Page 1: Content
ELECTROLYTE ANALYZER OPERATOR AND SERVICE MANUAL DIESTRO 103APV4R V 1.0 MARCH 2022 RE 0851 CONTENT...
Page 2: Table Of Contents
DIESTRO 103APV4R ELECTROLYTE ANALYZER CONTENT ........................... 1 1 - INTRODUCTION ......................5 2 - SECURITY MEASURES ....................6 IMPORTANT SAFETY INSTRUCTIONS ................ 6 SYMBOLOGY ........................ 7 3 – INSTALLATION ......................10 1. UNPACKING ........................10 2. INSTALLATION REQUIREMENTS ...................10 3. CONNECTION .........................12 RETRACTABLE FILL PORT ..................16...
Page 3 WEEKLY MAINTENANCE .....................72 OTHER MAINTENANCE AND REPLACEMENT OF SPARE PARTS OR COMPONENTS72 OPEN THE FRONT .......................74 MOUNT THE FRONT ....................74 INSTALLATION/REPLACEMENT OF THE DIESTRO SAMPLING CLEANER ....75 TRANSPORTATION OF EQUIPMENT ................77 WASTE DISPOSAL .......................78 FINAL DISPOSITION OF THE EQUIPMENT ..............78...
Page 4 DIESTRO 103APV4R ELECTROLYTE ANALYZER 19 - SERVICE ........................79 OVERVIEW ........................79 ACCESS TO THE SERVICE MENU ................81 REVIEW AND EVALUATION OF THE STATUS OF THE ELECTRODES ......83 SAMPLE V MEASUREMENT ..................84 20 – REPLACING ELECTRODES ..................85 REPLACING ELECTRODES ..................85 21 - REPLACING PRINTING PAPER ................
Page 5: Introduction
DIESTRO 103APV4R Ion Analyzer. All configured electrolytes can be measured simultaneously in the same sample. Each model of the DIESTRO 103APV4R is expandable in the amount of ions to be measured, until reaching the maximum quantity. Manufactured by: JS Medicina Electrónica S.R.L.
Page 6: Security Measures
The operator's manual includes instructions and guidelines to observe during the commissioning, operation and maintenance of the analyzer. Therefore, the operator or anyone handling the DIESTRO 103APV4R analyzer should carefully read the manual before starting to use the equipment. The buyer of the equipment is responsible for training and reading the manual to each new operator of the equipment.
Page 7: Symbology
DIESTRO 103APV4R ELECTROLYTE ANALYZER the results issued by the Analyzer. Do not process samples without having carried out a quality control and verified the correct functioning of the Analyzer. If the equipment is not used in the manner specified by the manufacturer, the protection provided by the equipment may be affected.
Page 8 DIESTRO 103APV4R ELECTROLYTE ANALYZER Do not dispose of the product as if it were household waste. Failure to comply with these instructions may have detrimental effects. The user must dispose of the product as special waste, complying with the regulations applicable in their jurisdiction.
Page 9 DIESTRO 103APV4R ELECTROLYTE ANALYZER − For more information about the analyzer, press the +INFO button. +INFO Menu Contents To exit, press the back arrow. JS Medicina Electrónica...
Page 10: Installation
3 – INSTALLATION 1. UNPACKING Carefully unpack the two boxes and check for the following items: • DIESTRO Analyzer 103APV4R. • Autosampler for DIESTRO Analyzer 103APV4R (Optional). • ISE Calibration Pack. • Urine diluent ISE. • ISE Cleaning Solution. • Sodium Conditioner.
Page 11 DIESTRO 103APV4R ELECTROLYTE ANALYZER The mains voltage must be free of noise and variations. If necessary, use a stabilizer. 2.2. Environmental conditions of installation Verify the environmental operating conditions detailed in the "Technical Specifications" section For more detailed information see section: TECHNICAL SPECIFICATIONS 2.3.
Page 12: Connection
DIESTRO 103APV4R ELECTROLYTE ANALYZER 3. CONNECTION Before performing the installation, see the "DIAGRAMS" section to identify the parts and accessories of your analyzer. Use the cables and accessories provided with the equipment. If any need to be replaced, use spare parts provided or recommended by the manufacturer.
Page 13 DIESTRO 103APV4R ELECTROLYTE ANALYZER − Unscrew the caps, break the aluminum security seals and insert the special connection caps. Connect them to their corresponding couplings in the analyzer. Keep the caps that you removed to cover the bottles of the Pack at the time of discarding it.
Page 14 DIESTRO 103APV4R ELECTROLYTE ANALYZER Clamp screw Clamp screw Clamp screw 1) Opening front 2) Opening front 4) Opening front 3) Opening front Take the Cleaning Module, open the transparent packaging and remove the safety seal from the Sample Taking Cleaner as indicated in the figure.
Page 15 Opening the cleaner, step 1 Opening the cleaner, step 2 Carefully lift the fill port until it takes a horizontal position, present the DIESTRO cleaning module on the front of the position guides, and slide gently until it stops against the bottom.
Page 16: Retractable Fill Port
DIESTRO 103APV4R ELECTROLYTE ANALYZER See the section "CALIBRATION" AND "PURGE" When the calibration is complete, the analyzer displays the following screen: -Check that the date and time of the analyzer are correct. 4. RETRACTABLE FILL PORT The analyzer with the fill port in the resting position...
Page 17 DIESTRO 103APV4R ELECTROLYTE ANALYZER Fill port position for Capillary Fill port position for Tube or Syringe. See "RETRACTABLE FILL PORT" 4.1 Capillary Adapter BIOHAZARD. Samples, capillaries and adapters are potentially infectious. Handle with gloves. After removing the sample, clean the sampling capillary well with ISE Cleaning...
