO FI 10 779 F3 IgPO 1gPO 0 48 pH 7 4 lg 0 0013 BE 26 7 26 7 or enter adult 1 1 661 F2 0 074 4 172 Fetal lgQ 2 9 1g PO FI 1077 79 1gPO 0 48 pH 7 2 lg 5 0 0013 26 7 21 5 or enter P fetal F1 1 3632 F2 0 0533 F3 4 113 In this table the fetal P50 value is for pH 7 4 and should be preferred to use 12 22 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appen
228. trodes do not require any Preparation 1 Fig 3 7 Removal of transport housing Before installing the remembranable electrodes remove transport housing twist 1 and pull 2 and fit them with a new electrode housing see chapter 12 Care and Maintenance of Remembranable pH Blood Gas Electrodes NOTE Save transport housing for possible storage or transport The electrodes do not require cleaning with electrode paste at this stage Install the electrodes from right to left in the following sequence e PO Electrode blue e PCO Electrode green e pH Electrode gray Pull out the electrode clips and insert the electrodes into the measuring chamber block Secure the electrodes with the clips and connect the electrode cables 1 Carefully remove the protective caps from the pH Reference Electrode nipples Connect the unmarked tube to the lower nipple and the yellow coded tube to the yellow coded upper nipple Yellow ao N Fig 3 8 pH Reference Electrode yellow marking Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 Installation Shutdown Replace the pH Reference Electrode housing with a new one Fill the pH Reference Electrode with pH Reference Solution before inserting into the measuring chamber block 2 Plug the power cord into an electrical outlet and switch on the analyzer 3 The following display appears COMPACT 3 Please wait When the correct temperature is reached
229. ture Check odes electrodes pH Module temperature too high because of excessive ambient temperature Module temperature in excess or insufficient because of thermostat failure Voltage too high too low Excessive insufficient slope pH Electrode plug disconnected pH Reference Solution Blockage in pH Reference Electrode housing pH Reference Electrode housing not full pH Electrode soiled Measuring chamber temperature Buffer Type 1 Buffer Type 2 contaminated with micro organism wrong pH value Tightness of flap Measuring chamber valve Electrode position Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Switch off the analyzer Check ambient temperature 15 32 C 59 0 89 6 F Check Module cables and plug Call AVL customer support Print out a calibration report and check status of the analyzer Check sample path for leaks and clots Activate User programs Maintenance Wash Change electrodes Perform the corresponding calibration Check pH Reference Electrode Replace pH Electrode Perform QC measurement Repeat measurement Call AVL customer support Connect plug Check pH Reference Solution cap for leak Screw cap on tight Call AVL customer support Replace pH Reference Electrode housing see chapter 9 Maintenance Fill up
230. tus For details please refer to chapter 12 section Description of Various Reports Printout ar A Report ps S 4 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 C F z Calibration 22 v m gt Edit patient data UP DOWN YES YES C p Lastreport I Prinout XS 2 M E UP DOWN os YES a gt Printout Last 3 reports M 2 M UP DOWN YES EOD Scroll results ELE PO2 Ne BE BEecf BB HCO3 TCO2 st HC sr pH O2sat O2cont cH AaDO2 Shunt ee UP DOWN A NES 7 L E Printout 2A report j N UP DOWN a YES E Eraseemot Error report Printout 1 L L J UP DOWN YES System pyintout 4 V 4 Patient Testing Measurement Reports Data Input Reports 4 20 If for example on completion of a measurement the parameters have been modified or patient related data have been entered an updated measurement report showing the modified parameters and data may be printed out Activate User Programs ERV Printout WES Data i newt YES This function enables the input of patient related and sample specific data The input if these data overrides the preset default values for the last measurement Confirm by pressing For details please refer to section Parameter a
