Bloodgas Series Training

Blood Gas/Electrolyte analyzer
HCO3-
Installation&opreation training AG
pCO2 SBC
BEb
pO2
BEecf
pH TCO2
sO2%
K+
P50
Na+ iCa
Cl- TCa
pH(TC)
Ca 2+
pCO2(TC)
HCT pO2(TC)
Meizhou Cornley Hi-Tech CO.,Ltd
Installation Steps ：
Check the details by packing list 。
Operating environment ：
（ 1 ） Ambient Temperature ： 15 ℃ ～ 30℃ 。
（ 2 ） Relative Humidity ： ≤ 80 % 。
（ 3 ） Barometric Pressure ： 86kPa ～ 106 kPa 。
(4) Power supply ： AC 110V 240V 50/60Hz,
Perfect Grounding UPS
Grounding test ：
attention ：
measuring
range﹥220V
step1 live-neutral≈220V step2 ： live-earth≈220V
Voltage ：
V live -neutral ＝ V live -earth ＋ V neutral-earth
Perfect grounding ：
step3 ： neutral-earth≤3V
Vneutral-earth≤ 3V
3
System Description
10.4`` LCD Front view
Touch panel Measuring
chamber
Human
sensor
Sample
sensor
Pumps
Cal pack
System Description
Back view
Nameplate Printer
Fan Scanner
port
USB RS232
ports serial port
RJ45
Ethernet
Back-up Power
battery switch
switch
Back-up Power
battery socket
System Description
Measuring chamber
Magnet Grounding
Liquid Spring-loaded
sensor 2 latch
Pre-heater Liquid sensor 3
Insulation Electrodes
board
Door Metal clip

6
System Description
Sample assembly
Sample
Port
Probe
Sample Type Liquid

Detector Detector 1
System Description
Battery installation
、 unscrew the four screws 2 、 push out the battery
Attention ： Be carefully when pull out it ,if not it will damage the connection
between the battery and the wire
8
3 、 unscrew the screws in the battery box 4 、 uninstall the block of the
box
5 、 push the battery into the box as pictures
show,
then insert the block and twist the screw
tightly.
6 、 put the battery box in place and twist the

screws tightly.
Attention ： please mind the polarity of the batter when insert it in,
and insert it into the box slightly.
Charging time: 6 hours to get full charge 10
Maximum using time: 30mins
System Description
Scanner installation
Scanner interface Scanner

11
System Description
Scanner installation
Connect the scanner to machine, and twist the screws tightly ，

Need to power off first
12
System Description
Pump tube installation
1 、 Hold one hand of the tube and fix it on the tube rack 。
.2 、 Hold another end of the tube and go

Every 6 months around the pump, pull the tube until it reach the
rack
13
System Description
Sample port installation
1 、 click system setup>>replace sample port, the sample
probe will be back up.
2 、 pull up the sample port directly

Every 6 months
14
System Description
Electrode installation
No rust
Check all the electrodes
K+ Na+ Cl- Ca2+ pH Ref
Enough refill
pO2,pCO2 ,enough refill solution solution
No air
pCO2 Refill solution guide.pdf
bubbles
No broken of
pO2 Refill solution guide.pdf O ring
15
System Description
Electrode installation
2 、 insert all the electrolyte electrodes one by

1 、 use the clip to block the one from left to right
spring-loaded latch.
16
3 、 Hct electrode should be installed
before the Ref electrode.
4 、 insert the Cl between Ref and PH, then

Attention ： keep all the electrodes in release the tensioner, and level all electrodes
the same level. with thumb by pressing them inward.
17
System Description
Cal pack installation
1.Take out the Cal pack ,tear off the tape on it ,then pull up the plastic plugs in
it
18
System Description
Cal pack installation
Hold label side upward and point its connecting

side into the machine and push it gently until its in
place
19
Installation steps
a. Switch on( 1. turn on the switch on power socket 2.turn on the switch of UPS )
b. Calibrate the touch (follow the steps show on the screen)
c. Self test
d. Scanner setup
e. Expendable management ， scan the barcodes of electrodes,pump tubes, sample port

too
f. LIS setup ( ask the local network engineer and refer to the u if you need )
g. Wait for the thermostat keeping the temperature at 37±0.2℃,Be ready when the
temperature is ok
h. Calibration 1&2,if the electrodes were stable, do 3 levels QC, or do QC calibration
i. Test sample when the machine be in ready state