Page 18 DIESTRO 103APV4R ELECTROLYTE ANALYZER 1) 2) Capillary Adapter 1 Capillary Adapter 2 BIOHAZARD. Capillary samples and adapters are potentially infectious. Handle with gloves. Before starting to measure capillaries, clean the fill port with ISE Cleaning Solution REF IN 0400 JS Medicina Electrónica...
Page 19: Calibration Solutions (Pack)
If the pack type is not appropriate, the analyzer will display an error message: "Pack Invalid" JS Medicina Electrónica recommends the simultaneous ® replacement of the Fill Port Cleaner with the DIESTRO Pack. See the section: "ERROR MESSAGES"...
Page 20: Microchip (Uchip)
DIESTRO 103APV4R ELECTROLYTE ANALYZER 2. MICROCHIP (uChip) Pack’s uChip The uChip integrated in the Pack/Kit provides the analyzer with information about the volumes of solutions, calibration values, content, type, batch and expiration date of the Pack. 3. VALIDITY OF THE PACK...
Page 21: Pack Performance
DIESTRO 103APV4R ELECTROLYTE ANALYZER 5. PACK PERFORMANCE The performance of the Pack/Kit depends on the way the analyzer is used and maintained. To get the best performance we recommend whenever possible: • Measuring samples in batches, rather than randomly spaced: this saves calibration solutions and improves repeatability in measurements.
Page 22 DIESTRO 103APV4R ELECTROLYTE ANALYZER Take care not to contaminate the green or orange lids and their respective tubing, as they will be used for the next pack. In the Empty Pack, replace the green, orange and red original caps before discarding to avoid spills.
Page 23 DIESTRO 103APV4R ELECTROLYTE ANALYZER See the section: "CALIBRATION" and "PURGE". Once the calibration process is complete, the analyzer will display the following screen and be ready to measure. JS Medicina Electrónica...
Page 24: Serum/Plasma/Whole Blood Measurement
DIESTRO 103APV4R ELECTROLYTE ANALYZER 5 - SERUM/PLASMA/WHOLE BLOOD MEASUREMENT 1. OVERVIEW Ensure the correct functioning of the analyzer by servicing it correctly and periodically performing quality controls. See sections: "MAINTENANCE" and "QUALITY CONTROL". The sample must be free of fibrins and clots It is recommended to centrifuge the samples and measure the serum.
Page 25: Measurement
DIESTRO 103APV4R ELECTROLYTE ANALYZER 3. MEASUREMENT Pressing "X" at any time will abort the current measure 3.1-From the initial menu press "Serum". By lifting the lever you can also load the sample, without the need to press any buttons. 3.2-In the measurement menu you can select whether to measure TCO2 (if installed), IONS or both.
Page 26 DIESTRO 103APV4R ELECTROLYTE ANALYZER 3.3-The analyzer will display the following screen. 3.4 Once the load is finished, remove the tube or capillary and lower the lever If the lever is not brought to the resting position, the analyzer will not continue with the measurement and start emitting an audible signal.
Page 27 DIESTRO 103APV4R ELECTROLYTE ANALYZER The analyzer then automatically loads the StdA needed for rinsing and one point calibration. If the analyzer is not able to load Std. A will display the "Not Filled" error and the measurement will not be completed.
Page 28: Printing Results
DIESTRO 103APV4R ELECTROLYTE ANALYZER The operator can enter the sample manually in case it cannot be detected (a conductivity sample) pressing "Manual Loading". "Undetectable samples" section 4. PRINTING RESULTS ======================= Measure Report  Measure ID 04/04/2022 10:19:36  Measure Date & Time JS Medicina Electronica ...
Page 29: Ph Corrected Calcium Measurement
DIESTRO 103APV4R ELECTROLYTE ANALYZER 5. pH Corrected Calcium Measurement (Only equipment with Calcium and pH electrodes installed and enabled) The analyzer can measure pH to correct the value of ionized calcium at pH=7.40, and thus obtain standardized Ionic Calcium. The pH is determined at room temperature and corrected to 37°C using a temperature sensor included in the electrode plate.
Page 30: Urine Measurement
DIESTRO 103APV4R ELECTROLYTE ANALYZER Slide the display until you see the pH electrode, then select between 37°C and room temperature. If you select 37°C, the analyzer will calculate the corrected pH at that temperature. For more details, see section: "SERUM/PLASMA/WHOLE BLOOD MEASUREMENT"...
Page 31: Sample Loading
DIESTRO 103APV4R ELECTROLYTE ANALYZER 2. SAMPLE LOADING BIOHAZARD. Samples, capillaries and adapters are potentially infectious. Handle with gloves. After removing the sample, clean the sampling capillary well with ISE Cleaning Solution Solution ISE REF IN 0400. Urine samples are always loaded from a tube, always DILUTE with the provided urine diluent.
Page 32: Calibration
DIESTRO 103APV4R ELECTROLYTE ANALYZER 7 - CALIBRATION 1. OVERVIEW The analyzer performs 3 types of calibration a. One Point Calibration of Ions and pH Two Point Calibration of Ions and pH c. TCO2 calibration (if installed) Ensure the correct functioning of the analyzer by maintaining it properly and performing quality controls.