231. ube damage in the AVL COMPACT 3 analyzer during transport relief clamps are inserted under the solenoid valves to NOTE The clamps designed for this purpose can easily be removed by lifting the solenoid fixtures Six of them V3 V4 V5 V7 V11 V12 are inserted to the right of the measuring chamber see Fig 3 12 one to the right of the peristaltic pump see Fig 3 13 The remaining three red solenoid valve relief clamps have to be inserted V6 V8 V10 in the bottle compartment see Fig 3 14 Fig 3 12 Solenoid valve relief clamps fill module Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 13 3 Installation Shutdown Storage Transportation Fig 3 14 Solenoid valve relief clamps bottle compartment Protect the AVL COMPACT 3 with a dust cover during storage For transportation purposes use the original shaped parts packing material Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 4 Patient Testing 4 PATIENT TESTING Sample Preparation sccwscsccsccceccscevesencdecesovcsdcesavdscvecesscecaveccvedevscsnsesesoasccuessessadecsvedevsdenssenedenteveces 4 1 Important when Storing cece cece cece cece eee e eI Ie mee men meme eerie hen thinner enne 4 1 Sample Measurement SEPT H 4 2 Syringe Measurement osse teste dee mede ri YR SIS Coe E REN Se Be gU ee b Ree ee beer ee e ERE AE DE ERR 4 2 Capillary or Micro
232. ulation system and the sample The pH Reference Solution is transported only if the bottle cap is closed tightly The bottle is placed behind the pH Reference Solution inside the bottle compartment A cleaning cycle is automatically performed after 50 samples during the next main calibration CAUTION Do not mix or refill reagents Use only AVL reagents Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 Description of the Analyzer Sample Fill Module This module consists of the following parts e Flap e Fill port and tube e Sample drip tray Flap Fill port Sample drip tray Fig 2 5 Sample fill module Flap The flap has to be opened for a sample input CAUTION If the flap is opened by mistake the running action will be interrupted The analyzer prompts the operator to close the flap and a wash dry cycle will be performed Fill Port and Tube The fill port see Fig 2 5 allows samples to be injected or aspirated from e syringes e AVL Microsampler and e capillaries without the need of adapters Sample Drip Tray The sample drip tray is placed on the lower end of the fill module to avoid sample spilling The tray is replaced as part of the scheduled maintenance procedures or when it becomes very soiled Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 5 2 Description of the Analyzer Description of the Sample Path Fill Port Sample Inlet Path Measuring Capillary Measuring Chamber
233. ument C27 A 1993 National Committee for Clinical Laboratory Standards Protection of Laboratory Workers from Infectious Disease Transmitted by Blood Body Fluids and Tissue Second Edition Tentative Guideline NCCLS Document M29 T2 1992 National Committee for Clinical Laboratory Standards Percutaneous Collection of Arterial Blood for Laboratory Analysis Second Edition Approved Standard NCCLS Document H11 A 1992 National Committee for Clinical Laboratory Standards Additives for Blood Collection Devices Heparin Tentative Standard NCCLS Document H24 T 1988 National Committee for Clinical Laboratory Standards Evaluation of Precision Performance of Clinical Chemistry Devices Second Edition Tentative Guideline NCCLS Document EP5 T2 1992 Snyder John R Senhauser Donald A eds Administration and Supervision in Laboratory Medicine ond ed Philadelphia J B Lippincott Co 1989 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 1 Introduction 1 INTRODUCTION Analyz r D scripti n 2 1 Intended T 1 1 Clinical Significance eee ea eoo eoe eoo Eu no eaae ceo e ye on e e eee aene ea ev en ae ean o epa uae va de aa 1 2 ple LEE 1 2 FC Os ot eh tet Se tale Steg ed b et ae et DP ERR TE Re OR ESTEE ee UO DES ARN Des 1 2
234. une 1998 12 64 13 Preanalytical Requirements for Blood Gas Analysis 13 PREANALYTICAL REQUIREMENTS FOR BLOOD GAS ANALYSIS luu n 13 1 Sample LII DIL LI ELICIT ES 13 1 Arterial de Pm 13 1 Venous Blood ER egeo v eo te oh ecu oes oe e RE LEER ER ae 13 1 Arterialized Capillary Blood m tuit aa a Rp Ve E eO ages 13 1 Sampling Procedures eee En ee Pese te ed paa Eoo de 13 2 Sampling REPRE P MF HE OR RN LPS e RR ENSER NP IR SEE 13 2 DEVICE 13 2 Niusup ce 13 2 EA is rU EI REUS 13 2 AVE Microsampler E ERE ERROR EORR E DEAE ig gah He eie Pe EUER 13 2 AMTICO aA SUL ALO Minis hss ies janet cock te sehen Sorte undoes Len DAS Leni qeb tees bes ex odes eee UO Pe CORR UIDES ARES Ue Cen Une tud 13 3 Effect of Heparin on Measurement Para meters 0 0 0 0 cece cece ence nee e ee ee hen rene 13 3 Use of EDTA ERR caue Nee ance qe recep 13 3 Sampling Proced re dee de Hee t see Pe e Sa ESSERE CR EEE Ses Menges Ie 13 4 Preparation of Puncture Site edet ere ree ure teret ese on t ere di eye edes dde oe eee 13 4 Nunc 13 4 Sampling 5h eer E ud
