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Maintenance Log

Wartungs-Logbuch Sunthvrhsh Cuaderno


de Mantenimiento Cahier de Maintenance
Registro delle manutenzioni Registo de
Manuteno - Underhllslogg

Stat Profile pHOx Plus Analyzer


Stat Profile pHOx Plus C Analyzer
Stat Profile pHOx Plus L Analyzer
Maintenance Log Instructions (EN) Instruciones para la Vitacora de Mantenimiento (ES)
In addition to the complete English Maintenance Log, the Month 12 pages of En adicion a la vitacora completa, los doce meses de procedimientos
the maintenance procedures and the pages for Quality Control are at present preventivos y las paginas de control de calidad estan traducidas en los
translated into the following languages: German, Greek, Spanish, French, siguientes idiomas: Aleman, Greco, Espaol, Frances, Italiano, y
Italian, and Portuguese. Month 12 pages have all maintenance procedures: Portuges. Cada pagina contiene un mes y contiene los mantenimientos
daily, as needed, monthly, quarterly, and yearly. The Quality Control pages are requeridos, diario, como necesario, mensual, trimestral y anual. Las
exactly the same from month to month. As an alternative to the English log, paginas de control de calidad son las mismas de mes a mes. Como una
these pages can be copied to make your own maintenance log or can be used alternativa a la vitacora en Ingles, estas paginas se pueden copiar para
as a reference to the procedures in English. If you copy these pages to make hacer su propia vitacora de mantenimiento o para usarse como referencia
your own log, remember that month 12 pages have all maintenance proce- a los procedimientos en Ingles. Si usted copia las paginas recuerde que
dures. Do not do the quarterly and yearly procedures every month. The log algunas paginas contienen todos los procedimientos y otras no. No haga
pages have boxes for each day of the month up to 31 days; only use the number los procedimientos trimestrales y anuales cada mes. Las paginas de la
of space boxes needed for each month. For a completed procedure, a check vitacora contienen espacio para 31 dias en cada mes. Use los espacios
mark or your initials can be handwritten into the appropriate day box. When necesarios para el mes correspondiente. Cuando se completa un
numerical data is required, write into the appropriate day box the numerical mantenimiento preventivo una marca o las iniciales de el usuario pueden
result. ser escritas en el espacio correspondiente. Cuando la informacion
requerida es un valor numerico entre el valore en el espacio apropiado.
Anleitung Wartungs-Logbuch (DE)
Odhgive~ hmerologivou suntrsh~ (EL)
Zustzlich zu dem vollstndigen englischsprachigen Wartungs-Logbuch, Ektov~ apov to plhvre~ Agglikov hmerolovgio sunthvrhsh~, oi mhniaive~
wurde die 12-Monats Seite der Wartungsprozeduren sowie die Seiten fr die dwvdeka selivde~ th~ diadikasiva~ sunthvrhsh~ kai oi selivde~ tou
Qualittskontrolle in die folgenden Sprachen bersetzt: Deutsch, Griechisch, Elevgcou Poiovthta~ eivnai metafrasmevne~ sti~ akovlouqe~ glwvsse~
Spanisch, Franzsisch, Italienisch und Portugiesisch. Die 12-Monats Seite Germanikav, Ellhnikav, Ispanikav, Gallikav, Italikav kai Portogalikav.
beeinhaltet alle vollstndigen Wartungsprozeduren: Tglich, bei Bedarf, Oi mhniaive~ dwvdeka selivde~ ecoun ovle~ ti~ diadikasive~ sunthvrhsh~
monatlich, vierteljhrlich und jhrlich. Die Seiten fr die Qualittssicherung hmerhvsie~, ovpw~, creiavzetai, mhniaive~, trimhiaive~ kai ethvsie~. Oi
sind fr jeden Monat exakt gleich. Alternativ zu den englischen Ausfhrungen selivde~ ton E v legcou Poiovthta~ eivnai akribwv~ ivdie~ apov mhvna se
knnen die bersetzten Seiten kopiert werden, um eigene Wartungs- mhvna. Enallaktikav tou Agglikouv hmerologivou, autev~ oi selivde~
Logbcher anzufertigen oder sie knnen als Anleitung zu den mporouvn na antigrafouvn wvste na ftiavxete to dikov sa~ hmerolovgio
englischsprachigen Prozeduren genutzt werden. Wenn Sie diese Seiten sunthvrhsh~ hv mporouvn na crhsimopoihqouvn san anaforav tou
kopieren, um Ihre eigenen Logbcher anzufertigen, denken Sie daran, dass Agglikouv hmerologivou Eavn antigravyete autev~ ti~ selivde~ gia na
die 12-Monats Seite smtliche Wartungsprozeduren beinhaltet. Fhren Sie ftavxete to dlkov sa~ hmerolovgio, qumhqeivte ovti oi mhniaive~ dwvdeka
die vierteljhrlichen und die jhrlichen Prozeduren nicht monatlich aus. Die selivde~ evcoun ovle~ ti~ diadikasive~ sunthvrhsh~, Mhn kavnete ti~
Logbuchseiten beeinhalten Kstchen fr jeden Tag des Monats bis zu 31 trimhniaive~ kai ethvsie~ diadikasive~ kavqe mhvna Oi selivde~ tou
Tagen. Nutzen Sie nur soviel Raum wie Kstchen fr den jeweiligen Monat hmerologivou evcoun koutavkia gia kavqe mevra tou mhvna evw~ 31 hmevre~
bentigt werden. Um eine abgeschlossene Prozedur zu kennzeichnen, crhsimopoieivste movno ton ariqmov twn koutiwvn pou eivnai aparaivthta
knnen die jeweiligen Kstchen abgehakt oder mit Initialien versehen gia kavqe mhvna Gia evna sumplhrwmevno hmerolovgio, evna tsekavrisma hv
werden. Falls numerische Werte erforderlich sind, knnen dieses in die h monografhv sa~ mporouvn na eivnai ceirovgrafa mevsa sto koutiv th~
jeweiligen Kstchen eingegeben werden. anavlogh~ hmevra~. O v tan zhtouvntai ariqmhtikav stoiceiva, gravyte
mevsa sto koutiv th~ anavlogh~ mevra~ to ariqmhtikov apotevlesma.
i
Cahier de Maintenance : Instructions (FR) Instrues para Registo da Manuteno (PT)
Outre le cahier de Maintenance complet, rdig en langue anglaise, les 12 Para alm do Registo de Manuteno completo em ingls, as pginas para
pages mensuelles concernant les oprations de Maintenance et les pages 12 meses de Registo de Manuteno e as pginas para o Controlo de
concernant le Contrle de Qualit sont ce jour traduites dans les langues Qualidade esto presentemente traduzidas para as seguintes lnguas: alemo,
suivantes : Allemand, Espagnol, Franais, Grec, Italien et Portugais. Les 12 grego, espanhol, francs, italiano, e portugus. As pginas para 12 meses
pages mensuelles rappellent toutes les oprations de maintenance : contm todos os procedimentos de manuteno: dirios, mensais, trimestrais,
quotidienne, la demande, mensuelle, trimestrielle et annuelle. Les pages e anuais, de acordo com as necessidades. As pginas do Controlo de
Qualidade so exactamente as mesmas de ms para ms. Como uma
ddies au Contrle de Qualit sont absolument identiques dun mois
alternativa ao registo ingls, estas pginas podem ser copiadas para elaborar
lautre. En remplacement du cahier en anglais, ces pages peuvent tre
o seu prprio registo da manuteno, ou podem ser usadas como uma
photocopies pour constituer votre propre cahier de Maintenance ou peuvent
referncia para os procedimentos em ingls. Se copiar estas pginas para
tre utilises comme une rfrence pour les procdures en anglais. Si vous
fazer seu prprio registo, lembre-se que as pginas para 12 meses contm
photocopiez ces pages pour constituer votre propre cahier, rappelez-vous
todos os procedimentos de manuteno. No repita os procedimentos
que les 12 pages mensuelles contiennent toutes les oprations de Mainte- trimestrais e anuais todos os meses. As pginas do registo tm caixas para
nance. Evitez deffectuer chaque mois les oprations seulement trimestrielles cada dia do ms at 31 dias; use apenas o nmero de caixas necessrias para
et annuelles. Les pages du cahier contiennent des cases pour chaque jour du cada ms. Para cada procedimento terminado, poder increver mo, na
mois (maximum 31 jours). Nutilisez que les cases ncessaires pour chaque caixa apropriada do dia, uma marca de verificao ou as suas iniciais.
mois. Lorsque lopration est effectue, cochez la case correspondant au Quando so requeridos dados numricos, escreva na caixa apropriada do dia
jour ou crivez-y vos initiales. Lorsquune information numrique est o resultado numrico.
ncessaire, reportez-la dans la case du jour correspondant.
Utilizzo dei Registri di Manutenzione (IT) UNDERHLLSLOGGS INSTRUKTIONER (SV)
Oltre al registro di manutenzione completo in lingua inglese, attualmente, le
Som ett tillgg till den kompletta engelska underhllsloggen, de 12 sidor
pagine delle procedure di manutenzione dei 12 mesi e le pagine relative al
av underhllsprocedurer och sidor fr kvalitetskontroller r f.n. versatta
Controllo di Qualit sono state tradotte nelle seguenti lingue: Tedesco, Greco,
till fljande sprk: Tyska, Grekiska, Spanska, Franska, Italienska, och
Spagnolo, Francese, Italiano e Portoghese. Le pagine mensili contengono
tutte le procedure di manutenzione: giornaliere, se richieste, mensili, Portugisiska. De 12 sidorna har alla underhllsprocedurer: daglig, vid
quadrimestrali e annuali. Le pagine del Controllo di Qualit sono esattamente behov, mnadsvis, kvartalsvis, och rligen. Kvalitetskontrolls-sidorna r
le stesse di mese in mese. In alternativa al registro in inglese, queste pagine exakt samma frn mnad till mnad. Som ett alternativ till en engelsk
possono essere copiate per realizzare il proprio registro di manutenzione o logg, kan dessa sidor kopieras fr att gra en egen underhlls logg eller
possono essere utilizzate come riferimento per le procedure in inglese. Nel som referens till de engelska procedurerna. Om du kopierar de hr
copiare queste pagine per realizzare il Vostro registro di manutenzione, sidorna fr att gra en egen logg, kom ihg att de 12 sidorna har alla
ricordate che le pagine mensili contengono tutte le procedure di manutenzione. underhllsprocedurer. Gr inte kvartalsvis och rliga kontroller varje
Non effettuate le procedure quadrimestrali ed annuali ogni mese. Le pagine mnad. Loggsidorna har formulr fr varje dag av mnaden; anvnd bara
del registro contengono dei riquadri giornalieri fino a 31 giorni; utilizzate solo det utrymme som behvs fr varje mnad. Fr en komplett procedur, ett
il numero di riquadri necessari per ogni mese. Quando la procedura kontrollmrke eller din signatur kan handskrivas in i lmpligt
completata, baster riportare una croce o le iniziali del proprio nome nel dagformulr. Nr numerisk data krvs, skriv i lmpligt dagformulr, det
riquadro giornaliero appropriato. Se richiesto un dato numerico, sar numeriska resultatet.
necessario scrivere il risultato numerico nel riquadro giornaliero appropriato.
ii
STAT PROFILE pHOx PLUS, PLUS L, and Plus C PREVENTIVE MAINTENANCE LOG BOOK
This Log Book is designed to assist you in performing preventive maintenance procedures on your Stat Profile pHOx Plus and Plus L Analyz-
ers. The fill-in charts accommodate the maintenance requirements for the analyzer. For complete instructions on all preventive maintenance
procedures, refer to the Stat Profile pHOx Series Instructions for Use Manual.
This Log Book combines maintenance schedules and monthly performance data work sheets. The performance data work sheets allow you to
record data sensor slopes for all parameters measured by your analyzer. The Notes Section, included for your convenience at the bottom of
each Maintenance Page, can be used to record any other nonscheduled maintenance (Na+ Conditioning, sensor cap replacement, sensor replacement, etc.)
or service performed on your analyzer. The note entries are also a useful resource for Nova Biomedical service representatives during system
troubleshooting.