Page 33: Two Point Calibration Of Ions And Ph
DIESTRO 103APV4R ELECTROLYTE ANALYZER 3. TWO POINT CALIBRATION OF IONS AND PH 3.1 Automatic Calibration It is performed when the analyzer is turned on, and every 8 hours. The calibration frequency can be modified in the calibration options menu. Route: "HOME" screen →...
Page 34: Calibration Result
DIESTRO 103APV4R ELECTROLYTE ANALYZER Before calibrating, the analyzer will wash the TCO2 module and display the following screen Wait until the rinse is finished. The Analyzer will then ask you to lift the lever and place the calibration solution. Follow the on-screen instructions.
Page 35 DIESTRO 103APV4R ELECTROLYTE ANALYZER ION Calibration Result Visualization TCO2 calibration result display (if available) You can print these results by pressing the Print button. The legend "Calibrated" indicates that the electrode is ready to measure. See the "ELECTRODE GAIN" section for gain ranges If the sodium or pH gain is less or greater than expected, perform a wash with sodium conditioner.
Page 36: Printing The Calibration Result
DIESTRO 103APV4R ELECTROLYTE ANALYZER 6. PRINTING THE CALIBRATION RESULT The printed output includes the following information: ======================= Calibration Report #125  Calibration ID 04/04/2022 10:08:18  Calibration Date & Time JS Medicina Electronica  Institution Name 103APV4R S/N: 1  Analyzer Model and Serial Number UI: 1.0 uISE: 1.57...
Page 37: Saved Results
DIESTRO 103APV4R ELECTROLYTE ANALYZER 7. SAVED RESULTS The analyzer saves all the calibrations. To read them, navigate to the Calibration Memory window. Route: "HOME" screen → → Memory → Calibration Memory By clicking on an item in the list, you can access the results of the calibration you want to view.
Page 38 DIESTRO 103APV4R ELECTROLYTE ANALYZER By clicking on the electrode enable button, you will be able to enable or disable it. In this window you can also select the units of measurement. In the case of pH, you can select the temperature at which the result will be reported (37°C or Tamb) 8.2 Configuring the measurement correction...
Page 39 DIESTRO 103APV4R ELECTROLYTE ANALYZER Route: "HOME" screen → → Calibration → Options → Corrections From the drop-down list, select the electrode to which you want to apply the correction. Then press "a" to modify the quadratic term, "b" for the linear term, and "c" for the delta.
Page 40: Electrode History
DIESTRO 103APV4R ELECTROLYTE ANALYZER 9. ELECTRODE HISTORY Overview: This menu contains all the data related to the installed electrodes, such as: ● Serial number. ● Date of manufacture. ● Date until which it can be in stock without being installed.
Page 41: Standby Function
DIESTRO 103APV4R ELECTROLYTE ANALYZER ● Calibrations performed. ● Wets of Std A. ● Samples in Batch mode. ● Samples in random mode. ● Normal washes. ● Wets of Std B. ● "Not empty" errors ● "Not filled" errors This allows you to verify the use of the analyzer.
Page 42: Rinse
DIESTRO 103APV4R ELECTROLYTE ANALYZER 8 – RINSE 1. OVERVIEW While the analyzer is measuring or calibrating, it will need to rinse the electrodes. This procedure renews the Std.A in the electrodes preventing the mixing of different substances, also cleans the liquid circuit by removing bubbles, clots, dirt or other substance that can change the result of the measurement or calibration.
Page 43 DIESTRO 103APV4R ELECTROLYTE ANALYZER 3.4 pH/Sodium Rinse In case of having a pH or Na glass electrode, the equipment will automatically ask for a pH /Sodium rinse after a week of the last one. You must place the pH/Na cleaning solution at the time the equipment requires it.
Page 44: Purges
DIESTRO 103APV4R ELECTROLYTE ANALYZER 9 – PURGES To access this menu, navigate to: Route: "HOME" screen → → Rinse 1. PURGE STDS During this process, the pack and equipment pipes are filled with both calibration solutions. 2. PURGE LACTIC In equipment equipped with a module for measuring TCO2, the lactic acid pipe circuit must be purged when changing the Lactic Acid bottle.
Page 45: Quality Control
The DIESTRO Analyzer has the possibility to perform statistical calculations to assist the operator in the quality control of their equipment The Control Ampoules Diestro Control and Diestro Trilevel come in 3 levels, low, medium (the normal value) and high.
Page 46: Quality Control Measurement [Level 1, 2 And 3]
DIESTRO 103APV4R ELECTROLYTE ANALYZER If serums are used, use gloves. The greater the number of control samples measured, the more accurate the analysis will be. The equipment allows you to analyze up to the last 50 samples measured from each level.
Page 47: Statistics
DIESTRO 103APV4R ELECTROLYTE ANALYZER 3. STATISTICS Route: "HOME" screen → → Quality Control → Statistics Pressing the chosen analyte shows a graph where you can see the evolution of the measurements, the limits for that control, and the standard deviations represented with horizontal dotted lines for +/- 1, +/- 2 and +/- 3 standard deviations.
Page 48: Ranges
DIESTRO 103APV4R ELECTROLYTE ANALYZER Optionally you can enable the result of applying the Westgard rules by pressing the "<" bar to the right of the chart, which will make a table appear indicating if the criterion for each rule is met;...
Page 49: Memory
DIESTRO 103APV4R ELECTROLYTE ANALYZER To modify the existing value, you must press on the corresponding box and a keyboard will appear that will allow us to enter a new value. Finish by pressing "Enter". The average level will be calculated automatically.