20
Scanner setup
 1.Connect the scanner
 2.Scan the barcode as follows:
a. initial set up
 b. output mode: serial mode
 3. buzzer ： sound enabled
 4. serial port: band rate19200
 5. handshake protocol: none
21
Scanner setup
 6. data bits ： 8bits
 7. stop bit ： 1bit
 8. check bit: none
 finished
22
Expendable management
1 、 Click Expendable OK 2 、 Use scanner to read the barcode
Attention : The start date and the expiration date will be recorded and calculated by the system.
23
Expendable management
3 、 Click Return after read the barcode, then click New Cal Cassette to enter self-test.
4 、 Back to main menu for Calibration or Sample test.
24
Working principles Of ISE electrodes
The electrode is built on ISE technology. A suitable membrane is selective permeable to single ion. And a
potential difference is generated when the ion adsorbed on the membrane. The magnitude of potential is
determined by the concentration difference between two sides of the membrane. The relationship between
activity and potential is expressed by Nernst equation below.
To measure this tiny potential , the following model is used which a reference is introduced and an Ag rod
coated with AgCl is dipped into the internal solution. It consists of four portions: a reference electrode filled
with saturated chloride solution, an electrode filled with fixed concentration solution, a voltage meter ,an
unknown concentration sample bridged REF and ISE to form a closed circuit loop.
Contact
Ag rod coated with AgCl

Saturated solution
Membrane
Sample
25
ISE REF
Principle of pCO2 electrode
The pCO2 electrode system uses principles similar to those for pH measurement.It employs a Severinghaus pCO2
electrode, which combines a glass pH-measuring
electrode and a silver-silver chloride reference electrode. A membrane permeable to CO2 but not to H+ separates
the sample from the measuring system. The pCO2 electrode also contains a spacer( usually a porous membrane of
Dacron or nylon)that acts as a support from an aqueous HCO3- layer. As CO2 diffuses through the membrane and
into the support, the pH of the electrolyte changes because of the change in carbonic acid concentration as follows:
H2O +CO2= H2CO3= H+ + HCO3-
The output of this modified pH electrode is proportional to the pCO2 present in the sample.
26
Principle of pO2 electrode
pO2 is measured by using a polarographic electrode system consisting of a platinum cathode ( in the center of a
glass rode) and a silver-silver chloride anode. An O2-permeable membrane separates the blood sample from the
measuring system. O2 that diffuses through the membrane is reduced at the cathode when a 0.7V potential is
applied between the anode and cathode (polarizing voltage). The following reaction represents the reduction
occurring at the cathode.
The circuit is completed when silver is oxidized at the anode:
The current developed by these reactions is directly proportional

to the pO2 in the sample.
27
Opreation
28
1.Test
1.Sample Type :
•Arterial (Clinical)
•Venous
•Capillary
Choose sample type>>

Choose parameters>>
Go
Must use the anticoagulated sample.

Heparin is the only anticoagulation For
Bloodgas!
Recommened : sodium heparin or

lithium Heparin
Awareness ： For capillary ， need to switch the sample port,

or use Ratiometer capilary tube 29
About 120μL
FIO2=(0.21+0.04* （ x ） L/min)*100%
e.g. 2L/min
Clean the port with tissues, after test FIO2=(0.21+0.04*2)*100%
=0.29*100% 30
=29%
Sample collection and processing
Arterial blood collection
Preparation Arterial Blood collection site
OR
Common syringe Arterial blood Disinfections

12500ui/100ml Heparin NaCl collection
solution syringe pack
Rubber block
Radial Artery
Arterial Blood processing