Trademarks and Patents

Stat Profile is a registered trademark of Nova Biomedical.

pHOx is a registered trademark of Nova Biomedical.

Contents

Scheduled Maintenance and Monthly Performance Data Work Sheets

Schedule Data Work Sheets pages 40 to 87

Nova Telephone Technical Service

If you need technical assistance, call Nova Biomedical Technical Services (available by telephone 24 hours a day, 7 days a week) at:
Inside United States and Canada: 1-800-545-NOVA or 781-894-0800 FAX: (781) 894-0585
For technical assistance outside the United States and Canada, call your local Nova subsidiary or authorized distributor.

1 EN REF 27730F 2004/08


EU Authorized Representative

Nova Biomedical Telephone: 01244 287087

C3-5, Evans Business Centre Fax: 01244 287080

Deeside Industrial Park, Deeside Accounts Fax: 01244 287085

Flintshire, CH5 2JZ

Ordering Information

To obtain a new Stat Profile pHOx Plus and Plus L Preventive Maintenance Log Book, order PN 27730 from

Nova Biomedical TEL 1-800-822-0911 1-800-458-5813 or 781-894-0800

200 Prospect Street FAX 1-800-316-1178 (To order by) (781) 893-6998 (in the U.S.A.) or

Waltham, MA. 02454-9141 +1-781-899-0417 (outside the U.S.A.)

Stat Profile pHOx Serial Number ______________________________________________________


Date of Installation __________________________________________________________________
Institution Name ____________________________________________________________________
Lab Location _______________________________________________________________________
For the Period _____/_____/_____ to _____/_____/_____

NOTE: This maintenance log is provided as a convenience for those users who do not have alternative methods such as computerized logging
or log procedures to record Stat Profile pHOx Plus or Plus L maintenance activities, or quality control recording systems such as data
management or analyzer tape archival. It is only necessary to record control values outside the package insert limits. However, you may opt
to record all values. Indicate in the box below which option your lab is following:

Record only results out of control Record all Q.C. values Use other Q.C. records

If no other recording method is available in your lab, record your information in this log book.

