Tng Wess Lee, 0702570C
TG02, Grp 10
Allocation: Clinical Biochemistry Laboratory
There are a total of 3 rooms in my working environment. We are allocated to 10 machines to learn 1 machine each week before being transferred to another lab. For the first 2 weeks, the machines which i have handled are basically non-analytical but an organiser.
The first week, i was allocated to Laboratory Automated System. The workstation requires me to sort sample according to their priority. (1. Urgent/Stat, 2. Ward, 3. Routine) For the entire duration i only received blood and urine specimens. The specimens are sent via a telelift system called a pneumatic tube system/carrier system. Upon arrival, the specimens are punched with time and date, to prevent dispute between the wards/clinics and the lab.
After sorting these samples, clerks will collect the sorted samples and enter the appropriate data in the LIS and print specific barcode labels, which are pasted onto the tubes. They will then pass the tubes back to me to place it at the inlet.
The samples then run along a line, where it is then sent to be centrifuged to separate the blood cells from the serum. After being centrifuged, the sample enters the Serum Level Detector to determine the volume of serum and if there is sufficient serum to be tested. After that, the sample is brought by the line into the decapper to remove the caps.
The sample is then sent to the labeller to label another tube if a separate test is required to be conducted. If there is an extra tube which exits from the labeller, both the original tube and the newly labelled tube will enter the aliquoter. The aliquoter aliquots the serum from the original tube to the new labelled tube. If no aliquots need to be done, the original tube will pass through the aliquoter.
The specimen then enters the analyser. The LAS is a preanalytical stage whereby it prepares the sample for analysis. It compromises of the Inlet, the Centrifuge, the serum level detector, the decapper, the labeller and the aliquoter.
hi wess!
ReplyDeleteu said the sample enters the Serum Level Detector to determine the volume of serum and if there is sufficient serum to be tested. then what happen to those samples with insufficient serum? where will they go to?
stella
0701059H
they will by pass all samples and exit at the outlet. my next machine. samples which do not need to be aliquoted will go straight to the outlet and be placed in the pending rack.
ReplyDeletewhile tubes which need to be aliquoted, will have an extra tube like i mentioned right ? the 2 tubes will exit and appear on the aliquot error rack.
got it ?
then we will record down on a paper, claiming its a shoret sample and pass it to the matcher.
hope tt answers yr qns.
wess.
sry. they will bypass analysers. not samples. and exit at the outlet.
ReplyDeleteHey Wess,
ReplyDeleteA)how confident can i be when i use this LAS? It can't be 100% fool-proof right..
B)based on you reply to stella, what will happen to the sample once its on the aliquot error rack? should more blood be collected if there was insufficient serum?
Yvonee, Group 8
HELLO !
ReplyDeleteglad you ask such qns.
ok.
A) the LAS is known as Laboratory Automated System. It compromises of the inlet, centrifuge, decapper, labeller and aliquoter. All these machines are connected by a line. Something like a travellator. On these travellators, there are pucks. Pucks are like little carriers which you slot in the blood tubes. IT FITS NICELY. so i can say it's fool-proof. cause it's all automated. just need slot the samples in. the barcode will decide it's future in the machine.
Hope you understand. =S
B) sometimes, i really don't understand how the phlebotomist can collect so little blood.
but there are instances where a reasonable amount of blood is collected. but after being spun in the centrifuge, the ratio of red cells to plasma is very unproportionate (more red cells than serum). in this case, we transfer whatever serum we have into a cup. and place it back into the analyser to work on the sample.
if really not enough serum, must take more blood from patient by calling the nurse.
but to be honest, the amount of serum needed to conduct a test is very little (microlitres). but the height of the tube might affect the result as the probe is unable to come in contact with the serum and suck it.
hope you understand my explanation.
=D
This comment has been removed by the author.
ReplyDeletehaha wess, so there's zero chance for error? and yes i understand part B.. thanks:)
ReplyDeleteHi
ReplyDeleteThe Serum level detector sounds very convenient. At the lab i'm attached to we just observe if the amount is sufficient, but at times there are labels covering the surfaces of the tubes that makes it hard for us to determine the amount of serum.
May I know how the Serum level detector works?
Liyana
0703827F
Yvonee
ReplyDeletenot that there's zero chance of error. what kind of error are you referring to ? mechanical error ? to date, if all automation is in tip top condition, i will say that there won't be an error. the only major error that i can think of is from the start, at the manual sorting of samples by priority. the people place the sample to the wrong form. (eg: Blood tube - Tan A.A but Request Form - Chua B.B) However this error should be minimize as the samples will be passed over to the clerk to enter info into the LIS. and if this person key in wrongly, there is an INLET IC which check that the label is pasted on properly and verify the name before loading it into the inlet. The rest is automation already. So error is VERY VERY LOW.
Liyana
HAHAHAHAHA. UNLUCKY YOU!!!
sorry.
anyway, your method was used by the organisation i'm attached to in the past. a few years back.
however, now we've got the serum detector. and yes. sometimes the labels can be a pain. but the serum level detector is a very good instrument.
the arms(in 5) will pick up 5 tubes from the pucks. and place them in a chamber(of 5). the tubes will sink into the chamber and slowly emerge. this allows infrared to be sent THROUGH the tubes and be sensored from the other side. The tubes we process are plain tubes containing a gel or fluoride tubes.
The infrared is penetrable to serum but not the gel and red cells. After manual testing and research, it has been proven that the SLD is at least 90%++ effective at detecting the sufficiency of serum. However, the rule is that not more than 3 layers of stickers are pasted. As this would reduce the efficiency of the reader to 70% odd.
Hey Wess!
ReplyDeleteIts my turn to ask u now..haha =)
May i know if the minimum serum level required is the same for tubes that need aliquots and those that DONT need aliquots?
Coz if the serum needs to be aliquoted into 2 tubes, then how does the 'Serum Level Detector' detects if the eventual serum level in the 2 tubes will be sufficient?
Thanks!!
Siti
TG02
gROUP 10
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ReplyDeleteWess Lee, respond to Siti's question (posted July 9.....2 weeks ago!)
to siti
ReplyDeletesorry for the long awaited response.
most of the time, there is a required level of blood to obtain in a blood tube. however there are instances, whereby the nurses failed to retrieve a considerable amount of blood. but that is all right.
the purpose of getting quite a no. of blood is to provide the level for the probe of the analyser to be able to suck the serum.
if let's say the height of the serum is not enough. the sample will then be sent to aliquot error rack. we will then run the test manually. by pouring whatever serum we have into a cup. the cup will be placed in a rack which gives it an elevation. this allows the probe to carry out it's test.
to be honest. very little amount of serum is used for one test. they only require volumes of microlitres.
so i hope this answers your question.
Yes it does...thanks a lot!!
ReplyDelete=D
Siti
gROUP10
TG02