Page 50: Brand And Lot
DIESTRO 103APV4R ELECTROLYTE ANALYZER To see a measurement, click on it and a new screen will open with the results. The "Delete" button allows us to remove only this measurement from the list of control measurements. 6. BRAND AND LOT Route: "HOME"...
Page 51: Clock
DIESTRO 103APV4R ELECTROLYTE ANALYZER 11 - CLOCK 1. DEFINITION The analyzer keeps the date and time despite being turned off. 2. CLOCK ADJUSTMENT To access your analyzer's date and time setting, navigate to: Route: "HOME" screen → → Settings → Date and time...
Page 52: Memory
DIESTRO 103APV4R ELECTROLYTE ANALYZER 12 – MEMORY 1. OVERVIEW It allows the operator to have access to the results of the measurements and calibrations carried out, ordered chronologically. JS Medicina Electrónica...
Page 53: Results History
DIESTRO 103APV4R ELECTROLYTE ANALYZER 2. RESULTS HISTORY Route: "HOME" screen → → Memory → Results History Here we can select the measurement we want to see, they appear ordered chronologically, indicating order number, date, time, id and name. Once the study we want to bring has been selected, the results will be displayed and it will be allowed to print if necessary by pressing the "Printer"...
Page 54 DIESTRO 103APV4R ELECTROLYTE ANALYZER By pressing on the desired one, a screen will open with the measurements of each tube, if there was more than one repetition, the value shown will be the average of the n measurements made. The values shown in red indicate that the expected maximum CV or SD for that ION/pH/TCO2 has been exceeded.
Page 55: Calibration History
DIESTRO 103APV4R ELECTROLYTE ANALYZER 4. CALIBRATION HISTORY Route: "HOME" screen → → Memory→ Calibration History Here we can select the calibration that we want to see (Ions or TCO2), they appear ordered chronologically, indicating order number, date, time, and type of calibration.
Page 56: Non-Detectable Samples
DIESTRO 103APV4R ELECTROLYTE ANALYZER 13 - NON-DETECTABLE SAMPLES 1. OVERVIEW It may happen that a sample (Serum, Whole Blood or Urine) with low conductivity or insufficient volume is not detected giving an error in the analyzer (Error: Not Filled). The operator can position the sample manually to perform the measurement.
Page 57 DIESTRO 103APV4R ELECTROLYTE ANALYZER 2.3 Using the Left and Right buttons, position the sample so that it is in contact with the reference electrode and the electrodes for which it reaches volume. 2.4 Once the sample is positioned correctly and without bubbles, lower the lever and press "Measure".
Page 58: Configuration
DIESTRO 103APV4R ELECTROLYTE ANALYZER 14 – CONFIGURATION 1. OVERVIEW The settings menu is accessed from: Route: "HOME" → → Configuration As there are more options than those that fit on a screen, you must make a vertical scroll of the menu using the scroll bar located on the right to access the options that are hidden.
Page 59: Enabling/Disabling Electrodes And Unit Selection
DIESTRO 103APV4R ELECTROLYTE ANALYZER 2. ENABLING/DISABLING ELECTRODES AND UNIT SELECTION In this menu you can enable or disable an electrode present and choose on which unit the result will be displayed. In the case of being enabled, you will see a green circle to the left of the name of the ion, to disable it touch the circle and it will turn black (disabled).
Page 60: Normal Values
DIESTRO 103APV4R ELECTROLYTE ANALYZER 5. NORMAL VALUES This screen allows you to edit the lower and upper bound values considered "normal" by the analyzer. If any measurement falls outside these values it will be marked with a down or up arrow depending on whether it is below or above the limit.
Page 61: Internal Printer
DIESTRO 103APV4R ELECTROLYTE ANALYZER 7. INTERNAL PRINTER Enables or disables the internal ticket printer. To disable press the green button. To enable it press again. 8. DETECTION THRESHOLDS Allows you to edit the values used in the detection of the various liquids used.
Page 62: Language
DIESTRO 103APV4R ELECTROLYTE ANALYZER 10. LANGUAGE To change the language press the square with the current language and choose the required one from the list. The analyzer must be turned off and back on for it to become effective. JS Medicina Electrónica...
Page 63: Serial Port Output Configuration For Lis Interface
DIESTRO 103APV4R ELECTROLYTE ANALYZER 15 – SERIAL PORT OUTPUT CONFIGURATION FOR LIS INTERFACE The analyzer has the option to send data according to the "LIS" communication protocol. A USB to RS232 adapter will be required. Connection cable Pins DB9 Female...
Page 64 DIESTRO 103APV4R ELECTROLYTE ANALYZER Serial output configuration: To configure serial output, navigate to the menu: Route: "HOME" screen → → Configuration → Connections Press "Serial Output" to enable it. Select the port from the drop-down menu. Here you can choose the communication speed and enable/disable the Xon/Xoff protocol.
Page 65 DIESTRO 103APV4R ELECTROLYTE ANALYZER ▪ The analyzer sends the measurement data in a data string with the following format: # Sample Number;& Patient; Date Time; Na measurement result; Measurement result of K; Cl measurement result;Ca measurement result; Li;CR measurement result...
Page 66 DIESTRO 103APV4R ELECTROLYTE ANALYZER EXAMPLE OF STRINGS SENT OVER THE NETWORK: Serum measurements in analyzer with Na-K-Cl-Ca-Li configuration, Sample number 7, Patient Juan Perez1234, Na Measurement with errors ? Cl, K Measurement with errors ? Q, Cl Measurements OK, Ca below normal value and Li above normal value.