2
STAT PROFILE pHOx PLUS, PLUS L UND PLUS C WARTUNGS-LOGBUCH (DE)

Dieses Logbuch untersttzt Sie bei der Durchfhrung von prventiven Wartungsmanahmen an den Analysatoren Stat Profile pHOx Plus/L/
C. Die Tabellen erleichtern Ihnen die Einhaltung der Wartungsanforderungen fr den Analysator. Vollstndige Anweisungen zu allen prven-
tiven Wartungsverfahren finden Sie in der Bedienungsanleitung zur Stat Profile pHOx-Serie.
Dieses Logbuch kombiniert Wartungsplne und monatliche Leistungsdaten-Arbeitsbltter. Auf den Leistungsdaten-Arbeitsblttern knnen
Sie Elektrodenslopes fr alle auf dem Analysator gemessenen Parameter aufzeichnen. Im Notizen-Abschnitt unten auf jeder Wartungsseite
knnen Sie etwaige auerplanmigen Wartungen (Na+-Konditionierung, Elektrodenkappenerneuerung, Elektrodenwechsel usw.) oder Pflegemanahmen am
Analysator eintragen. Die Notizeneintrge sind auch eine ntzliche Ressource fr Kundendienstmitarbeiter von Nova Biomedical bei der
Fehlersuche.

Warenzeichen und Patente

Stat Profile ist ein eingetragenes Warenzeichen von Nova Biomedical.

pHOx ist ein eingetragenes Warenzeichen von Nova Biomedical.

Inhalt

Wartungsplan und Monatliche Leistungsdaten-Arbeitsbltter

Plandaten-Arbeitsbltter Seiten 40 bis 87

Telefonischer technischer Kundendienst von Nova

Wenn Sie Hilfe vom technischen Kundendienst bentigen, knnen Sie unter den folgenden Nummern an 7 Tagen pro Woche rund um
die Uhr bei Nova Biomedical Technical Services anrufen:

In den Vereinigten Staaten und Kanada: 1-800-545-NOVA oder 781-894-0800 FAX: (781) 894-0585

Auerhalb der USA und Kanada wenden Sie sich an die lokale Nova-Niederlassung oder den Nova-Vertragshndler.

EU-Vertretung

Nova Biomedical Telefon: 01244 287087


C3-5, Evans Business Centre Fax: 01244 287080
Deeside Industrial Park, Deeside Kunden-Fax: 01244 287085
Flintshire, CH5 2JZ
3 DE
Bestellinformationen

Um ein neues Stat Profile pHOx Plus, Plus L, Plus C Wartungs-Logbuch zu erhalten, bestellen Sie PN 27730 bei

Nova Biomedical TEL 1-800-822-0911 oder 781-894-0800

200 Prospect Street FAX 1-800-316-1178 (in den USA) oder

Waltham, MA. 02454-9141 +1-781-899-0417 (auerhalb der USA)

USA

Stat Profile pHOx Plus, Plus L oder Plus C-Serienummer __________________________

Aufstellungsdatum ________________

Name des Instituts __________________________________________________

Laborstandort __________________________________________________

Fr die Periode _____/_____/_____ bis _____/_____/_____

HINWEIS: Dieses Wartungs-Logbuch wird Benutzern angeboten, denen keine alternativen Methoden wie computergesttzte Protokolle oder
Kontrollverfahren zur Aufzeichnung der Wartungsaktivitten fr den Stat Profile pHOx Plus/L/C oder Aufzeichnungssysteme fr Qualitts-
kontrollmanahmen wie Datenmanagement oder ein Analysator-Magnetbandarchiv zur Verfgung stehen. Es mssen nur Kontrollwerte
aufgezeichnet werden, die auerhalb der dem Paket beiliegenden Grenzwerte liegen. Auf Wunsch knnen Sie jedoch auch alle Werte auf-
zeichnen. Geben Sie im nachfolgenden Feld an, welche Option in Ihrem Labor befolgt wird:

Nur Ergebnisse auerhalb der Kontrollbereiche aufzeichnen Alle QK-Werte aufzeichnen

Andere QK-Aufzeichnungsmethoden verwenden

Wenn Ihnen in Ihrem Labor keine andere Aufzeichnungsmethode zur Verfgung steht, zeichnen Sie die Daten in diesem Logbuch auf.

HINWEIS: Die folgenden Seiten enthalten die in jede Sprache bersetzten Verfahrensweisen. Kopieren Sie diese Seiten fr den eigenen
Gebrauch so oft wie ntig.

4
Wartungs-Logbuch
Monat/Jahrr____________ Analysator-Nr._________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Probennadel/Elektrodenmodul (PN 12704 verwenden) nach Bedarf enteiweien *
Schl uche in Klemmventilen einmal wchentlich neu positionieren
Sonstiges

LEISTUNGSDATEN-PROTOKOLL 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
pH
P CO2
P O2
S O2 (LED1)
Hct
Elektrodenslopes einmal pro Woche aufzeichnen: Na+
K+
Cl-
Ca++
Glu
Lac

* Die Hufigkeit, mit der eine Enteiweiung durchgefhrt werden muss, hngt von der Anzahl der pro Tag analysierten Proben ab. Kunden
mit einer hohen Anzahl von Proben mssen die Enteinweiung hufiger durchfhren als Kunden mit einer niedrigen Anzahl von Proben.
Laboratorien mssen eine Hufigkeit festlegen, die fr Ihre Probenverteilung geeignet ist.

NOTIZEN:

5 DE
QUALITTSKONTROLL-PROTOKOLL
Kontrollbereich Tag 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Kontrollen
Niedrig Mittel Hoch
pH
Level 1 PCO2
Lot-Nr. ___________ PO2
Verfallsdatum ______ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot-Nr. ___________ PO2
Verfallsdatum ______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot-Nr. ___________ PO2
Verfallsdatum ______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INITIALEN DES TECHNIKERS

6
Wartungs-Logbuch
Monat/Jahrr____________ Analysator-Nr._______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Probennadel/Elektrodenmodul (PN 12704 verwenden) nach Bedarf enteiweien *
Schl uche in Klemmventilen einmal wchentlich neu positionieren
SO2-Elektrode alle 3 Monate reinigen Anfangs- und Ausfhrungsdatum. Initialen des Technikers____Datum__
Pumpenschl uche alle 3 Monate erneuern Anfangs- und Ausfhrungsdatum. Initialen des Technikers____Datum__
R-Schlauch und W-Schlauch alle 3 Monate erneuern Anfangs- und Ausfhrungsdatum. Initialen des Technikers____Datum__
Sonstiges

LEISTUNGSDATEN-PROTOKOLL 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
pH
P CO2
P O2
S O2 (LED1)
Hct
Elektrodenslopes einmal pro Woche aufzeichnen: Na+
K+
Cl-
Ca++
Glu
Lac

* Die Hufigkeit, mit der eine Enteiweiung durchgefhrt werden muss, hngt von der Anzahl der pro Tag analysierten Proben ab. Kunden
mit einer hohen Anzahl von Proben mssen die Enteinweiung hufiger durchfhren als Kunden mit einer niedrigen Anzahl von Proben.
Laboratorien mssen eine Hufigkeit festlegen, die fr Ihre Probenverteilung geeignet ist.

NOTIZEN:

7 DE
QUALITTSKONTROLL-PROTOKOLL
Kontrollbereich Tag 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Kontrollen
Niedrig Mittel Hoch
pH
Level 1 PCO2
Lot-Nr. ___________ PO2
Verfallsdatum ______ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot-Nr. ___________ PO2
Verfallsdatum ______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot-Nr. ___________ PO2
Verfallsdatum ______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS
8
STAT PROFILE pHOx PLUS, PLUS L, PLUS C
Stat Profile pHOx
Plus/L/C. .
, Stat Profile pHOx.
.

. O , ,
, , (
Na+, , , .) .
, ,
Nova Biomedical.

Stat Profile Nova Biomedical.

pHOx Nova Biomedical.

4 51

Nova

, VA (
24 24, ) :

: 1-800-545-NOVA 781-894-0800 FAX: (781) 894-0585

, NOVA
.

