1. Micros 60 & Quality Control
MLAB 1415: Hematology
Micros 60
&
Quality Control

2. CBC Quality Control Commercial Controls: 3 levels (low, normal, high)
Values stored in instrument computer
Levey-Jennings graph generated and stored for each parameter
Mode to Mode QC:
Most automated hematology instruments have a primary and secondary mode of sample aspiration. Controls must be run on BOTH and correlate.
Primary=Automated or Closed
Secondary=Manual or Open
Delta Checks
When the Laboratory Information System (LIS) and the instrument are interfaced (connected) delta checks are conducted by the LIS on select parameters.
Current values compared to most previous result
Differences greater than the limits set within the LIS are flagged

3. Micros 60 3-part differential Sample size= 10µL Environment
Indoor only
Level work station
Avoid direct exposure to sunlight
Proper ventilation
60-90oF
Linearity (AMR)
WBC (103/mm3): 0-100
RBC (106/mm3): 0-8.0
Hgb (g/dL):
Hct (%):
Plt (103/mm3):

4. Linearity (Reportable Range/ AMR)
Instruments are calibrated for each analyte with a range that is clinically relevant.
With concentrations above or below the reportable range or Linearity range, the result does not correspond with the calibration curve in linear fashion.
Results outside of linearity are NOT acceptable.
Linearity ranges vary by instrument.
Example:
Parameter
Coulter STKS
Advia
WBC
X 103 /µL
X 103 /µL

5. Parameters Parameters Measurements/Calculations WBC/RBC/PLT
Hgb
Hct
MCV
MCH
MCHC
RDW
Platelet
MPV
Lym #
Lym%
Mono #
Mono%
Gra#
Gra%
WBC/RBC/PLT
Impedance change
HGB
Spectrophotometry
LYM%/MON%/GRA%
Calculations
MCV, MCH,MCHC,RDW,MPV,LYM#, MON#, GRA#

6. Automation Specs
Principle of operation: The counting principle used for the red blood cells, white blood cells and platelets is based on the variations in impedance generated by the passage of cells through a calibrated aperture.
Number of samples which can be analyzed per hour: 60
Number of tests performed on this analyzer: 1
Quality control: Three levels run each day of patient testing, or following instrument repair, reagent lot change, or when indicated.
Calibration: Shift in control values, replacement of instrument parts, reagent number change, or when indicated
Preventative maintenance: Daily: start up and shut down, general cleaning
Acceptable samples: whole blood from an EDTA tube ran within 4 hours of collection
Limitations: Lipemia, cold agglutinins, high WBC’s

7. Equipment 8 Main parts Electrical supply Electronic board
Dilution pneumatics
Control panel with keyboard and LCD screen
Reagent compartment
Printer
Smart card reader
Bar code reader (optional)

8. Reagents Waste Diluent Cleaner LYSE: potassium cyanide
ABX minidil: sodium hydroxide/azide
Determines and differenciates blood cells
Cleaner
ABX miniclean: enzymatic detergent
Cleans system
LYSE: potassium cyanide
ABX Alphalyse: Lyses RBCs, releasing hemoglobin and WBCs. WBCs are counted by impedance.
Waste

9. Distribution curves
WBC
RBC
Plt

10. Daily Start Up
Turn on instrument, once on, the start-up will begin automatically
Instrument is performing a cleaning and rinsing cycle: detergent in the chamber is rinsed with diluent
Cycle lasts about 130 seconds
At cycle completion, background values will be displayed. These values must be less than the below:
WBC < 0.3 x 103/mm3
RBC < 0.02 x 106/mm3
Hgb < 0.0 g/dL
Plt < 10x 103/ mm3
If the values are not within this range, another cycle will begin. If still not in range, the Micros will do another start-up. After 3 failed cycles, it will give a “start-up failed” message. Troubleshooting will now start.

11. Daily start-up con’t Run a primer sample Perform QC and evaluate
Complete maintenance sheet
If all QC in, can continue with patient samples.

12. Running a Patient Press the ID button on the key pad
Manually enter the ID. Use the up and down arrows to enter alphabetical characters. Please Enter after each entry.

13. Shutdown Hit the Stand by key, wait 1 minute
Switch off instrument and printer.
When the shutdown hit is pressed, the Micros 60 performs a complete cleaning with the Miniclean and puts the system into a Standby mode. Once this process is complete, the instrument can be switched off.