Page 67: Installation Of Barcode Reader And/Or External Keyboard (Optional)
DIESTRO 103APV4R ELECTROLYTE ANALYZER 16 – INSTALLATION OF BARCODE READER AND/OR EXTERNAL KEYBOARD (OPTIONAL) The equipment allows you to connect an external USB barcode reader and / or an external USB keyboard in one of the two USB ports that it has on the back of the cabinet.
Page 68: 17- Error Messages
DIESTRO 103APV4R ELECTROLYTE ANALYZER 17- ERROR MESSAGES 1. ANALYZER STATUS The operator can quickly view the status of the equipment, from any location: 1) Semaphore Indicates the overall status of the analyzer. By clicking on the indicator, you can access more information.
Page 69: Error Messages
DIESTRO 103APV4R ELECTROLYTE ANALYZER 2. ERROR MESSAGES The errors that may appear during the different processes that the analyzer runs are: Error Description Possible Cause Effect Action ● Check if there are Uncalibrated other symbols in Check the profit The parameter electrode.
Page 70 DIESTRO 103APV4R ELECTROLYTE ANALYZER inverted. changed measured. Pack. contaminated. ● Purge calibrate. ● Change for a new Pack. Insufficient sample. ● Verify the sample ● Verify the charging Sample with clots, fibrins, or process. The sample or bubbles. ● Check...
Page 71: Maintenance
DIESTRO 103APV4R ELECTROLYTE ANALYZER Technical Service. Failure electronic components balance during 1-point ● Repeat calibration differs from the External measurement last 2-point interference calibration calibration. during ● Check for blockages measurement. or leaks in pipes balance Bubbles and electrodes. during 1-point liquid circuit.
Page 72: Weekly Maintenance
DIESTRO 103APV4R ELECTROLYTE ANALYZER 1.1.2 Clean all outer surfaces of the analyzer with a cloth gently moistened with 1:10 solution of sodium hypochlorite. 1.1.3 Decontaminate the Fill Port with ISE Cleaning Solution Solution ISE REF IN 0400. 1.2 ISE Cleaning To protect the analyzer from possible contamination and from obstructions and plugs, perform ISE Cleaning daily.
Page 73 DIESTRO 103APV4R ELECTROLYTE ANALYZER The following table provides instructions, recommended frequencies, and who can make the changes: Precaution. Potentially infectious elements, discard according to the laws of your country for the treatment of pathological waste. Handle with gloves. Spare Part...
Page 74: Open The Front
DIESTRO 103APV4R ELECTROLYTE ANALYZER 4. OPEN THE FRONT 4.1 Loosen the clamp button using a screwdriver or coin. 4.2 Open the front by tilting it forward. 5. MOUNT THE FRONT 5.1 Close the front. 5.2 Adjust the clamp button using a flat screwdriver or coin.
Page 75: Installation/Replacement Of The Diestro Sampling Cleaner
6.2 Carefully lift the capillary sample until it takes a horizontal position, remove the used Sample Cleaner and discard it in accordance with current regulations related to potentially infectious biological waste. 6.3 Clean the needle with a disposable cloth or towel moistened with Diestro ISE Cleaning solution. JS Medicina Electrónica...
Page 76 6.4 Open the transparent packaging and remove the safety seal from the new Sample Taking Cleaner as shown in the figure. 6.5 Present the DIESTRO cleaning module on the front of the position guides, and slide smoothly until you stop against the bottom.
Page 77: Transportation Of Equipment
DIESTRO 103APV4R ELECTROLYTE ANALYZER 7. TRANSPORTATION OF EQUIPMENT Perform ISE Cleaning and, if necessary, clean and decontaminate all necessary surfaces of the equipment. Wear gloves in all cases. Prevent damage to the power cord during transport or storage of the equipment.
Page 78: Waste Disposal
DIESTRO 103APV4R ELECTROLYTE ANALYZER 3. Connect a pipe to the Standard A and B couplings of the equipment and immerse in distilled water, then proceed as in step 2 to wash the entire circuit. 4. Repeat step 2 by previously removing the pipes from the distilled water, until the entire circuit is dry.
Page 79: Service
DIESTRO 103APV4R ELECTROLYTE ANALYZER 19 - SERVICE 1. OVERVIEW The Analyzer has a menu for use by the manufacturer or authorized personnel, which allows to evaluate the operation of the hydraulic circuit and the state of the electrodes Analyzer hydraulic circuit (without TCO2) Analyzer connection diagram JS Medicina Electrónica...
Page 80 DIESTRO 103APV4R ELECTROLYTE ANALYZER Analyzer hydraulic circuit (with TCO2) Notes: ● The Sampler is Optional ● The number of electrodes depends on the configuration of the equipment (the image shows the widest available electrode train). JS Medicina Electrónica...
Page 81: Access To The Service Menu
DIESTRO 103APV4R ELECTROLYTE ANALYZER 2. ACCESS TO THE SERVICE MENU 2.1. To access the manual maintenance menu, navigate to: Route: "HOME" screen → → Maintenance → Manual To manually position StdA, press the "A" button and then CW (with General Persitáltica enabled), until the liquid is brought to the desired position.
Page 82 DIESTRO 103APV4R ELECTROLYTE ANALYZER 2.2. To access the automatic maintenance menu, navigate to: Route: "HOME" screen → → Maintenance→ Automatic Automatic positioning: FA: Position StdA on the ION chamber. FB: Position StdB on the ION chamber. FS: Load Sample from the FillPort (requires fill port out) FI: Move loaded sample to the ION chamber.