9 EL
:

edicon hellas : 210-6606000


5 - Fax: 210-6612666

.. 15344

pHox, pHOx Plus, Plus L, or Plus C


PN 27730

Nova Biomedical TEL 1-800-822-0911 or 781-894-0800


200 Prospect Street FAX 1-800-316-1178 (in the U.S.A.) or
Waltham, MA. (U.S.A.) 02454-9141 +1-781-899-0417 (outside the U.S.A.)

Stat Profile pHOx Plus, Plus L, or Plus C ___________________________

________________

_________________________________________________

__________________________________________________

_____/_____/_____ _____/_____/_____

: ,
Stat Profile
pHOx Plus/L/C, .
. ,
( ). :

,
.

: .
.
10

/ ____________ #_________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
/ (
PN 12704) *

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
pH
P CO2
P O2
S O2 (LED1)
Hc t
: Na+
K+
Cl-
Ca++
Glu
Lac

* (deproteinizing) .
.
.
:

11 EL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls

pH
l 1 PCO2
# __________ PO2
. _______ Na+
K+
Cl-
Ca++
Glu
Lac
pH
2 PCO2
# __________ PO2
. _______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
l 3 PCO2
# __________ PO2
. _______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac

12

/ ____________ #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
/ (
PN 12704) *

SO2 3 ____ / _____
3 ____ / _____
R W 3 ____ / _____

17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
pH
P CO2
P O2
S O2 (LED1)
Hct
: Na+
K+
Cl-
Ca++
Glu
Lac

* (deproteinizing) .
.
.

13 EL

17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls

pH
l 1 PCO2
# __________ PO2
. _______ Na+
K+
Cl-
Ca++
Glu
Lac
pH
2 PCO2
# __________ PO2
. _______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
l 3 PCO2
# __________ PO2
. _______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac

14
CUADERNO de MANTENIMIENTO PREVENTIVO para STAT PROFILE pHOx PLUS, PLUS L, y PLUS C (ES)

Este Cuaderno de Mantenimiento est hecho para asistirlo en la realizacin de los procedimientos de mantenimiento preventivos de sus
analizadores Stat Profile pHOx Plus/L/C . Las tablas para ser llenadas se ajustan a los requerimientos del analizador. Para instrucciones
completas sobre todos los procedimientos de mantenimiento preventivos, refirase al manual de los Stat Profile pHOx.
Este cuaderno combina el calendario de mantenimiento y las hojas de datos del desempeo mensualmente. Las hojas de datos del desempeo
le permiten registrar los datos de las pendientes de los electrodos de todos los parmetros medidos por el analizador. La Seccin de Notas,
incluida para su conveniencia al final de cada Pgina de Mantenimiento, puede ser usada para registrar otros mantenimientos no programados
(Acondicionamiento de Na+ ,reemplazo de membrana, reemplazo del sensor, etc.)o servicios realizados a su analizador.
Las notas son tambin tiles ayuda de investigacin para el personal de servicio de Nova Biomedical durante el trabajo de bsqueda de fallas.

Marcas Registradas y Patentes

Stat Profile es una marca registrada de Nova Biomedical.

pHOx es una marca registrada de Nova Biomedical.

Contenido

Calendario de Mantenimiento y Hojas de Datos de Desempeo mensual

Hojas de Datos del Calendario pginas 40 al 87

Telfono de Servicio Tcnico de Nova

Si necesita asistencia, llame al Servicio Tcnico de Nova (disponible telefnicamente las 24 horas del da, los 7 das de la semana) en:
En Estados Unidos y Canad: 1-800-545-NOVA 781-894-0800 FAX: (781) 894-0585

Para asistencia tcnica fuera de los Estados Unidos y Canad, llame a la subsidiaria de Nova o su distribuidor local autorizado.

15 ES
Unin Europea Representante Autorizado
Nova Biomedical Telfono: 01244 287087
C3-5, Evans Business Centre Fax: 01244 287080
Deeside Industrial Park, Deeside Cuenta Fax: 01244 287085
Flintshire, CH5 2JZ
Informacin para Ordenar
Para obtener un nuevo Cuaderno de Mantenimiento Preventivo Stat Profile pHOx Plus, Plus L, Plus C ordnelo con el siguiente
cdigo PN 27730 a:
Nova Biomedical TEL 1-800-822-0911 781-894-0800
200 Prospect Street FAX 1-800-316-1178 (en U.S.A.)
Waltham, MA. 02454-9141 +1-781-899-0417 (fuera de U.S.A.)
U.S.A.

Stat Profile pHOx Plus, Plus L, o Plus C Nmero de Serie _________________________________


Fecha de Instalacin _________________________________________________________________
Nombre de la Institucin _____________________________________________________________
Ubicacin del Laboratorio ____________________________________________________________
Para el Periodo de _____/_____/_____ a _____/_____/_____
NOTA: Este cuaderno de mantenimiento es usado para su conveniencia por aquellos usuarios que no tengan mtodos alternativos como
procedimientos de mantenimiento computarizados para registrar las actividades de mantenimiento de los equipos Stat Profile pHOx Plus/L/
C, o un sistema de registro de control de calidad como un programa de manejos de datos. Este es solo necesario para registrar los valores
fuera de los lmites del inserto en el paquete. Sin embargo, usted puede optar por registrar todos los valores. Indicar en el recuadro siguiente
cual es la eleccin de su laboratorio:

Registrar solo los resultados fuera de control Registrar todos los valores de control Usar otros registros de control

Si no hay disponible otro mtodo de registro en su laboratorio, use este cuaderno de mantenimiento para registrar su informacin.

NOTA: Las siguientes pginas son los procedimientos traducidos para cada idioma. Reproducir ests pginas para su propio uso
tantas veces como lo necesite.

16
Cuaderno de Mantenimiento
Mes/A r____________ Analizador #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Desproteinice Muestreador / Modulo Sensor (Use PN 12704) segn se requiera *
Re-posicione la Tubera de las Vlvulas Semanalmente
Otros

CUADERNO DE DATOS DEL DESEMPE O 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Registre las Pendientes de los Electrodos Semanalmente: Na+
K+
Cl-
Ca++
Glu
Lac

* La frecuencia de desproteinizado depende del numero de muestras analizada por da. Un alto numero de anlisis por da requerir
mayor frecuencia de desproteinizado que un bajo numero. Cada laboratorio debe establecer la frecuencia que le sea mas apropiada.

NOTAS:

17 ES
CUADERNO DE CONTROL DE CALIDAD
Rangos Da 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controles
Bajo Media Alto
pH
Nivel 1 PCO2
Lote # ____________ PO2
Fecha de Exp. _____ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nivel 2 PCO2
Lote # ____________ PO2
Fecha de Exp. _____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nivel 3 PCO2
Lote # ____________ PO2
Fecha de Exp. _____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INICIALES del TECNICO
18
Cuaderno de Mantenimiento
Mes/A o____________ Analizador #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Desproteinice Muestreador / Modulo Sensor (Use PN 12704) segn se requiera *
Re-posicione la Tubera de las Vlvulas Semanalmente
Limpiar el Sensor de SO2 Cada 3 Meses Iniciales y Fecha de quien lo Hizo. Iniciales del T cnico ____ Fecha _____
Cambie las Tuberas de la Bomba Cada 3 Meses Iniciales y Fecha de quien lo Hizo. Iniciales del T cnico ____ Fecha _____
Cambie las Tuberas R y W Cada 3 Meses Iniciales y Fecha de quien lo Hizo. Iniciales del T cnico ____ Fecha _____
Otros

CUADERNO DE DATOS DEL DESEMPE O 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Registre las Pendientes de los Electrodos Semanalmente: Na+
K+
Cl-
Ca++
Glu
Lac

* La frecuencia de desproteinizado depende del numero de muestras analizada por da. Un alto numero de anlisis por da requerir
mayor frecuencia de desproteinizado que un bajo numero. Cada laboratorio debe establecer la frecuencia que le sea mas apropiada.