235. ure otherwise exit this program by pressing i If again no droplet has formed replace the pH Reference Electrode housing in accordance with the instructions given in chapter 9 Maintenance droplet Fig 3 9 pH Reference Electrode droplet If the droplet has formed wipe it off carefully insert the electrode into the measuring chamber and secure with the clip Press to exit the program Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 9 3 Installation Shutdown Inserting Printer Paper 1 Push the paper roll holder slightly to the side 2 Put a new roll of paper into the mounting support 3 Insert the paper in the feeder 4 Press the paper feed black button until the paper appears at the outside of the cover w Fig 3 10 Paper insertion NOTE The paper is heat sensitive on one side only Make sure that it is inserted correctly 3 10 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 3 Installation Shutdown Shutdown Longer than 3 Days Rinse and Dry the Tubes If the AVL COMPACT 3 is to be put out of use for a longer period of time it is possible to activate the economy standby mode During this time the analyzer does not need Buffer Type or Buffer Type 2 but the electrodes have the optimal conditioning If necessary a Manual Standby or Automatic Standby can be activated For details see chapter 8 Settings section Manual Standby or Automatic Standby This economy
236. urements and calibrations to prevent electrical interference and maintain temperature stability of the measuring system The cover can be held in an open position using the door rod to secure the door Fig 2 3 View with open top cover Bottle Compartment 1 the bottle compartment the following reagents containers are required Waste Rinse Buffer Type 1 Buffer Type 2 pH Reference Solution Cleaning Solution Cleaning Solution Buffer Type 2 Fig 2 4 Reagents NOTE The ambient temperature for storing all reagents ranges from 5 C to 30 C 41 F to 86 F Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 3 2 Description of the Analyzer Waste Rinse Buffer Type 1 pH 7 383 Buffer Type 2 pH 6 841 PH Reference Solution Cleaning Solution 2 4 All liquids used by the analyzer are collected in the Waste container CAUTION A trouble free wash and dry cycle can be ensured only if the system is completely sealed The Waste container lid must be tightly closed The Rinse is used e to wash out the sample e to wash out the calibration solution The Buffer Type 1 is used to determine the first point of a pH calibration The bottle is placed behind the Buffer Type 1 bottle inside the bottle compartment The Buffer Type 2 solution is used to determine the second point of a pH calibration This solution is pumped into the pH reference electrode by means of a KCl pressure circ
237. ut of the puncture site This will add tissue fluids which cause a thin blood film that quickly mixes with ambient air This will result in a falsification of the blood gas values Air bubbles must be avoided since they may cause contamination of the sample Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 13 7 13 Preanalytical Requirements for Blood Gas Analysis Sampling froma Catheter This type of sampling is used when therapeutic reasons require the installation of an arterial catheter With the aid of the catheter repeated sampling can easily be performed Usually the catheter is perfused with physiological saline solution containing heparin to prevent coagulation to keep the catheter open A three way stop cock is placed at the proximal end of the catheter for blood sampling purposes Two precautions have to be taken to ensure valid sampling e The catheter is to be flushed with a volume corresponding to four times its dead space before drawing a sample To do this the sampling syringe which most commonly is connected to the three way valve with a Luer Lok connector is slowly filled several times and emptied out into the catheter e Sample aspiration should be very slow and without evacuation or should be automatic due to the arterial pressure Caution Various medications may cause contamination of the measuring chamber of the blood gas analyzer To avoid this cleaning cycles should b
238. v ay anon pe o Ee No a RENE aa EY Le y ene 13 Calculated Va lue s 1 o p co secu sa so ao sed P ea Es e oo Peg ges ep evade aa ees ad 14 Specific Performance Characteristics 17 Bibliography ES 26 1 INTRODUCTION Analyzer Description ene ono a nee ew aea vo sau eoe ve on eua aea ee e ve aun uo en oY eoo ao exu na eu on ve 1 1 iri ET MUT 1 1 Clinical Significance se eese ee cotes ooo EET EE pe ae ees aee YE RE 1 2 Handling th ArnalyZer iieri riz iere co eden Ir etos Lain ires 1 3 Handling Blood and Blood Products caeca eee eee eee eese eese 1 3 Handling AVE Reagents eo esseen ess Ea 1 4 De c ntaminatl0n 2 uei esesdsessssecdecesedsceussbeisdesunendsceeedeadesess secsevapedseacoeSaeseeadeadscssacdeasssleccdees 1 5 Handling the Electrodes c M M S 1 8 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 Contents 2 DESCRIPTION OF THE ANALYZER Main 2 1 Analyzer COMPOMeMts LLL 2L DLL LL LL 2 2 Description of the Sample