Take the blood from radial artery and
then remove the bubble and air
Insert the needle into rubber

block ,and mix the blood with
heparin
Remove the needle , seal with plug

and label it . Then send to test
immediately
Storage at 4 ℃,and no more than 2

hours ( only if a delay in running the
sample is expected )
Arterial Blood VS Venous Blood
Lots of Oxygen =Bright red
Lots of CO2 = Dark crimson
From the color we can judge which sample pO2 is higher ?
Blood gas
analysis considerations
34
The factors might affect the results
•Testing time : the bloodgas sample should be tested within 10mins, sample with Glu,Lac
Samples should be within 30mins.if the test can’t be done in 10mins, The PO2, PH might
Decrease, the sample should be stored in 4℃ refrigerator. When take out, need to
Recover to Room temperature
•Smple storage: test immediately, if not ,in 25℃,need to be tested with in 20mins .In 4℃,
Within, 2 hours. Or PO2 ,PH ↓ ， PCO2↑ 。
•Bubbles : the bubbles during collecting or testing the samples might cause pCO2↓ ， pO2↑ ，
PH↓.the first two drops of the sample should be removed.
•Heprain:the content of the heprain will affect the results directly,when

The content of Heparin ↑ ,the PH,pO2↑ ， pCO2↓.
Heparin is an anionic group.If the concentration is increased, it would adsorb
the electrolyte in the blood,make the results ↓.
Recommend to use special syringe for ABG. Or mix 12500IU heprain with 100ml Saline(Use once,
Within 24 hours, avoid sunlight in the 4’ C refrigerator)
Preparation of heparin sodium syringe for ABG:

1.Using 2CC normal syringe to aspirate 1CC Heparin sodium anticoagulant ，
2.Pull out the Heparin anticoagulant from the syringe.
3.Pull out the remaining liquid and air bubbles . Repeat several times.
Finally remaining liquid content should be little enough 50~100IU/ml 35
•Hemolysis, coagulation: The Hemolysis, coagulation of the sample would affect the
results directly.when the coagulation happened, it would cause the blockage, decrease the
lifepan of electrodes. the hemolysis of the sample will make pCO2↑,pO2↑,K↑,PH↓.Because
the pCO2,pO2 in blood cell is higher than plasma, and PH lower.
•Sample collecting : after collecting the samples, need to mix the samples
Upside down 5-6times and gently rub and roll by your plam. If not, the results
Might be affected by the Heparin （ PH 6.560 ） in dead space in the syringe
Cause PH↓. And if not mixing the sample after placing a while, it would make
HCT ↓
36
The difference between Arterial blood and Venous blood
normally Arterial blood Venous blood
PH 7.35 ～ 7.45 Less 0.03 ～ 0.05
PaO2 ＞ 48mmHg Normally 40±3mmHg
PaCO2 35-45mmHg More 5 ～ 7mmHg
HCO3- 22-27mmol/L Almost same but more 1 ～ 2mmol/L

Arterial blood mixed with Venous: it would affect the results directly ， Venous blood is
tested only for Acid-base balance
The body temperature affect:
PaO2 PaCO2 pH
When >37℃ ， 7.2% ↑ 4.4% ↑ 0.015 ↑

every↑ 1℃
When<37℃ ，
every ↓1℃ 7.2%↓ - -
37
2.Flush
Awareness ：
After testing some
samples, click “ Flush “to
avoid clogging.
After maintenance, Click
“Flush” to clean the flow
path
Ps: Flush solution is inside the
Cal Pack
38
3.Maintenance
Awareness ：
1.Clean: For Clean the Fat or
other waste after long time use.
2.Deproteinize : For the
maintenance of electrodes
3.Condition: For the
maintenance of Na and PH
electrodes only
PS: Cleaning solution is inside

the cal pack
Deproteinzie and condition is
required to get prepared.
Aspirate condition with syringe to feed. And mix

enzyme and dilute to transparent
39
4. One point calibration
1 PT calibration can
associate electrode
response with ion
concentration of Cal A
for all parameters except
Hct. It defines the first
point in 2 PT calibration.
Cal A is
used in 1 PT calibration.
40
mmol/L
2-point calibration
CAL B
5. Two points calibration standard
value
The mV value is
proportional to the 1-point calibration
logarithm of concentration. CAL A