NOTAS:

19 ES
CUADERNO DE CONTROL DE CALIDAD
Rangos Da 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controles
Bajo Media Alto
pH
Nivel 1 PCO2
Lote # ____________ PO2
Fecha de Exp. _____ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nivel 2 PCO2
Lote # ____________ PO2
Fecha de Exp. _____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nivel 3 PCO2
Lote # ____________ PO2
Fecha de Exp. _____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INICIALES del TECNICO
20
STAT PROFILE pHOx PLUS, PLUS L et PLUS C CAHIER DE MAINTENANCE PREVENTIVE
Ce cahier est conu pour vous aider effectuer les oprations de maintenance prventive de votre analyseur Stat Profile pHOx Plus/L/C. Les
tableaux remplir correspondent aux oprations effectuer. Pour toutes informations compltes concernant ces oprations, reportez-vous au
Mode demploi de lappareil.
Ce cahier combine les oprations de maintenance et les vrifications mensuelles de performances du Systme. Ces dernires vous permettent
de noter les valeurs de pente des lectrodes de toutes les chanes de mesure de votre analyseur. La section Notes , mnage pour vous
faciliter la tche en bas de chaque page de Maintenance, vous permet denregistrer toutes les autres oprations de Maintenance non
programmes (conditionnement de llectrode Na+, remplacement dun bouchon dlectrode, remplacement dune lectrode etc.) ainsi que
toutes les oprations de dpannage effectues sur votre appareil. Ces informations sont galement trs utiles pour les techniciens de Nova
Biomedical lors dune intervention de leur part.
Marques dposes et brevets

Stat Profile est une marque dpose de Nova Biomedical


pHOx est une marque dpose de Nova Biomedical
Contenu

Maintenance programme et vrifications mensuelles de performances


Oprations programmes pages 40 87
Tlphone des Services Techniques Nova

Si vous avez besoin dune assistance technique, appelez notre Service Technique (ouvert 24h/jour, 7 jours/semaine) :
USA et Canada : 1-800-545-NOVA ou 781-894-0800 FAX : (781) 894-0585
Pour une assistance technique hors USA et Canada, appelez votre Filiale nationale Nova ou votre Distributeur agr.
Reprsentant agr Nova pour la Communaut Europenne :

Nova Biomedical Tlphone : 01244 287087

C3-5, Evans Business Centre Fax : 01244 287080

Deeside Industrial Park, Deeside Fax clients enreg. : 01244 287085

Flintshire, CH5 2JZ Royaume Uni

21 FR
Information de commande

Pour obtenir un nouveau cahier de Maintenance prventive Stat Profile pHOx (Rf. 27730), contactez :

Nova Biomedical

15 avenue du Qubec Z.A. Courtabeuf

B.P. 632 91965 Les Ulis Cedex. France

Tl : 01 69 18 81 40 Fax : 01 69 07 01 60

e-mail : info@novabiomedical.fr

Stat Profile pHOx Plus, Plus L ou Plus C Numro de srie_________________

Date dinstallation________________

Nom de lEtablissement__________________________________________

Adresse du laboratoire___________________________________________

Pour la priode de____/____/____ ____/____/____

NOTE : Ce cahier de Maintenance est conu pour faciliter la tche de lutilisateur qui ne dispose pas dun autre moyen (tel que gestion
informatise) pour enregistrer les oprations de Maintenance effectues sur le Stat Profile pHOX Plus/L/C, ni de Systme denregistrement
de Contrle de Qualit (gestion informatise, enregistrement sur bande magntique). Il est seulement ncessaire denregistrer les valeurs de
contrles situes hors des limites figurant sur le document daccompagnement des contrles. Vous pouvez toutefois choisir de noter toutes les
valeurs. Soyez aimable dindiquer ci-dessous loption choisie :

Enregistrement exclusif des valeurs hors contrle Enregistrement de toutes les valeurs de CQ Autre Mode denregistrement

Si vous ne disposez daucune autre mthode denregistrement dans votre laboratoire, utilisez ce cahier.

NOTE : Les pages qui suivent sont la traduction des procdures dans chaque langue. Vous pouvez les reproduire autant de fois
que ncessaire pour votre usage personnel.

22
Cahier de Maintenance
Mois/Ann er____________ Analyseur N :________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A la demande* : D prot iniser sonde et ligne de mesure (avec Sol. N 12704).
Chaque semaine : Repositionner les tuyaux dans les vannes pincement.
Autres

CAHIER DE DONNEES DE PERFORMANCE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Chaque semaine : Enregistrer les pentes des
Na+
lectrodes.
K+
Cl-
Ca++
Glu
Lac

* La frquence de dprotinisation dpend de la charge de travail quotidienne. Une charge lourde demande une dprotinisation plus
frquente quun faible charge. Le laboratoire, aprs essais, devra choisir la frquence la mieux adapte ses conditions de travail.

NOTES

23 FR
CAHIER DE CONTROLE DE QUALITE
Fourchette de valeurs Jour 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Contr les
Bas Moyen Haut
pH
Niveau 1 PCO2
Lot N ___________ PO2
Date _____________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Niveau 2 PCO2
Lot N ___________ PO2
Date _____________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Niveau 3 PCO2
Lot N ___________ PO2
Date _____________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INITIALES TECHNICIEN(NE)
24
Registo de Manuten o
Mois/Ann e____________ Analyseur N :_____________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
A la demande* : D prot iniser sonde et ligne de mesure (avec Sol. N 12704).
Chaque semaine : Repositionner les tuyaux dans les vannes pincement.
Tous les 3 mois : Nettoyer le senseur SO2. Initiales et date de l op ration Initiales technicien(ne)____ Date______
Tous les 3 mois : Remplacer les tuyaux de pompe. Initiales et date de l op ration Initiales technicien(ne)____ Date______
Tous les 3 mois : Remplacer les tuyaux R et W. Initiales et date de l op ration Initiales technicien(ne)____ Date______
Autres

CAHIER DE DONNEES DE PERFORMANCE 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Chaque semaine : Enregistrer les pentes des lectrodes. Na+
K+
Cl-
Ca++
Glu
Lac

* La frquence de dprotinisation dpend de la charge de travail quotidienne. Une charge lourde demande une dprotinisation plus
frquente quun faible charge. Le laboratoire, aprs essais, devra choisir la frquence la mieux adapte ses conditions de travail.