239. ve cap EIL Fig 12 25 Electrode housing with protective cap Fill the electrode housing with or PO Filling Solution by holding the housing in a slightly inclined position and inserting the tip of the PCO or PO Filling Solution bottle Fill the housing to the overflow opening Fig 12 26 Filling electrode housing with electrolyte Gently tap the electrode housing to remove any air bubbles from the tip Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 41 12 Appendix Fig 12 27 Remove air bubbles Incline the housing slightly with the overflow hole downwards Carefully insert the inner electrode until resistance is felt Fig 12 28 Insert inner part Insert the inner electrode until it is flush with the housing Rotate the inner section one quarter in both directions Fig 12 29 Insert inner part NOTE Slightly turn the inner part of the electrode for optimal membrane tension This also prevents the inner element from being pushed back out of the housing after release due to the elasticity of the O ring 12 42 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 12 Appendix Dry the electrode carefully with a tissue Close the overflow hole of the housing with coroplast adhesive tape 10 mm x 10 mm Fig 12 30 Close overflow hole of the electrode housing ATTENTION Make sure that the tape does not overlap onto the two lateral flat spots of the electrod
240. ver the lazy dog 0123456789 amp tdi lt gt poe Exit this program by pressing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 17 10 Troubleshooting Program Version Autom Selftest 10 18 This test program shows the program version of the analyzer USER PROGRAMS System test Program version Press Example USER PROGRAMS COBA 3 ED X XX The display shows the actual program version of the AVL COMPACT 3 in the corresponding language versions Exit this program by pressing This test checks the measuring circuit of the analyzer USER PROGRAMS System test Autom Selftest Press RAM o EEPROM CLOCK TI ME INTERFACE o EXT ADC o I NT o pH MEASURE o k PO2 MEASURE o k The parameters are always shown in their current condition or ERROR Other test programs are not described in this chapter For details please refer to the Service Manual Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 11 Interface 11 INTERFACE General DESCripti OM sees 11 1 MM UH 11 1 PAINTING 11 1 COM TARS 232 tese es e ebbe eset etu be oer E 11 1 COM 2 RS 232 t Ru RU EN Haec e e hae td eR 11 1 GIORNO HONDA ELT 11 2 CM ES 11 2 Trans
241. vices site selection sample handling documentation and specific procedures used approved by the personnel responsible Lithium heparin Sodium heparin or balanced heparin salts as often used for samples taken also for electrolyte analysis are the only acceptable anticoagulants for blood gas analysis Other anticoagulants such as EDTA citrate oxylate and fluoride have a significant effect on blood pH and should not be used Lithium heparin should not be used for samples taken also for analysis of Lithium If liquid heparin is used as an anticoagulant collection devices should be no larger than the amount of blood required minimizing the effects of dilution of the blood by the anticoagulant solution Although plastic syringes are commonly used for collection of blood specimens for blood gas analysis there have been reports in the literature regarding the use of plastic syringes when PO values higher than normal are expected Particular attention should be paid to cooling blood samples in ice water because of the CO and oxygen solubility in some plastics If blood specimens are expected to have very high PO values care should be taken to analyze the specimen as quickly as possible following collection to avoid the need for cooling Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 9 Method Sheet Capillary Tubes AVL Microsampler Vacuum Tubes Capillary blood specimens should be collected using AVL capillary tubes which h
242. water and check the water for continuous gas flow Call AVL customer support Tightness of the flap Check fill port Check wash nipple Measuring chamber valve Check seal adapter Electrode position Check electrode support PO Voltage too high too low Replace PO Electrode Excessive insufficient slope Excessive electrode drift Gas bottle exchanged PO Electrode plug disconnected PO Electrode Gas bottle exchanged or empty Leaks Tightness of the flap Perform QC measurement Repeat measurement Call AVL customer support Connect plug Replace electrode housing or electrode Check gas supply and tubing see chapter 9 Maintenance Connect properly Activate Susten Test Electrodes 3 2 internal Check quad ring between preheating tube and measuring chamber On the left side of the measuring chamber place a tube reaching into a cup of water and check the water for continuous gas flow Call AVL customer support Check fill port Check wash nipple Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 Troubleshooting Error Messages Possible Cause Instructions for Elimination PO Measuring chamber valve Check seal adapter Electrode position Check electrode support Service alarms Calibration can not be performed Remove cause of alarms because of alarm s Activate calibration Ch