Page 83: Review And Evaluation Of The Status Of The Electrodes
DIESTRO 103APV4R ELECTROLYTE ANALYZER 3. REVIEW AND EVALUATION OF THE STATUS OF THE ELECTRODES When there is a solution in the measuring chamber, the analyzer can measure the voltage (mV) in the electrode train, proportional to the concentration of each electrolyte.
Page 84: Sample Mv Measurement
DIESTRO 103APV4R ELECTROLYTE ANALYZER 4. SAMPLE mV MEASUREMENT Measure the voltages corresponding to the electrodes installed in the equipment. The mV shown (mV difference between the electrode in question and the reference electrode), are proportional to the concentration of each ION (Interpretation of the results obtained).
Page 85: Replacing Electrodes
DIESTRO 103APV4R ELECTROLYTE ANALYZER 20 – REPLACING ELECTRODES 1. REPLACING ELECTRODES Buy original spare parts from the manufacturer and authorized seller. To replace an electrode, perform the following sequence: 1.1. Disconnect the power supply from the mains. 1.2. Open the front of the analyzer and electrode cover to access the electrodes, remove the stop screw from the right, and open the electrode cover.
Page 86 DIESTRO 103APV4R ELECTROLYTE ANALYZER Fig. 41: Removing the electrode cover Fig. 42: Separating the electrode train. JS Medicina Electrónica...
Page 87: Replacing Printing Paper
DIESTRO 103APV4R ELECTROLYTE ANALYZER 21 - REPLACING PRINTING PAPER To replace the thermal paper roll perform the following sequence: 1. Open the lid of the roll holder, gently pulling from the slot out. Roll door opening 2. Replace the roll and remove the end of the paper as described in the image.
Page 88: Peristaltic Head Relacement
DIESTRO 103APV4R ELECTROLYTE ANALYZER 22 - PERISTALTIC HEAD RELACEMENT After the change of the peristaltic head, it will be necessary to perform a purge. 1. On the back of the equipment, disconnect the peristaltic pipes from both couplings. REMOVE PUMP PIPES...
Page 89 DIESTRO 103APV4R ELECTROLYTE ANALYZER View of the peristaltic without head 3. Place the new head by pressing towards the equipment, and connect the pipes. 4. Perform a purge JS Medicina Electrónica...
Page 90: 23-Fill Port Needle Replacement
DIESTRO 103APV4R ELECTROLYTE ANALYZER 23–FILL PORT NEEDLE REPLACEMENT Retractable Fill Port 1. Change of the tip 1.1 Open the front to access the fill port assembly. 1.2 Remove the tip that wraps the stainless steel capillary. 1.3 Place the new tip and leave in the same position.
Page 91 DIESTRO 103APV4R ELECTROLYTE ANALYZER Needle sampling with Tip placed JS Medicina Electrónica...
Page 92: 25- Autosampler (Optional)
DIESTRO 103APV4R ELECTROLYTE ANALYZER 25– AUTOSAMPLER (Optional) 1. OVERVIEW The Autosampler allows up to 40 samples to be measured automatically. By having the internal barcode reader option, it allows the automatic identification of samples. Samples can be taken from a primary tube, primary pediatric tube or sample cups.
Page 93 DIESTRO 103APV4R ELECTROLYTE ANALYZER Remove this screw 3. Connect the flat cable to the cable connector in the side of the analyzer. Do the same with the tubing. 4. Stick the flat cable to the analyzer´s cabinet with the provided double sided tape. Screw the plastic piece to the analyzer´s cabinet.
Page 94 DIESTRO 103APV4R ELECTROLYTE ANALYZER 6. Put the needle cover and screw it. JS Medicina Electrónica...
Page 95: Measurement Using The Autosampler
DIESTRO 103APV4R ELECTROLYTE ANALYZER 6. Now plug the power supply and perform a purge. NEEDLE COVER 3. MEASUREMENT USING THE AUTOSAMPLER To access the Autosampler menu press the "Sampler" button on the HOME screen The equipment has three ways to make the measurement with the autosampler: a.
Page 96 DIESTRO 103APV4R ELECTROLYTE ANALYZER By pressing this button the sampler performs a scan of all the tubes and if it finds a label with a valid barcode it uses it to identify the tube in that position. All tubes must contain the same type of sample, in this case serum or urine as the case of the button pressed.
Page 97: Ways To Load The Sample Into The Autosampler
DIESTRO 103APV4R ELECTROLYTE ANALYZER We load the first sample into position 1 of the tube disc of the sampler and select serum or urine according to what we want to measure. If we are going to make serum and urine measurements we must place all the serums together and all the urine together, without mixing the order with each other, in order to achieve a better measurement.
Page 98 DIESTRO 103APV4R ELECTROLYTE ANALYZER Loading from a tube into the sampler Loading from sample cup JS Medicina Electrónica...
Page 99: Configuration
DIESTRO 103APV4R ELECTROLYTE ANALYZER BIOHAZARD. Samples, capillaries and adapters are potentially infectious. Handle with gloves. After removing the sample, clean the sampling capillary well with ISE Cleaning Solution Solution ISE REF IN 0400. Correct tube placement BIOHAZARD. Samples, capillaries and adapters are potentially infectious.
Page 100: Bar Code Specifications
DIESTRO 103APV4R ELECTROLYTE ANALYZER a) Primer enabled in tube #1. If we enable this option, the sampler will make, before starting to measure the other tubes, n measurements of the primer solution placed in position # 1. As a primer , serum or a serum pool is usually used to condition the electrodes before starting with the measurement run.