NOTES

25 FR
CAHIER DE CONTROLE DE QUALITE
Fourchette de valeurs Jour 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Contr les
Bas Moyen Haut
pH
Niveau 1 PCO2
Lot N ___________ PO2
Date _____________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Niveau 2 PCO2
Lot N ___________ PO2
Date _____________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Niveau 3 PCO2
Lot N ___________ PO2
Date _____________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INITIALES TECHNICIEN(NE)

26
REGISTRO DI MANUTENZIONE PREVENTIVA PER GLI ANALIZZATORI STAT PROFILE pHOx PLUS, PLUS L, E PLUS C

Il presente registro inteso come ausilio per lesecuzione delle operazioni di manutenzione preventiva sugli analizzatori Stat Profile pHOx
Plus/L/C. Le schede da compilare contengono tutti i requisiti per la manutenzione dellanalizzatore. Per le istruzioni complete riguardanti la
manutenzione preventiva, consultare il Manuale delle istruzioni per luso degli analizzatori Stat Profile pHOx.
Il registro comprende programmi di manutenzione e schede mensili con i dati relativi alle prestazioni. Tali schede consentono di registrare le
pendenze degli elettrodi per tutti i parametri misurati con lanalizzatore Stat Profile pHOx. La sezione delle note alla fine di ogni pagina
Manutenzione pu essere utilizzata per registrare altre operazioni di manutenzione non programmata (condizionamento Na+, sostituzione cappuccio
sensore, sostituzione sensore, ecc.) o assistenze eseguite sullanalizzatore. Le note sono anche utili ai tecnici dellassistenza per interventi in caso di
guasto del sistema.

Marchi e brevetti

Stat Profile un marchio registrato di Nova Biomedical.

pHOx un marchio registrato di Nova Biomedical.

Indice

Manutenzione programmata e schede dei dati relativi alle prestazioni mensili

Schede dati prestazioni pagg. 40 - 87

Assistenza tecnica

Per lassistenza tecnica contattare:

GEPA S.r.l.
Via IV Novembre, 92
20021 Bollate (MI) Tel. 02-38301551 Fax: 02-38306258 e-mail info@gepasrl.it

oppure consultare il sito Internet www.gepasrl.it per contattare il centro autorizzato pi vicino.

27 IT
EU Authorized Representative
Nova Biomedical Telephone: 01244 287087
C3-5, Evans Business Centre Fax: 01244 287080
Deeside Industrial Park, Deeside Accounts Fax: 01244 287085
Flintshire, CH5 2JZ
Informazioni per gli ordini
Il registro di manutenzione preventiva degli analizzatori Stat Profile pHOx Plus, Plus L, Plus C pu essere ordinato a
GEPA S.r.l.
Via IV Novembre, 92
20021 Bollate (MI) Tel. 02-38301551 Fax: 02-38306258 e-mail info@gepasrl.it

Matricola Stat Profile pHOx Plus, Plus L o Plus C ___________________________

Data di installazione ________________

Nome Ente __________________________________________________

Sede laboratorio __________________________________________________

Per il periodo da _____/_____/_____ a _____/_____/_____

NOTA: il presente registro deve servire agli utenti che non dispongono di metodi alternativi, ad esempio registrazioni computerizzate delle
attivit di manutenzione degli analizzatori Stat Profile pHOx Plus/L/C, o sistemi di registrazione del controllo qualit, ad esempio sistemi di
gestione dati o archivi su nastro. Occorre solamente registrare i valori di controllo al di fuori dei limiti previsti sulla confezione. Oppure si
pu scegliere di registrare tutti i valori, Indicare nel riquadro sotto il metodo utilizzato presso il vostro laboratorio:

Registrazione solo dei risultati fuori limite Registrazione di tutti i valori CQ Uso di altre registrazioni CQ

Se il vostro laboratorio non dispone di altri metodi di registrazione, utilizzare il presente registro.

NOTA: Le seguenti pagine contengono le procedure tradotte in ogni lingua. Creare delle copie e utilizzare secondo le necessit.

28
Registro delle manutenzioni
Mese/annor____________ N. analizzatore__________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinizzare sonda/modulo sensore secondo le necessit *
Riposizionare i tubi nella valvola a pinza ogni settimana
Altro

REGISTRO DATI RELATIVI ALLE PRESTAZIONI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Registrare le pendenze degli elettrodi ogni settimana: Na+
K+
Cl-
Ca++
Glu
Lac

* La frequenza di deproteinizzazione dipende dal numero di campioni analizzati ogni giorno. Un numero elevato di analisi presuppone
interventi di deproteinizzazione pi frequenti. Ogni laboratorio deve stabilire una frequenza che sia adatta ai propri programmi di analisi.

NOTA:

29 IT
REGISTRO CONTROLLO DI QUALIT
Intervallo di analisi Giorno 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controlli
Basso Medio Alto
pH
Livello 1 PCO2
N. di lotto _________ PO2
Data di scadenza ____ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Livello 2 PCO2
N. di lotto _________ PO2
Data di scadenza ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Livello 3 PCO2
N. di lotto _________ PO2
Data di scadenza ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INIZIALI DEL TECNICO
30
Registro delle manutenzioni
Mese/annor____________ N. analizzatore______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinizzare sonda/modulo sensore secondo le necessit *
Riposizionare i tubi nella valvola a pinza ogni settimana
Pulire il sensore SO2 ogni 3 mesi Iniziali e data di esecuzione. Iniziali tecnico _______ Data________
Sostituire i tubi della pompa ogni 3 mesi Iniziali e data di esecuzione. Iniziali tecnico _______ Data________
Sostituire le linee R e W ogni 3 mesi Iniziali e data di esecuzione. Iniziali tecnico _______ Data________
Altro

REGISTRO DATI RELATIVI ALLE PRESTAZIONI 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Registrare le pendenze degli elettrodi ogni settimana: Na+
K+
Cl-
Ca++
Glu
Lac

* La frequenza di deproteinizzazione dipende dal numero di campioni analizzati ogni giorno. Un numero elevato di analisi presuppone
interventi di deproteinizzazione pi frequenti. Ogni laboratorio deve stabilire una frequenza che sia adatta ai propri programmi di analisi.

NOTA:

31 IT
REGISTRO CONTROLLO DI QUALIT
Intervallo di analisi Giorno 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controlli
Basso Medio Alto
pH
Livello 1 PCO2
N. di lotto _________ PO2
Data di scadenza ____ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Livello 2 PCO2
N. di lotto _________ PO2
Data di scadenza ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Livello 3 PCO2
N. di lotto _________ PO2
Data di scadenza ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INIZIALI DEL TECNICO
32
LIVRO DE REGISTO DE MANUTENO PREVENTIVA PARA OS STAT PROFILE pHOx PLUS, PLUS L, E PLUS C (PT)

Este Livro de Registo foi concebido para o ajudar a executar os procedimentos de manuteno preventiva dos analisadores Stat Profile pHOx
Plus/ L/ C. As tabelas preenchidas fornecem os requisitos de manuteno do analisador. Para completar as instrues dos procedimentos de
manuteno preventiva, consulte o Manual da gama Stat Profile pHOx.
Este Livro de Registo rene a programao de manuteno e as folhas de dados de desempenho mensal. As folhas de dados de desempenho
permitem-lhe registar os dados dos declives dos elctrodos para todos os parmetros medidos no seu analisador. A zona de notas, includa,
para sua comodidade, no final de cada pgina de manuteno, pode ser usada para registar qualquer manuteno no programada
(condicionamento de Na+,substituio de membranas dos sensores, substituio de sensores, etc.) ou servios executados no seu
analisador. As Notas registadas, tambm so teis para os tcnicos de assistncia da Nova Biomedical, ou seus representantes, durante a
resoluo de problemas.

Marcas de fbrica e patentes

Stat Profile marca registada da Nova Biomedial..

pHOx marca registada da Nova Biomedial.