So we can determine a line standard
value
model by two mVs given
from two different fixed
mV
concentration. From that mV1 mV2
line model an unknown Fig. 6 2-point calibration
concentration can be got if

the mV values is given.
That is two point
calibration.
41
CAL A1
mv OR
>0.5V
Abnormal
Drift CAL A2
Normal Min(Cal B-Cal
range A) Max(Cal B-Cal A)
Drift
Abnormal
OR
Cal A Cal B LogC

check
•Check the Electrical contact,if it was
rustless or wet,
•Check the rod , if it was broken or fallen off(
~ turn white)
•Check the refill solution ,if it was enough or
Charge there was bubble.or expired,crystal(Ref)
Ref electrodes flow •Check the membranes, if was broken or
Affects all ISE waste(do some maintence)
•Check the flowpath, if there was bubbles.
ISE REF
6.QC
How to do QC:
a. Prepare QC solution.
b. Tape “QC” in main menu, click QC lot manager, and add new lot, input corresponding
info including lot number, expired date, target values and 2SD values of all 3 levels. Save
the lot. 2SD= (higher limit of range-lower limit of range)/2
c. Click change lot to select the lot number you just added and the QC level, click “Go”, a
dialog box saying “Place QC sample in the sample port. Press ok to continue!” appears, put
the syringe containing QC solution at the sample port. Remove the syringe when the
aspiration is finished.
43
Awareness ：
Please store QC ampule in the
room temperature ranging from15C
to 30C
Gently mix ,don't shake the
ampule before open it to keep the
solution stable.
Expel air bubbles from syringe
and cap it carefully after
transferring QC sample from
ampoule to a syringe.
 Push off the first two drops from
the syringe.
44
7.Data management
You can check the
results of test,calibration
and QC and also export
the data out to USB.
45
7.1 Test result
46
7.2 QC plot data, QC plot
This function can manage QC data The system can plot one recent
stored on this system. QC data can QC result of one day stored in
be searched by specifying a data the current QC file for each
range. Listed records can be further parameter and level, and this
viewed by specifying levels system can plot the recent 30
days QC results in total
47
8. Expendable
Click expendable to scan the
barcode,
The probe will be back up.
After scan the reagent pack, pump
tube, sample port, it will perform
self test and calibration
automatically after click “return”
Pump tubes need to be replaced

every 6 months.
Sample port need to be replaced

every 6 months,it has 2 barcodes.
Click”enter barcode” ,you can input

barcode manually, but need to get
the barcode from manufacturers,or
analyze it by app
48
9.System setup
This chapter shows useful information
about system setup. Use these
function to configure and control your
system. Most of these functions are
required to be set up on first start-up
and not required by normal operation
once they have been set up. Change
system setup only when necessary.
There are 15 functions under this
menu:
49
9.1 Correlation
When test results is other
than target value or
methodology, it can be
corrected by using correlation
coefficients through slope and
intercept by using a model of
y=ax+b where a is slope, b
is intercept, x is test results
and y is target value. Only
mathematical calculation is
involved with correlation. The
slope and intercept are got
from a regression analysis of
test results against results
from reference system.
50
9.2 Reference Range
Reference range decides if
a result is out of expected
range and mark it on the
test
report. Reference range
can be varied and
represent different clinical
meaning if
samples are drawed from
neonant ,infant, male or
female.
51
9.3 Unit
Click “Edit” and input the
password “77”, user can
set the Hb calculation
value.(Hb value ranging
from 0.10 to 0. 99).
52
9.4 Test parameters
All parameters can be
selected or deselected
under Test parameters.
This will enable or disable
a test channel.
This is useful when one
electrode has problem or
unwanted parameters are
present.
53
9.5 Calibration
intervals
The system can perform
calibration periodically
according to calibration
interval set.
The system default interval for
one-point calibration is 60
minutes, and the system
performs two-point calibration
automatically after 3 times of
one point calibration
54
9.6 Date and time
Set the date and time for the system,
which may have an effect on expired
date of consumables.
Password :77
55
9.7 LIS interface
For the LIS system connection.
Awareness ：
Normal network Cable is used
for connection of BloodGas
and Router .
Cross network Cable is used
for connection of BloodGas
and PC directly.
56
HL7 Server Setting
Server IP means the PC’s
IP
Server port should be over
1024,and the same with
the port in the LIS software
57
Local Network setting
58
9.8 Printer HP 1020/1020plus
HP PL2035
Auto thermal printer:

Paper width:80mm(W)×50mm(D)
59
9.9 Self test
Self test will be perfomed
after replacing the reagent
pack. Samport port, and the
electrodes ect.
Also for some trouble

shooting..
Op1 means the liquid sensor 1.
which is below the sample port ，
Op2 means the liquid sensor
before the electrodes
Op3 means the liquid sensor
behind the electrodes
The 2 numbers difference

should over 40..[w,e] 222,116
60
9.10 Shutdown
It's strongly recommended that user
should perform shutdown operation if
the
system won't be used for a long time.
61
9.11 Other utilities
This menu is used for service
part.
62
9.11.1 QC Cal
This menu is for engineer to do the QC calibration
QC Cal _BG.pdf
63
9.11.2 pO2 Zero
calibration
The default value is 110,
Higher value will cause
lower results of pO2,
Lower value will cause
Higher results of pO2
Password :99
64
9.11.3Hospital Info
setting
Password : 99
65
9.11.4 Barometric
pressure
There is pressure sensor,
If the senor is broken,
Using the value entered,
which should be the local
barometric pressure
66
9.11.5 Gas test
This menu is for checking
the pO2 electrode
calibration
The theory value of gas

test pO2 is
(B.P.-47) X 0.21
The theory value should
not be different from the
test value 10
67
9.11.6 Service tools>>super service tool
password:20130606
68
9.11.7 Maintenance setup
Clean 3 days / 50 tests
Deproteinizing
30days/200 tests
Over 300 tests per month
15days/200tests
Over 500 tests per month
7days/300tests
Conditioning 30days/200tests
Over 300 tests per months
15days/200test
Conditioning(NH4F) is hurtful to Na&PH

electrodes, not need to do often
For BG800E/Gaslite 80E

Please take out the Glu, Lac electrodes
when doing maintenance 69
Trouble shooting
(No Cal A, No cal A cal B or cleaning solution )
pass Do 2 point calibration （ Remarks: When there’s few solution in cal pack,
Selftest sometimes selftest can be passed while calibration can’t.
Fail
Use syringe to inject water from the right side
Flush Leakage from sample of measure chamber to probe
port Liquid passes Blockage
Clean or replace sample Don’t use force to inject the

No liquid Liquid passes port solution, observe if there’s liquid
flowing through. (remove probe
from sampler when doing this
1. Replace with Restart machine, if selftest fails,
test)
shutdown kit, do self test enter system setup->other
again, if passes, then utilities->service tools->super
change a new reagent service tool, input password In most cases the blockage is in
pack “20130606”, enable printdebug, HCT, TH or probe, clean and
2. If fails, then replace do selftest again, then printer flush the path. Or there may be
pump tube or sample
will print the voltage of 3 liquid blockage in teck tube, use 84
port and selftest again.
3. Magnetic valve failure sensors, send us a picture of the solution (NaClO) to soak the
print paper.or check the tubes in path.
sensors 70
If you’ve moved electrodes before failure occurs, then just reinstall electrodes and do calibration again;
If reagent pack is close to expiration, then there may be no solution in pack and you’ll need to replace a new one.
Sample error
Check if there’s bubble in YES Collect sample again, suggest using critical care collection
sample syringe
NO
Check if sampler detector keeps
swinging, then take off syringe, do
NO selftest again ， if error still exists,
YES Check if sample is then enter super service tool and
If sampler detector moves
normally
aspirated to disable sample detect.
measuring chamber
NO
YES Use syringe to inject water from
the right side of measure chamber
Check if sampler to probe
Restart machine, if selftest fails,
detector installed
enter system setup->other utilities-
correctly, if so enter
>service tools->super service tool,
super service tool- If liquid cant flow thoroughly,
input password“20130606”, ”pg1”
>setup 2 and disable enable printdebug, do selftest again,
then there’s blockage in this
sample detect. then printer will print the voltage of path, clean the path of HCT,
3 liquid sensors, send us a picture of TH and probe; If there’s liquid
the print.or clean the tubes in the flowing through, then change
sensors the aspiration pump tube.
71
Electrodes calibration failed
K,Cl,Ca electrodes failed Na,PH electrodes failed
Do deprotein,after that, if still Do deprotein,condition,after that, if

failed follow the Only one still failed follow the Only one
electrode failed process electrode failed process
Take out the electrode, flush the channel with distilled

