HemoCue AB Box 1204 262 23 Ängelholm SWEDEN   Phone: +46 77 570 02 10 Fax: +46 77 570 02 12 E-mail: info@hemocue.se    Contact in your country    Online Privacy Policy    Printer friendly	• How often do I need to recalibrate my HemoCue instrument?       • How often should I clean the control cuvette?       • How often should I clean the cuvette holder?       • How often should I clean the cover glasses of the optronic unit?       • How should I store my HemoCue Hemoglobin microcuvettes?       • I lost the control cuvette! What do I do?       • The control cuvette gives erroneous results. What do I do?       • The control cuvette is cracked or damaged! What do I do?       • The liquid control solution values are too high or too low, what do I do?       •What can I do if the analyzer gives an error code?       • What is good quality control?       • What level of control solution shall I use?       • Why do the capillary Hemoglobin double samples differ more than forvenous double samples?       • Why is there sometimes a difference between HemoCue Hemoglobin results compared with laboratory results?  The Hemoglobin analyzers are factory-calibrated against the hemiglobincyanide (HiCN) method and do not need recalibration. B-Hemoglobin; Donor Hb Checker:  Clean the control cuvette when the value deviates from the assigned value (± limits).   Cleaning the control cuvette:  1. Dampen a fresh cotton swab with alcohol or isopropanol (without additives). 2. Clean the control cuvette filter gently but thoroughly. 3. Wipe dry with a fresh, dry cotton swab. 4. Visually check that the control cuvette filter is clean. If not, repeat the procedure. The cuvette holder should be cleaned after being used, on the days of testing, with alcohol or a mild soap solution after being completely removed from the analyzer. The cuvette holder can also be autoclaved. The holder must be completely dry before being reinserted in the analyzer. Cleaning frequency may depend on the amount of samples being analyzed and/or local regulations regarding maintenance. Clean the coverglasses of the optronic unit with the HemoCue Cleaner.   Warning! Do not open the optronic assembly!   The HemoCue Cleaner should not be used for B-Hemoglobin Photometers produced earlier than July 1992. Read the relevant Operating Manual to make sure that the cleaner may be used. For alternative cleaning of B-Hemoglobin instruments produced earlier than July 1992, please contact your local HemoCue distributor.   Follow the directions in the HemoCue Cleaner instructions for use. 1. Turn the instrument off and remove the cuvette holder as described in the operating manual 2. Remove the cleaner from the package and insert into the instrument 3. Move the cleaner over the entire optronic unit 4. Inspect the cleaner. If it is dirty, repeat the procedure with a new cleaner 5. Wait 15 minutes before replacing the cuvette holder 6. Check the system as required   Note! Dispose of the cleaner as potentially infectious waste. Do not reuse the cleaner. B-Hemoglobin:  Store the B-Hemoglobin microcuvettes dry at room temperature (15-30 ° C, 59-86° F). The microcuvettes are stable in an unopened container for two years from manufacturing date.   Once the container is opened, the microcuvettes are stable for three months. Remove only the microcuvette required for the immediate testing.   The reagents within the B-Hemoglobin microcuvettes are moisture sensitive. Replace cap immediately after the B- Hemoglobin microcuvettes are removed from the container.   Hb 201:  Store the Hb 201 microcuvettes dry at room temperature (15-30 ° C, 59-86 ° F). The microcuvettes are stable in an unopened container for two years from manufacturing date.   Once the container is opened, the microcuvettes are stable for three months. Remove only the microcuvette required for the immediate testing. The reagents within the Hemoglobin microcuvettes are moisture sensitive.   Replace cap immediately after the HemoCue Hemoglobin microcuvettes are removed from the container.   Individually packaged microcuvettes are stable for one year from the date of manufacturing.   Donor Hb Checker:  Store the Donor Hb Checker microcuvettes dry at room temperature (15-30 ° C, 59-86 ° F). The microcuvettes are stable in an unopened container for one year from manufacturing date.   Once the container is opened, the microcuvettes are stable for three months. Remove only the microcuvette required for the immediate testing.   Hb 301:  The microcuvettes are to be stored at 10-40 °C (50-104 °F). Once the seal of the vial is broken, the microcuvettes are stable for 3 months.   An unopened vial of microcuvettes can be stored for a shorter period of time (6 weeks) between -18-50 °C (0.4-122 °F). Use the microcuvettes prior to the expiration date that is printed on the package.   Keep the vial properly closed. All unused microcuvettes should remain in the original package. The control cuvette is specific to an instrument, if it is lost, contact your local HemoCue distributor for replacement. B-Hemoglobin; Donor Hb Checker  The control cuvette is an optical interference filter, which is used to verify that the calibration is stable and does not change from day to day. When you check the received value, it should not exceed the established range on the control cuvette card.   Hemoglobin: ±0.3 g/dL (3 g/L, 0.2 mmol/L)   Make sure that the instrument and the control cuvette are clean.   