Contedo

Manuteno programada e folhas de dados de desempenho mensal

Folhas de dados de trabalhos programados pgina 40 87

Telefone dos servios tcnicos da Nova

Se necessitar dos servios tcnicos da Nova, ligue para a assistncia tcnica da Nova Biomedical (disponveis 24 horas por dia e 7 dias por
semana), para:
Dentro dos Estados Unidos ou Canad: 1-800-545 ou 781-894-0800 FAX: (781) 894-0585
Para assistncia tcnica for a dos E.U.A. e Canad, telefone ao distribuidor local autorizado pela Nova.

33 PT
Representante autorizado na C.E.
Nova Biomedical Telefone: 01244 287087
C3-5, Evans Business Centre Fax: 01244 287080
Deeside Industrial Park, Deeside Contas de Fax: 01244 287085
Flintshire, CH5 2JZ
Informao para pedidos
Para obter um Livro de Registo de Manuteno Preventiva para o Stat Profile pHOx Plus, Plus L, Plus C encomende a Ref. 27730 da
Nova Biomedical TEL 1-800-822-0911 ou 781-894-0800
200 Prospect Street FAX 1-800-316-1178 (nos E.U.A.) ou
Waltham, MA. 02454-9141 +1-781-899-0417 fora dos E.U.A.)
E.U.A.

Nmero de srie do Stat Profile pHOx Plus, Plus L ou Plus C ______________________________


Data da instalao ___________________________________________________________________
Nome da instituio _________________________________________________________________
Localizao do laboratrio ___________________________________________________________
Para o perodo de _____/_____/_____ a _____/_____/_____

NOTA: Este registo de manuteno fornecido para comodidade daqueles utilizadores que no tm mtodos alternativos, como registos
computorizados ou procedimentos para registar actividades de manuteno do Stat Profile pHOx Plus/ L/ C, ou sistemas de registos do controlo
de qualidade bem como dados de gesto ou fita de arquivo do analisador. somente necessrio registar valores de controlos fora dos limites da
bula. Contudo, pode optar por registar todos os valores. Indique na caixa abaixo, qual a opo que o seu laboratrio segue:

Gravar somente resultados fora de controlo Gravar todos os valores de CQ Utilizar outros registos de CQ

Se no seu laboratrio no houver outros mtodos de registos disponveis, anote as suas informaes no livro de registo.

NOTA: Em anexo os procedimentos traduzidos para cada idioma. Para seu uso pessoal, repita estas pginas as vezes que achar
necessrio.

34
Registo de Manuten o
Ms/ anor____________ Analisador #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Desproteiniza o do m dulo de sondas/sensores(use Ref. 12704)quando necessrio*
R e p o s i o s e m a n a l d o t u b o n a v l v u l a d e p r e s s o
Outros

REGISTO DE DADOS DE DESEMPENHO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Grava o semanal dos declives dos el ctrodos: Na+
K+
Cl-
Ca++
Glu
Lac

* A frequncia de desproteinizao depende do nmero de amostras analisadas num dia. Quantidades elevadas de amostras requerem
desproteinizao mais frequentemente do que quantidades reduzidas de amostras. Os laboratrios devem desenvolver a frequncia
adequada ao seu volume de amostras.

NOTAS:

35 PT
REGISTO DE CONTROLE DE QUALIDADE
Gamas de anlise Dia 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controlos
Baixo M dio Elevado
pH
Nvel 1 PCO2
Lote # ___________ PO2
Data de exp. ______ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nvel 2 PCO2
Lote # ___________ PO2
Data de exp. ______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nvel 3 PCO2
Lote # ___________ PO2
Data de exp. ______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INICIAIS DO T CNICO

36
Registo de Manuteno
Ms/ anor____________ Analisador #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Desproteinizao do mdulo de sondas/ sensores (use Ref. 12704) quando necessrio *
Reposio semanal do tubo na vlvula de presso
Limpeza trimestral do sensor SO2 Inicial e data quando efectuado. Iniciais do tcnico_______ Data______
Troca trimestral dos tubos de bomba Inicial e data quando efectuado. Iniciais do tcnico_______ Data______
Troca trimestral das linhas R e W Inicial e data quando efectuado. Iniciais do tcnico_______ Data______
Outros

REGISTO DE DADOS DE DESEMPENHO 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Gravao semanal dos declives dos elctrodos: Na+
K+
Cl-
Ca++
Glu
Lac

* A frequncia de desproteinizao depende do nmero de amostras analisadas num dia. Quantidades elevadas de amostras requerem
desproteinizao mais frequentemente do que quantidades reduzidas de amostras. Os laboratrios devem desenvolver a frequncia
adequada ao seu volume de amostras.

NOTAS:

37 PT
REGISTO DE CONTROLO DE QUALIDADE
Gamas de anlise Dia 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controlos
Baixo M dio Elevado
pH
Nvel 1 PCO2
Lote # ____________ PO2
Data de Exp._______ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nvel 2 PCO2
Lote # ____________ PO2
Data de Exp._______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Nvel 3 PCO2
Lote # ____________ PO2
Data de Exp._______ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
INICIAIS DO T CNICO
38
STAT PROFILE pHOx PLUS, PLUS L, OCH Plus C FREBYGGANDE UNDERHLLS LOGGBOK
Den hr Loggboken r utformad fr att assistera dig i utfrandet av frebyggande underhllsprocedurer p din Stat Profile pHOx Analysator.
Ifyllnadskorten tillgodoser underhllskraven fr analysatorn. Fr kompletta instruktioner p alla frebyggande underhllprocedurers, hnvisas
till Stat Profile pHOx Series Anvndarinstruktioner.
Den hr Loggboken kombinerar underhllsscheman och mnatlig utfrandedata-arbetsblad. Utfrandedata-arbetsbladen lter dig spela in
dataelektrodkurvor fr alla parametrar som r uppmtta av din analysator. Notera-avsnittet, som r inkluderat lngst ner p varje
underhllssida, kan anvndas fr att lagra ngon annan icke schemalagt underhll (Na+ Konditionering, sensor kopps utbyte, sensor utbyte, etc.) eller
service som r utfrd p din analysator. Det som r skrivet under Notera r anvndbara kllor fr Nova Biomedical service representanter under
systemfelskning.

Varumrken och Patent

Stat Profile r ett av Nova Biomedical registrerat varumrke.

pHOx r ett av Nova Biomedical registrerat varumrke.

Innehll

Schemalagt underhll och mnatlig utfrandedata-arbetsblad

Schemalagt data-arbetsblad Sidorna 45 till 93

Nova Telephone Technical Service

Om du behver teknisk assistans, ring Nova Biomedical Technical Services (tillgnglig genom telefon 24 timmar om dygnet, 7 dagar i
veckan) p:
Inom United States och Canada: 1-800-545-NOVA eller 781-894-0800 FAX: (781) 894-0585
Fr teknisk assistans utanfr United States och Canada, ring din lokala Nova bitrdande eller auktoriserade distributr.

39 SV
EU Auktoriserad representant

Nova Biomedical Telefon: 01244 287087

C3-5, Evans Business Centre Fax: 01244 287080

Deeside Industrial Park, Deeside Redovis Fax: 01244 287085

Flintshire, CH5 2JZ

Bestllnings information

Fr att erhlla en ny Stat Profile pHOx Plus, Plus L, Plus C Frebyggande Underhllsloggbok, bestll PN 27730 frn

Nova Biomedical TEL 1-800-822-0911 1-800-458-5813 eller 781-894-0800

200 Prospect Street FAX 1-800-316-1178 (fr att bestlla) (781) 893-6998 (i U.S.A.) eller

Waltham, MA. 02454-9141 +1-781-899-0417 (utanfr U.S.A.)