243. when the measuring capillary is contaminated protein residue or if components of the measuring path are being replaced Such cleaning process basically interferes with the measuring system and the electrodes They must be conditioned afterwards The decontamination agent is introduced via the fill port If necessary decontaminate the measuring chamber specially the connecting pieces with a cloth saturated in disinfectant Procedure Activate User programs 7 YE 3x Maintenance 7 YE 2x Cleaning 7 YES Perform cleaning according instructions on the display NOTE After reinstalling of the decontaminated electrodes at a later time or a new electrode perform two measurements with a wetting agent e g whole blood to moisten the system Handling the Electrodes Handle the electrodes with great care to prolong their operation life Avoid contact between the electrode tip and hard surfaces Never allow the electrodes to dry out or store them unprotected For details please refer to chapter 9 section Care and Maintenance of pH Blood Gas Electrodes and chapter 12 section Care and Maintenance of Remembranable pH Blood Gas Electrodes Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 2 Description of the Analyzer 2 DESCRIPTION OF THE ANALYZER Features s 0 iccssescciscevscsvsiensccdesdeeccsdesensccsesenscsdssobecsssiooccodesenccdecbeescodsceuescodssesecsosbsecdetoesssotsees 2 1 Measureme
244. which control the status of the analyzer Operator messages indicating detected system errors or malfunctions will be displayed and printed out All error messages are printed on the Error Report On this report max 20 alarms can be listed Displayed and Printed Warning HO Cleaning Solution This warning indicates that the Cleaning Solution bottle is empty Check and replace the Cleaning Solution No system stop Displayed and Printed Alarms There are two kinds of displayed alarms before and during the READ mode during a calibration conditioning or measurement The displayed alarms are Electrode Alarms e FOOSE nat calibrated e FOS not calibrated e FH not calibrated e Check electrodes NOTE Even if one or two of the electrodes are not calibrated the analyzer will stay limited for the remaining parameter Liquid level alarms e Check Waste e Ha Rinze e REF Drift alarms e Ho Gas 1 Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 10 1 10 Troubleshooting Alarm Causes Software detection contact path e Ha Buffer 1 e Ha Buffer Various alarms e Check HC temm e Check Lempa e fleas Fath filled e Check meas Fath e Check e samele e Serpuice alarms e Check BARO Main Calibration has not been performed accordingly Low levels of pH Reference Solution Buffer Type 1 Buffer Type 2 or Rinse Waste container full Low fl
245. wort Pa wort code 1 2 code 1 2 code 1 2 code 1 2 code 1 2 code 1 code 1 v lt Pa wort e Pa wort gt code 1 7 Fig 8 2 Password The figure above shows which password codecards give access in which area A password as well as an activated barcode scanner are necessary for this function This should block the analyzer making further access to the analyzer impossible Activate Settings Fx Nw for dx ZAK USER PROGRAMS Settings Deuice lock NOTE This function can only be activated with the password codecard 1 USER PROGRAMS OH OFF Deuice lock Oska or blinks Confirm the selected condition by pressing Operator s Manual AVL COMPACT 3 Rev 2 0 June 1998 8 21 8 System Functions The following is shown on the display READY 16 35 Device locked Password 7 No further operation of the analyzer is possible without reading password codecard 1 For further details please refer to section Password pg 8 19 Report Activate Settings Bx NV far 3x AN3 Main Calibration Report This function allows to activate or deactivate the report of the main calibration Activate Settings Bx Nw tor 3x AQ Eerort YES Main cal reraort YES USER PROGRAMS OFF Main cal rerort OH or is blinking Switch between OH and OFF by pressing Nv or A Activate the blinking selection

Roche AVL Compact 3 Bloodgas Analyzer

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