Page 101: Specifications Of Primary Tubes And Cups
DIESTRO 103APV4R ELECTROLYTE ANALYZER The following photos indicate the correct way to glue the code to the tube: 45mm max 10mm Barcode pasted correctly (Fig. 62) 7. SPECIFICATIONS OF PRIMARY TUBES AND CUPS 101 JS Medicina Electrónica...
Page 102 DIESTRO 103APV4R ELECTROLYTE ANALYZER Tubes (Fig. 63) Type of primary tubes: 1-Tube 12 x 86mm, round bottom for 5ml. 2-Tube 12 x 75mm, round bottom for 5ml. (For this tube change the separators of the sampler disc. See section 10 of this chapter) 3-Tube 12 x 56mm, round bottom for 3ml.
Page 103 DIESTRO 103APV4R ELECTROLYTE ANALYZER Pediatric Primary Tube Type: 6-Pediatric primary tube 11 x 42mm for 0.5ml. For better utilization of the pediatric primary tube, place it inside an adult primary tube as shown in the following photo. 103 JS Medicina Electrónica...
Page 104: Maintenance
DIESTRO 103APV4R ELECTROLYTE ANALYZER 8. MAINTENANCE At the end of the working day perform an ISE Cleaning Solution of Autosampler. (ISE Cleaning Solution from sampling does NOT REPLACE ISE Cleaning Solution of the Autosampler). 9. HOW TO REMOVE THE TUBE HOLDER DISC FROM THE SAMPLER In case of a spill of liquids inside the sampler it will be necessary to remove the disc to be able to clean it correctly.
Page 105 DIESTRO 103APV4R ELECTROLYTE ANALYZER Screws to be loosen. 10.1.5 Remove the center screw. Remove the disc using the previously unadjusted screws. Removing the tube holder disc (Fig. 65) Clean the residues that are inside the sampler. 105 JS Medicina Electrónica...
Page 106 DIESTRO 103APV4R ELECTROLYTE ANALYZER Replace the disc by matching the sampler hole to the shaft lock. Shaft lock Sampler hole Adjust the center screw. Adjust the two screws at the top. JS Medicina Electrónica...
Page 107: Change Sampler Disc Separators
DIESTRO 103APV4R ELECTROLYTE ANALYZER Reconnect the analyzer outlet and check in the sampler settings menu that the source position is correct. If it is not correct, correct it in the Autosampler settings menu. 10. CHANGE SAMPLER DISC SEPARATORS In the case of using tubes of 75mm long or shorter, it is recommended to change the separators of the sampler disc for the shorter ones provided with the analyzer.
Page 108: 26- Diagrams
DIESTRO 103APV4R ELECTROLYTE ANALYZER 26- DIAGRAMS Touch Printer keyboard Pack Screen Sampling Tray door pack Barcode reader Front view Sampling drive lever Side view JS Medicina Electrónica...
Page 109 DIESTRO 103APV4R ELECTROLYTE ANALYZER Cable Uchip Pack Rear View 109 JS Medicina Electrónica...
Page 110 DIESTRO 103APV4R ELECTROLYTE ANALYZER Printer Pack Clamping button Sampling Barcode reader Autosampler Front view Pack Pack tray Autosampler Side view JS Medicina Electrónica...
Page 111 DIESTRO 103APV4R ELECTROLYTE ANALYZER Autosampler Pack 111 JS Medicina Electrónica...
Page 112 DIESTRO 103APV4R ELECTROLYTE ANALYZER Rear view detail JS Medicina Electrónica...
Page 113 DIESTRO 103APV4R ELECTROLYTE ANALYZER Front View with Open Lid 113 JS Medicina Electrónica...
Page 114 DIESTRO 103APV4R ELECTROLYTE ANALYZER Electrode cable Electrode lock Electrode chamber JS Medicina Electrónica...
Page 115: 27- Technical Specifications
DIESTRO 103APV4R ELECTROLYTE ANALYZER 27- TECHNICAL SPECIFICATIONS SIZE AND WEIGHT OF THE EQUIPMENT 103APV4R 103APV4R with AutoSampler option Height [mm] Width [mm] Depth [mm] Analyzer [kg] Weight (w/ battery) [kg] Pack [kg] Power Supply [g] Urine Diluent [g] ISE Cleaning Solution [g] 1.1 Size and Weight of the analyzer box...
Page 116 DIESTRO 103APV4R ELECTROLYTE ANALYZER 1. ENVIRONMENTAL OPERATING CONDITIONS Ambient temperature: Between 15º and 30º C (59°- 86°F). Humidity: Less than 80% non-condensed. Avoid direct exposure to the sun's rays. 2. ENVIRONMENTAL STORAGE AND TRANSPORT CONDITIONS Ambient temperature: Between 5º and 35º C (41°- 95°F).
Page 117 DIESTRO 103APV4R ELECTROLYTE ANALYZER 9. MEASUREMENT SPECIFICATIONS SODIUM POTASSIUM CHLORIDE CALCIUM LITHIUM TCO2 Serum Detection 40.0 6.80 1.0 30.0 20.0 250.0 0.20 5.00 0.30 5.00 Range 220.0 7.80 100.0 [mmol/L] Urine Detection 20.0 2.0 150.0 20.0 300.0 Range 300.0 [mmol/L]...
Page 118 DIESTRO 103APV4R ELECTROLYTE ANALYZER These values are for reference only. They depend on the operation of the electrode, installation time, correct operation of the analyzer and the Pack/Kit. 12. BATTERY FOR INTERNAL CLOCK 3V Lithium Battery CR1220 13. BACKUP BATTERY (OPTIONAL) Pack Batteries NiMh 14.4V 2400 mAh provided by the manufacturer of the equipment.