Stat Profile pHOx Plus, Plus L, eller Plus C serienummer__________________________________


Installationsdatum __________________________________________________________________
Institutionens namn _________________________________________________________________
Lab:s lokalisering ___________________________________________________________________
Fr Perioden _____/_____/_____ till _____/_____/_____

NOTERA: Den hr underhllsloggen r till fr de anvndare som inte har alternativa metoder som datoriserad loggbok eller loggprocedurer
fr att lagra Stat Profile pHOx Plus/L/C underhllsaktiviteter, eller kvalitetskontrollslagrings system som datamanagement eller
analysatorbands arkiv. Det r bara ndvndigt att lagra kontrollvrden som ligger utanfr kontrollpackens grnser. Hur som helst, s du kan
vlja att lagra alla vrden. Ange i formulret nedan, vilket val ditt Lab fljer:

Lagra bara resultat som r utanfr kontrollen Lagra alla QC vrden Anvnd annan QC lagring

Om ingen annan lagringsmetod r tillgnglig i ditt Lab, lagra din information i denna loggbok.

NOTERA : De fljande sidorna r versatta procedurer fr varje sprk. Du fr kopiera dessa sidor, fr
egen anvndning, s mnga gnger du vill.
40
UNDERHLLSLOGG
M nad/rr____________ Analysator #___________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Depr ot einiser ing Pr ov n l/Sensor modul (A nv nd PN 12704)*
t er st ll slangar i magnet v ent iler , v ar je v ecka
v r igt

PRESTATIONSDATA LOGG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
pH
P CO2
P O2
S O2 (LED1)
Hct
Lagr a elekt r odkur v or v ar je v ecka: Na+
K+
Cl-
Ca++
Gl u
Lac

* Frekvensen av deproteinisering r beroende p hur mnga prover som analyseras per dag. Hgt antal prover krver mer frekvent
deproteinisering n vad ett ftal prover gr. Laboratorier ska utveckla en frekvens som r lmplig fr deras provtagningsintervalls
mnster.

NOTERINGAR:

41 SV
KVALITETSKONTROLLS LOGG
J ust er ingsint er v all Dag 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
K ont r oller
L g Snit t Hg
pH
Niv 1 PCO2
Lot # ____________ PO2
B st f re dat um ____ Na+
K+
Cl-
Ca++
Gl u
Lac
pH
Niv 2 PCO2
Lot # ____________ PO2
B st f re dat um ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Gl u
Lac
pH
Niv 3 PCO2
Lot # ____________ PO2
B st f re dat um ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Gl u
Lac
TEKNIKERNS SIGNATUR

42
UNDERHLLSLOGG
M nad/rr____________ Analysator #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Depr ot einiser ing Pr ov n l/Sensor modul (A nv nd PN 12704)*
t er st ll slangar i magnet v ent iler , v ar je v ecka
Rengr SO2 Sensor v ar 3:e m nad Signatur och datum n r det r gjort. Teknikers signatur_______ Datum_____
B y t pumpslang v ar 3:e m nad Signatur och datum n r det r gjort. Teknikers signatur_______ Datum_____
B y t R-slang och W-slang v ar 3:e m nad Signatur och datum n r det r gjort. Teknikers signatur_______ Datum_____
v r igt

PRESTATIONSDATA LOGG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
pH
P CO2
P O2
S O2 (LED1)
Hct
Lagr a elekt r odkur v or v ar je v ecka: Na+
K+
Cl-
Ca++
Gl u
Lac

* Frekvensen av deproteinisering r beroende p hur mnga prover som analyseras per dag. Hgt antal prover krver mer frekvent
deproteinisering n vad ett ftal prover gr. Laboratorier ska utveckla en frekvens som r lmplig fr deras provtagningsintervalls
mnster.

NOTERINGAR:

43 SV
KVALITETSKONTROLLS LOGG
J ust er ingsint er v all Dag 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
K ont r oller
L g Snit t Hg
pH
Niv 1 PCO2
Lot # ____________ PO2
B st f re dat um ____ Na+
K+
Cl-
Ca++
Gl u
Lac
pH
Niv 1 PCO2
Lot # ____________ PO2
B st f re dat um ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Gl u
Lac
pH
Niv 1 PCO2
Lot # ____________ PO2
B st f re dat um ____ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Gl u
Lac
TEKNIKERNS SIGNATUR
44
Maintenance Log (EN)

Wartungs-Logbuch (DE)

Sunthvrhsh (EL)

Cuaderno de Mantenimiento (ES)

Cahier de Maintenance (FR)

Registro delle manutenzioni (IT)

Registo de Manuteno (PT)

Underhllslogg (SV)

45

MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.
NOTES:

46 Month 1
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

47
Month 1
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

48 Month 1
QUALITY CONTROL LOG
Assay Range Da y 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

49
Month 1
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.
NOTES:

50 Month 2
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS
51
Month 2
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

52 Month 2
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

53
Month 2
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.
NOTES:

54 Month 3
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

55
Month 3
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Clean the S O2 Sensor Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the Pump Tubing Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the R-Line and W-Line Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

56 Month 3
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

57
Month 3
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

58 Month 4
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS
59
Month 4
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.
NOTES:

60 Month 4
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

61
Month 4
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

62 Month 5
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

63
Month 5
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

64 Month 5
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

65
Month 5
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

66 Month 6
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

67
Month 6
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Clean the S O2 Sensor Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the Pump Tubing Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the R-Line and W-Line Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

68 Month 6
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

69
Month 6
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

70 Month 7
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS
71
Month 7
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

72 Month 7
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

73
Month 7
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

74 Month 8
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

75
Month 8
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

76 Month 8
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

77
Month 8
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

78 Month 9
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

79
Month 9
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Clean the S O2 Sensor Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the Pump Tubing Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the R-Line and W-Line Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

80 Month 9
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

81
Month 9
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

82 Month 10
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

83
Month 10
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

84 Month 10
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

85
Month 10
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

86 Month 11
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

87
Month 11
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

88 Month 11
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

89
Month 11
MAINTENANCE LOG
Month/Year____________ Analyzer #_____________________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Deproteinize Probe/Sensor Module (PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Other

PERFORMANCE DATA LOG 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

90 Month 12
QUALITY CONTROL LOG
Assay Range Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

91
Month 12
MAINTENANCE LOG
Month/Year____________ Analyzer #_______________________ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Deproteinize Probe/Sensor Module (Use PN 12704) as needed *
Reposition Tubing in Pinch Valves Weekly
Clean the S O2 Sensor Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the Pump Tubing Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Change the R-Line and W-Line Every 3 Months Initial and Date When Done. Tech's Initial's_______ Date_______
Other

PERFORMANCE DATA LOG 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31


pH
P CO2
P O2
S O2 (LED1)
Hct
Record Electrode Slopes Weekly: Na+
K+
Cl -
Ca++
Glu
Lac

* The frequency of deproteinizing is dependent upon the number of samples analyzed in a day. High sample number accounts will require
more frequent deproteinizing than low sample number accounts. Laboratories should develop a frequency that is appropriate for their
sampling pattern.

NOTES:

92 Month 12
QUALITY CONTROL LOG
Assay Range Day 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Controls
Low Mean High
pH
Level 1 PCO2
Lot # _____________ PO2
Exp. Date _________ Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 2 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
pH
Level 3 PCO2
Lot # _____________ PO2
Exp. Date _________ SO2
Hct
Hb
Na+
K+
Cl-
Ca++
Glu
Lac
TECHNICIAN'S INITIALS

93
Month 12
94