Chemistry: How to run a blood chemistry panel using the Abaxis Piccolo Xpress POC Analyzer

Medical Lab Lady Gill
31 Aug 201713:25
EducationalLearning
32 Likes 10 Comments

TLDRThis video script offers an in-depth tutorial on using the Abox Piccolo, a point-of-care chemistry analyzer. It covers the correct use of specimen tubes, addresses the importance of avoiding sodium heparin to prevent falsely elevated sodium levels, and demonstrates the process of running a complete metabolic panel. The presenter also discusses the impact of hemolysis on test results and the analyzer's capabilities, including its use of a spectrophotometer for accurate measurements and the importance of quality control.

Takeaways
  • 🔬 The Abox Piccolo is a point-of-care chemistry analyzer that can perform both CLIA waived and higher complexity testing.
  • 💉 For CLIA waived testing, a green top lithium heparin tube is used, while for higher complexity testing, a red top tube is used despite the slight hemolysis.
  • ⚠️ Sodium heparin should not be used for complete metabolic panels as it can falsely elevate the sodium levels in the patient's plasma.
  • 🌞 Reagent discs are light sensitive and must be used within 20 minutes of opening the foil package, and should not be touched on the top part to avoid contamination.
  • 📏 The specimen must reach the fill line in the analyzer for accurate testing, and care must be taken to avoid bubbles in the pipette tip.
  • 🔍 The analyzer uses a spectrophotometer to measure light absorbance or reflectance for determining analyte levels.
  • 📅 The reagent's expiration date is crucial; expired reagents will result in an error code and prevent testing.
  • 🔄 The analyzer automatically runs internal QC and calibration when a new reagent disc is loaded.
  • 💾 Results can be printed out, including patient ID, lot number, serial number, and detailed test results with reference ranges.
  • ⚠️ Hemolyzed specimens can cause falsely elevated results for certain tests, such as potassium and AST, and should be interpreted with caution.
  • 📊 The analyzer provides QC results to ensure the accuracy and reliability of the testing process, with acceptable ranges indicated.
Q & A

  • What is the Abox Piccolo point-of-care chemistry analyzer used for?

    -The Abox Piccolo is a point-of-care chemistry analyzer used for conducting various blood tests, including higher complexity testing and CLIA waived testing.

  • What type of specimen is required for CLIA waived testing with the Abox Piccolo?

    -For CLIA waived testing, the Abox Piccolo requires a green top tube, which is a lithium heparin tube, not a sodium heparin tube.

  • Why is sodium heparin not recommended for complete metabolic panel tests?

    -Sodium heparin is not recommended because it can falsely elevate the sodium level in the patient's plasma, affecting the accuracy of the test results.

  • What is the significance of the red top tube being slightly hemolyzed in the video?

    -The red top tube being slightly hemolyzed is significant because it can still be used for testing, but it requires a comment in the LIS to indicate that the specimen is hemolyzed, which can affect the test results.

  • How should the reagent discs be handled after being taken out of the refrigerator?

    -The reagent discs can be used right away after being taken out of the refrigerator. However, once the foil package is opened, they must be used within 20 minutes due to the light-sensitive powder reagents.

  • Why is it important not to touch the top part of the reagent disc?

    -It is important not to touch the top part of the reagent disc to avoid introducing bubbles or contaminants, which can interfere with the light absorbance or reflectance measurements performed by the spectrophotometer.

  • What does the analyzer do when a reagent disc is placed on it?

    -When a reagent disc is placed on the analyzer, it automatically runs quality control (QC) and calibration to ensure the accuracy of the results.

  • What is the purpose of the fill line on the reagent disc?

    -The fill line on the reagent disc indicates the correct level to which the specimen should be filled. It ensures that there is enough sample for the analyzer to perform the tests accurately.

  • What does the analyzer do if the reagent is expired?

    -If the reagent is expired, the analyzer will display a 'narrow coat error code' and will not run the test. A new reagent disc must be used.

  • What does the analyzer do after it has completed the analysis of a sample?

    -After completing the analysis, the analyzer saves the results and allows the user to print them out or view them on the screen. It also provides information about the test, patient ID, lot number, and serial number of the disc.

  • How does the Abox Piccolo analyzer handle hemolysis in blood samples?

    -The analyzer checks for hemolysis by looking at the 3 indices before starting the test. If hemolysis is detected, it can cause falsely elevated results for certain analytes, such as potassium and AST. The analyzer will flag these results with a warning symbol or asterisk, indicating that the results should be interpreted with caution.

  • What does the analyzer's QC process involve?

    -The QC process involves running a control sample to ensure the analyzer's performance is within acceptable parameters. The results are measured at specific wavelengths using the spectrophotometer, and the values are compared against acceptable minimums to confirm the analyzer's accuracy.

Outlines
00:00
🧪 Introduction to Abox S Piccolo Point-of-Care Chemistry Analyzer

This paragraph introduces the Abox S Piccolo, a point-of-care chemistry analyzer capable of performing both CLIA waived and higher complexity testing. It discusses the use of a lithium heparin green top tube for CLIA waived tests to avoid falsely elevated sodium levels due to the use of sodium heparin. The script also mentions the use of a red top tube for higher complexity testing, despite slight hemolysis, and the importance of not using sodium heparin. Reagent discs are highlighted as ready for immediate use once taken out of the refrigerator, with a 20-minute time limit after opening the foil package due to light sensitivity. The analyzer's use of a spectrophotometer is explained, and the need to avoid bubbles and touch the reagent disc's top part is emphasized. The process of loading the specimen and the importance of reaching the fill line are also covered.