Page 119: Annex I - Clinical Significance Of Serum/Plasma/Blood Electrolytes119
DIESTRO 103APV4R ELECTROLYTE ANALYZER ANNEX I - CLINICAL SIGNIFICANCE OF SERUM/PLASMA/BLOOD ELECTROLYTES Potassium Concentration: cK+ 1. DEFINITION cK+(P) is the concentration of potassium (K+) in plasma, while cK+(aP) is the equivalent for arterial blood. In the Ion Analyzer it is displayed as K+.
Page 120 DIESTRO 103APV4R ELECTROLYTE ANALYZER 5. CONSIDERATIONS Elevated levels of cK+ can be caused by hemolysis. This is because the red blood cells have a higher concentration of this Ion, with respect to the serum or plasma, so an artificially increased cK+ can be observed.
Page 121 DIESTRO 103APV4R ELECTROLYTE ANALYZER Mannitol infusion), Hyperventilation, Diabetes insipidus (due to ADH or nephrogenic deficiency), Decreased fluid intake. • Steroids 5. Considerations A regional edema in the sampling area can cause false decreased cNa+ values. Chloride Concentration: cCl- 1. Definition cCl-(P) is the concentration of chloride (Cl-) in plasma, while cCl-(aP) is the equivalent for arterial blood.
Page 122 DIESTRO 103APV4R ELECTROLYTE ANALYZER 4. Clinical interpretation 4.1 Low levels of cCa++ may be due to: * Alkalosis * Renal insufficiency * Acute circulatory insufficiency * Vitamin D deficiency * Hipoparatiroidismo 4.2 Elevated levels of cCa++ may be due to:...
Page 123 DIESTRO 103APV4R ELECTROLYTE ANALYZER 2. The cLi+ indicates: Lithium is a monovalent metal cation that is usually absent in the body. It is used for the treatment of manic – depressive psychosis. The drug produces important effects, but significant clinical complications associated with its use may appear. Lithium binding to plasma proteins is less than 10% and its half-life is 7 –...
Page 124 DIESTRO 103APV4R ELECTROLYTE ANALYZER its minimum expression the influence of pH and it is not necessary to apply the correction formula since there will be no change in pCO2 which will cause the pH not to change and consequently the Calcium is not modified.
Page 125: Annex Ii - Clinical Significance Of Electrolytes In Urine
DIESTRO 103APV4R ELECTROLYTE ANALYZER ANNEX II - CLINICAL SIGNIFICANCE OF ELECTROLYTES IN URINE The urinary ionogram is highly variable from one individual to another, and from one day to the next, in the same individual. Therefore, it should be compared with the plasma ionogram and with the patient's vital signs.
Page 126 DIESTRO 103APV4R ELECTROLYTE ANALYZER polyuric phase following anuria; chronic nephropathies (pyelonephritis, chronic glomerulonephritis or polycystic kidney) with saline incontinence syndrome; in adrenal insufficiency of Addison's disease; hypernatriria: appears in Schwartz–Bartter syndrome (excessive secretion of ADH). The determination of urinary sodium is of diagnostic utility in the following clinical situations: 1)
Page 127: Annex Iii - Principle Of Operation
DIESTRO 103APV4R ELECTROLYTE ANALYZER ANNEX III - PRINCIPLE OF OPERATION Measurement technology There are two different technologies for electrolyte measurement, commonly known as Direct ISE and Indirect ISE (ISE = Ion-selective electrode). ISE Direct The measurement is performed directly on the sample of whole blood, plasma or serum.
Page 128 DIESTRO 103APV4R ELECTROLYTE ANALYZER        . The sign is: + for cations and – for anions  , then E = Measured electrical potential Eº = Constant electrical potential that depends on the measurement system.
Page 129 DIESTRO 103APV4R ELECTROLYTE ANALYZER Then the equation for finding the concentration of the measured ion is This is the algorithm with which the 103APV4R DIESTRO Analyzer works. Principle of operation of TCO2 determination The determination of TCO2 is carried out as follows: A similar amount of Lactic Acid (L.A.) is added to a fixed amount of serum (...
Page 130: Annex Iv - Reference Values
DIESTRO 103APV4R ELECTROLYTE ANALYZER ANNEX IV - REFERENCE VALUES 1. ELECTROLYTE RANGE It is recommended that each laboratory establish its own criteria to determine the normal ranges and critical values of its electrolytes. The following table is a guide and serves as a reference:...
Page 131: Annex V - Parts, Reference Code And Guarantees
DIESTRO 103APV4R ELECTROLYTE ANALYZER ANNEX V - PARTS, REFERENCE CODE AND GUARANTEES INSTALL DESCRIPTION BEFORE GUARANTEE IMAGES EL 0001D Digital Reference Electrode 6 months 6 months EL 0002D Digital Sodium Electrode 6 months 6 months EL 0003D Digital Potassium Electrode...
Page 132 DIESTRO 103APV4R ELECTROLYTE ANALYZER RE 0505 Pinch Valve, White. indefinite 6 months Manual Diestro 103APV4R RE 0850 Español Manual Diestro 103APV4R RE 0851 English Indefinite 6 months RE 0905 Power Supply 15V 4A RE 1000 Ground Cable Indefinite RE 0952...
Page 133 1 year, from the date of its invoicing with the company or that of a distributor or seller duly authorized by JS. The electrodes of the DIESTRO 103APV4R analyzer have a 6-month warranty, under the same conditions established.