CC PART 2 Flashcards
introduction of electronics, robotics, and highly advanced
technical methodologies
AUTOMATION
Sample processing/ preparation
Pre-analytic
Analyte measurement or
chemical analysis
Analytic
Data management
Post-analytic
● Reagents, diluents and samples are pumped through a system of
continuous tubing
CONTINUOUS FLOW
● All samples are carried through the same analysis pathway.
● They automatically pass from one stage to another without waiting to bring the samples to the same stage of completion.
CONTINUOUS FLOW
● One sample, one test
● Samples and reagent flow through a system of continuous tubings
CONTINUOUS FLOW
Parallel testing: One test at a time
CONTINUOUS FLOW
Disadvantage
● Significant carry-over and costly
reagent waste
CONTINUOUS FLOW
● Serve as a separating and cleaning media / mechanism
Air bubbles - CONTINUOUS FLOW
● Introduced in continuous flow analyzer to minimize diffusion of reagents and mixing between samples
Air bubbles - CONTINUOUS FLOW
● As the rotor is accelerated, centrifugal force moves the reagent and sample to a mixing chamber and then through a small channel into a cuvette
CENTRIFUGAL ANALYSIS
● As the filled cuvette rotates past a fixed light beam, the absorbance of the reaction is measured spectrophotometrically.
CENTRIFUGAL ANALYSIS
● Many samples, one test (Batch
Testings)
● One test (analyte) in batch-type
systems
CENTRIFUGAL ANALYSIS
● All samples are loaded at the same time
● Uses centrifugal force to transfer specimens and reagents in cuvettes.
CENTRIFUGAL ANALYSIS
● The most versatile approach and with random access stat capability
DISCRETE ANALYSIS
● Each sample reactions is handled to a separate compartment and does not
come into contact with another sample
DISCRETE ANALYSIS
● The samples and standards are
handled on a batch and must be
brought before proceeding to the next procedure
● All reactions must be carried out until equilibrium is reached
DISCRETE ANALYSIS
● Carry-over will not be a problem
● Measures only the tests requested on
a sample
DISCRETE ANALYSIS
● Capable of measuring multiple tests (analyte) at one sample at a time
● Each sample and reagent mixture is handled separately in their own reaction container
DISCRETE ANALYSIS
● Many test, one sample OR many sample, one test
DISCRETE ANALYSIS
● Uses microvolumes and reagents on slides for dry chemistry analysis
DRY SLIDE / THIN FILE ANALYZERS
● A 16 mm square chip which contains several very thin layer that accepts a metered drop of serum, spreads it evenly into a reagent layer, then confines the colored product to a fixed area for reference spectrophotometry
DRY SLIDE / THIN FILE ANALYZERS
● No need for reagent preparation
DRY SLIDE / THIN FILE ANALYZERS
● Kodak Ektachem (Vitros)
DRY SLIDE / THIN FILE ANALYZERS
What analyzer: Many samples, one test?
■ Discrete analyzer
■ Centrifugal analyzer
What analyzer has an approach with random access capability?
Discrete Analyzer/ Analysis
What is a Random Access STAT Capability?
Allows stat samples to be prioritized in the middle of testing
other routine samples.
What analyzer: Many samples, one test OR many test, one sample?
Discrete analyzer
What analyzer: SSRIS - Dry Chemistry?
Dry Slide / Thin File Analyzer
What analyzer: One test, one sample?
Continuous flow analyzer
What analyzer: Reagent contamination?
Continuous Flow Analyzer
What analyzer: With Air Bubbles?
Continuous Flow Analyzer
TO READ:
FEATURES OF SELECTED HIGH VOLUME CHEMISTRY AND IMMUNOASSAY ANALYZER
- Throughput (tests per hour)
- Number of assays onboard simultaneously
- Number of open channels
- Number of ion selective electrode
- Detection/Separation technology
- Minimum sample volume aspirated (uL)
a. The less amount of sample, the better - Dedicated pediatric sample cup/dead volume
- Short sample/clot/interference detection
- Onboard test automatic inventory
a. Will tell the remaining reagents left and can be
refilled in the middle of an on-going test - Remote troubleshooting by modem
TO READ:
GOALS OF LABORATORY AUTOMATION
- Reduction of costs
a. Less manpower = less expenses of the laboratory - Expansion of laboratory testing to generate more revenue
a. Send-out samples = less expenses for the laboratory - Reduction In turnaround time
- Reduction in laboratory errors (volumetric pipetting steps, calculation of results and transcription of results)
- Minimize variation of results from one medtech to another
- Improvement in laboratory safety
- Increase number of tests performed
- Use of very small amounts of samples and reagents
- Better space utilization thru consolidation
Less manpower =
less expenses of the laboratory
Send-out samples =
less expenses for the laboratory
A laboratory that uses different machines but the sections are still divided in the lab
Automated Laboratory
○ All the machines in the laboratory are connected
○ No more sections
○ The sorting of the specimen is already done by the machines (sorting area)
Total Laboratory Automation
A laboratory that uses different machines placed side by side connected by a conveyor system
Partial Automation
○ With conveyor system wherein the tubes are delivered and transported to the different
machines
○ No more manpower (the machine can centri and make aliquots by itself)
Total Laboratory Automation
The only thing that the medtech will do is to insert the specimen tubes
Total Laboratory Automation
Usually by barcode reader (sticker)
Sample ID
Usually communicated by LIS
Test Selection
Usually by syringes, pumps or
pressurized reagent bottles. Vitros uses dry slides. Some offer reagent inventory
Reagent Delivery
Mixing and Incubation
Chemical Reaction
● Visible & UV spectrophotometry, ion-selective electrodes, fluorescence polarization immunoassay, chemiluminescence, bioluminescence. Most offer
automatic dilution and retesting
when linearity is exceeded
Measurements
Concentration derived from
calibration curve stored in analyzer
Data Handling
Usually reported to LIS through
interface
Reporting
Can be done by modem on many
analyzers
Troubleshooting
TO READ:
(5) FEATURES OF CLINICAL CHEMISTRY ANALYZERS
● Primary tube cap piercing
● Short sample and clot detection
● Automatic patient sample dilution and retest
● Onboard test automatic inventory
● Remote troubleshooting by modem
When should you dilute?
When the values do not meet the
reference range (lagpas)
Ex. Reference Range = 80-125 mg/dL; Reportable
Range = 30-1000 mg/dL
Patient A = 700 mg/dL
Should you release the result of Px A?
Yes, because it is within the reportable range
If Px A = 1400 mg/dL
Should you release the result of Px A?
Do not release, DILUTE
Reduction in laboratory errors
volumetric pipetting steps,
calculation of results and transcription of results