05:01
🔬 Demonstration of Abox S Piccolo Analyzer's Operation and Results Analysis

The second paragraph provides a step-by-step demonstration of using the Abox S Piccolo analyzer. It describes the process of filling the analyzer to the fill line, initiating the analysis, and the automatic running of quality control (QC) and calibration. The script mentions the analyzer's ability to detect hemolysis and other quality issues that could affect test results. It also details the process of printing results, including patient ID, lot number, and serial number, and the importance of interpreting results with caution when the specimen is hemolyzed. The paragraph concludes with a discussion of the analyzer's QC results, indicating that the chemistry QC was within the acceptable range.

10:03
📊 Impact of Hemolysis on Test Results and Quality Control in Abox S Piccolo

The final paragraph delves into the effects of hemolysis on test results, explaining how the release of red blood cell contents can lead to falsely elevated results for certain analytes, such as potassium. It emphasizes the importance of recognizing and reporting hemolysis to ensure accurate clinical interpretation. The script also discusses the analyzer's ability to detect other quality issues like icterus and lipemia. The paragraph concludes with a review of the QC results, which confirm the analyzer's proper functioning, and a thank you note to the viewers.

Mindmap
Keywords
💡Abox S Piccolo
The Abox S Piccolo is a point-of-care chemistry analyzer, which is a device used for medical testing at the patient's bedside or in outpatient settings. It is central to the video's theme as the script provides a detailed demonstration of its use. The video script discusses its capabilities for both CLIA waived and higher complexity testing, highlighting its versatility in medical diagnostics.
💡Point-of-Care Testing (POCT)
Point-of-Care Testing refers to medical tests performed at or near the site of patient care, which can provide quick results. In the script, the Abox S Piccolo is described as a POCT device, emphasizing its convenience and immediacy in delivering test results, which is crucial for patient care and decision-making in medical settings.
💡CLIA Waived Testing
CLIA Waived Testing denotes tests that meet the U.S. Clinical Laboratory Improvement Amendments criteria for simplicity and low risk, allowing them to be performed outside of a certified lab. The script mentions that the Abox S Piccolo can perform such tests, using a green top lithium heparin tube, which is significant for the video's educational purpose on correct specimen collection.
💡Hemolysis
Hemolysis refers to the rupture of red blood cells, releasing their contents into the plasma, which can affect test results. The video script uses hemolysis as an example of a condition that can lead to falsely elevated test results, such as potassium levels, underscoring the importance of specimen quality in accurate diagnostics.
💡Specimen
A specimen is a sample of bodily fluid or tissue collected for testing. The script emphasizes the importance of proper specimen handling, such as avoiding hemolysis and ensuring the correct fill line for accurate test results, highlighting the specimen's role in the testing process.
💡Reagent Discs
Reagent Discs are used in the Abox S Piccolo to perform chemical tests. The script provides instructions on their use, including the need to use them within 20 minutes of opening the package, and the importance of not touching the light-sensitive powder reagents, which are crucial for the spectrophotometric analysis.
💡Spectrophotometer
A Spectrophotometer is an instrument that measures light absorbance or reflectance at a specific wavelength. The script explains that the Abox S Piccolo uses a spectrophotometer to measure analytes in the reagent discs, illustrating the technology behind the testing process.
💡Quality Control (QC)
Quality Control in medical testing ensures the accuracy and reliability of test results. The script mentions running QC as part of the testing process with the Abox S Piccolo, emphasizing the importance of maintaining high standards in diagnostic procedures.
💡Hemolyzed
Hemolyzed is a term used to describe a blood sample where the red blood cells have been lysed. The script discusses how a hemolyzed sample can affect test outcomes, such as showing increased potassium levels, and the necessity to report this condition to interpret results correctly.
💡Lithium Heparin Tube
A Lithium Heparin Tube is a type of blood collection tube that contains lithium heparin as an anticoagulant. The script specifies that for CLIA waived testing, a green top lithium heparin tube should be used instead of a sodium heparin tube to prevent falsely elevated sodium levels in test results.
💡Complete Metabolic Panel
A Complete Metabolic Panel is a group of tests that provide an overview of an individual's metabolic health, including liver and kidney function. The script mentions running this panel as an example of higher complexity testing that can be performed with the Abox S Piccolo, demonstrating its capabilities in comprehensive diagnostics.
Highlights

Introduction of the ABox Piccolo point-of-care chemistry analyzer.

The analyzer uses 100 microliters of specimen for testing.

Different testing types: CLIA waived and higher complexity testing.

CLIA waived tests require a lithium heparin (green top) tube.

Sodium heparin should not be used for complete metabolic panels to avoid falsely elevated sodium levels.

Demonstration of checking for hemolysis in a red top tube.

Reagent discs should be used within 20 minutes of opening the foil package and are light sensitive.

Instructions on not touching the top part of the reagent disc to avoid bubbles.

Barcodes on the reagent discs for automatic QC and calibration.

Proper specimen filling to the fill line in the analyzer.

Handling of expired reagent with error code and the need for a new one.

Analyzer's home screen and initial steps including internal QC and warming up.

Process of adding a specimen to the analyzer and starting the analysis.

Explanation of how the analyzer uses a spectrophotometer for analysis.

How to handle a hemolyzed specimen and its impact on test results.

Interpretation of results with caution due to specimen quality issues like hemolysis.

Printing and reviewing results, including QC and error reports.

Understanding the impact of hemolysis on analytes like potassium and AST.

Final thoughts on the importance of specimen quality for accurate testing.

Transcripts

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Related Tags
Piccolo AnalyzerChemistry TestingSpecimen HandlingCLIA WaiveHemolyzed SpecimenQuality ControlSpectrophotometryMedical DiagnosticsPoint-of-CareLab Testing