1. Hemoglobin Testing Using the HemoCue

2. Instrument calibration At the beginning of each survey day, check the instrument accuracy using the calibrator cuvette. Record readings. If readings are in question, clean the cuvette holder and calibrator cuvette with a dry Kim wipe. If readings continue to be outside the correct range or reads ERROR, do not use the instrument. It should be serviced or replaced. If the calibrator cuvette reads within the specified range listed on its container, report the result and perform daily quality control (QC) on the instrument.

3. Daily quality control Perform daily QC (morning and evening) by measuring and recording the results for each of the low, normal, and high range control vials. Report results on the HemoCue Hemoglobin Quality Control Form.

4. Morning quality control HemoCue Serial Number:Low control lot number: CDC Number:Normal control lot number: Control cuvette number:High control lot number: Quality control for blood hemoglobin results (grams per deciliter - g/dL) Morning DateControl Cuvette specific for the Instrument Low Target: 8.0 + 0.4 (7.6 - 8.4) Normal Target: 11.9 + 0.6 (11.3-12.5) High Target: 15.9 + 0.8 (15.1 - 16.7) Initials

5. Procedure from a Microtainer or Vacutainer 1.Assemble all the materials needed prior to testing each subject. Reseal the cuvette container immediately after taking out one cuvette for use. 2.Remove the cap from the well- mixed Microtainer or Vacutainer tube.

6. Procedure from a Microtainer or Vacutainer 3.Fill the HemoCue cuvette by holding the Microtainer or Vacutainer tube in a horizontal position and carefully tilt the blood forward to the edge of the tube. Place the pointed tip (with the cuvette’s groove facing upward) of the HemoCue cuvette into the blood drop for a count of three. The cuvette will fill automatically by capillary action.

7. Procedure from a Microtainer or Vacutainer 4.Never try to “top off” the cuvette after the initial filling. If the cuvette is not filled with the first attempt, discard it in the sharps container and use a second cuvette. 5.Wipe off any excess blood from the cuvette with a Kim wipe, being careful not to touch the outer curved edge. This may be done by wiping the edges as you would a butter knife. Ensure that no blood is “sucked out” of the cuvette when wiping it.

8. Procedure from a Microtainer or Vacutainer 6.Place the cuvette in its holder and gently push the holder into the photometer. The results will be displayed in approximately 15-45 seconds and will remain displayed for 4 minutes or until the slide arm is pulled out for removal of the cuvette.

9. Procedure from a Microtainer or Vacutainer 7.Record your results, dispose of the cuvette in the sharps container, and dispose of all other materials in the biohazard bag.

10. Evening quality control Measure and record the results for each of the low, normal, and high range control vials. Report results on the HemoCue Hemoglobin Quality Control Form. Evening DateLow Target: 8.0 + 0.4 (7.6 - 8.4) Normal Target: 11.9 + 0.6 (11.3-12.5) High Target: 15.9 + 0.8 (15.1 - 16.7) Initials

11. HemoCue cleaning instructions Once or twice a day, clean the cuvette holder with an alcohol pad. Allow to completely dry before testing. Periodically, clean the reading chamber with dry gauze. More detailed cleaning instructions are provided in the manual.