For further information read the Troubleshooting Guide in the relevant Operating Manual. B-Hemoglobin; Donor Hb Checker  The control cuvette is specific to an instrument, if it is cracked or damaged, contact your local HemoCue distributor for replacement. A control of the total system i.e. photometer and microcuvette can be obtained by using liquid controls with a given hemoglobin value. The liquid controls should have a viscosity equal to that of normal blood. It is important that the liqui control is stored, mixed and handled according to manufacturer instructions. Note: Many liquid controls that are not assayed for the HemoCue Hemoglobin systems contain additives that cause turbidity (cloudiness). Since the HemoCue photometers compensate for turbidity it can give lower hemoglobin values.   Check the expiration date and storage of the liquid control and microcuvettes. They might be too old, damaged or improperly stored.   For further information, please check the Troubleshooting Guide in the relevant Operating Manual. The analyzer shows "ERROR" or "E" and a digit code.   May be an occasional fault.   Turn off the analyzer and switch it on again after 30 seconds. Take a new cuvette and repeat the measurement.   If the problem continues, see specific Error code in the Troubleshooting Guide in the relevant Operating Manual. Quality control testing, preferably performed regularly, verifies the function of the system and guarantees reliable patient results. The frequency of quality control testing will depend on factors such as patient sample frequency and/or local regulations.   Control cuvette  The function of the HemoCue photometer can be checked on the days of testing by measuring the enclosed control cuvette (NOTE: The control cuvette is required for the Donor Hb Checker and B-Hemoglobin photometers). The control cuvette, which is an optical interference filter, is used to verify that the calibration is stable i.e. not changing from day to day.   The measured value should not deviate from the assigned value (±limits) on the control cuvette card. The control cuvette is specific for each photometer i.e. the serial number on the control cuvette corresponds to the serial number of the photometer.   Liquid control solutions  It is good laboratory practice to check the function of the HemoCue system daily before use. A control of the total system i.e. both photometer and microcuvette, can be performed with liquid control solutions.   The HemoCue systems are developed to give correct results on fresh whole blood.   Commercially available quality control solutions, however, might differ significantly from fresh whole blood. They vary in composition, are stabilized, and contain preservatives or other additives that might cause erroneous readings. It is therefore recommended to use quality control solutions with assayed values specific for the HemoCue system. For suitable control solutions, see Quality Controls.   Control solution results should fall within assigned ranges. If results are out of range, local guidelines for failed quality control testing should be followed prior to any patient testing.   External quality control (Proficiency testing)  External quality control testing can be local, national or international. Specimens with unknown values are sent out to participants for analysis.   Personnel who routinely test patient samples are to test the external control solution in the same way as they test the real patient samples. The results are then usually reported as acceptable or unacceptable in terms of difference from the mean between results reported by participants and reference laboratories.   Contact national authorities for suitable proficiency testing programs. It is practical and relevant to use a control at a level in the same range as your most common patient result.   Please follow your local quality control regulations. Blood obtained by skin puncture may contain a concentration of red blood cells or be diluted with interstitial and intracellular fluid. A good capillary sampling technique is therefore essential for good results.   Make sure that the patientís hand is warm and relaxed and that the blood flow is spontaneous. If a second sample is to be taken from the same fingerstick this should be done immediately after the first sample has been taken.   For further information, read the relevant Operating Manual. A number of factors may influence the outcome of a comparison between two hemoglobin methods:   Calibration differences.  Variations in routines for calibration or differences in calibration material may cause differences between methods. The HemoCue Hemoglobin systems are delivered calibrated against the international reference method for determination of hemoglobin, the ICSH method.   Sample material  Venous and capillary blood are not quite the same even if the latter is freely flowing. The Hb concentration of peripheral (capillary) blood is greater than in venous blood. The discrepancies between peripheral and venous samples are more marked if the ear-lobe rather than the finger is chosen as the site for puncture.   Time of sampling  The hemoglobin concentration shows a declining trend through the daytime and the lowest values during the night. This should be taken into consideration when results are compared.   Body position  After transition from an upright position to a recumbent position a decrease in hemoglobin takes place. When comparing laboratory results, sampling is recommended to be performed under identical conditions.