HCT failed
water, use needle ,and NaClO solution For 5mins
Cl electrde After long time use, the membrane of Cl electrode will be dry,
Using the soft tissue line and 5%NaClO solution to clean channel
72
Electrodes calibration failed
1.Add the Refill solution.
Electrodes 2.Check the Slope of electrodes,if out of range
calibration failed PO2,PCO2 Replace new electrode
Failed 3.The calibrations voltage changes a lot, replace new
Check the REF electrode,if there

ISE electrodes
More than Was crystal inside(clean it with warm
Failed
One failed Distilled water).
if the refill solution was not enough. fill it
again
If there were bubbles on the bottom,
Only one failed
flick it away.if the Ag core Felt off
(turn white) ,replace new .
Replace new reagent pack
Check the calibration voltages and range,

if the Mv ranges,slope ranges are normal,replace refill solution,check if the Ag core felt off,
if the contact is rustless,after that, do 3 times 2 pt calibration.Still failed, replace new
one ,self test and calibration.
If the Mv ranges are normal, slop ranges are abnormal, replace refill solution, do 1 time
2 Pt calibration.still failed. Replace new electrodes.
If the Mv ranges are abnormal. Replace new refill solution, do calibration
73
Thank you!
Please read the manuals carefully!
74

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Blood Gas/Electrolyte analyzer

Perfect Grounding UPS

step1 live-neutral≈220V step2 ： live-earth≈220V

Pre-heater Liquid sensor 3

Door Metal clip

Sample Type Liquid

、 unscrew the four screws 2 、 push out the battery

6 、 put the battery box in place and twist the

Scanner interface Scanner

Connect the scanner to machine, and twist the screws tightly ，

.2 、 Hold another end of the tube and go

2 、 pull up the sample port directly

2 、 insert all the electrolyte electrodes one by

before the Ref electrode.

4 、 insert the Cl between Ref and PH, then

Hold label side upward and point its connecting

b. Calibrate the touch (follow the steps show on the screen)

e. Expendable management ， scan the barcodes of electrodes,pump tubes, sample port

h. Calibration 1&2,if the electrodes were stable, do 3 levels QC, or do QC calibration

i. Test sample when the machine be in ready state

 8. check bit: none

4 、 Back to main menu for Calibration or Sample test.

Ag rod coated with AgCl

The circuit is completed when silver is oxidized at the anode:

The current developed by these reactions is directly proportional

Choose sample type>>

Must use the anticoagulated sample.

Recommened : sodium heparin or

Awareness ： For capillary ， need to switch the sample port,

Arterial blood collection

Preparation Arterial Blood collection site

Common syringe Arterial blood Disinfections

Arterial Blood processing

Insert the needle into rubber

Remove the needle , seal with plug

Storage at 4 ℃,and no more than 2

Arterial Blood VS Venous Blood

Lots of Oxygen =Bright red

Lots of CO2 = Dark crimson

From the color we can judge which sample pO2 is higher ?

•Heprain:the content of the heprain will affect the results directly,when

Preparation of heparin sodium syringe for ABG:

PH 7.35 ～ 7.45 Less 0.03 ～ 0.05

PaO2 ＞ 48mmHg Normally 40±3mmHg

PaCO2 35-45mmHg More 5 ～ 7mmHg

HCO3- 22-27mmol/L Almost same but more 1 ～ 2mmol/L

The body temperature affect:

When >37℃ ， 7.2% ↑ 4.4% ↑ 0.015 ↑

PS: Cleaning solution is inside

Aspirate condition with syringe to feed. And mix

logarithm of concentration. CAL A

line model an unknown Fig. 6 2-point calibration

concentration can be got if

Cal A Cal B LogC

Pump tubes need to be replaced

Sample port need to be replaced

Click”enter barcode” ,you can input

Auto thermal printer:

Also for some trouble