Manual del operador

248 91 001N Rev. T, 2008-04

© 2008 Siemens Healthcare Diagnostics Inc .
Todos los derechos reservados.

Ninguna parte de este manual o los productos que describe pueden reproducirse de ninguna manera o de ninguna forma sin

el consentimiento previo por escrito de Siemens Healthcare Diagnostics Inc. El analizador de pH / gas en sangre 248 es para

uso diagnóstico in vitro. Complement, Mate, Rapidlab y RapidQC son marcas comerciales de Siemens Healthcare

Diagnostics. Vacutainer es una marca registrada de Becton-Dickinson. Nafion es una marca registrada de Dupont.

Virkon es una marca registrada de Antec International Limited.

Origen: Reino Unido

Tarrytown, NY 10591-5097 EE. UU.

Reino Unido Siemens Healthcare Diagnostics Inc.
Siemens Sq. Frimley, Camberley, GU16 8QD,
Siemens Healthcare Diagnostics Ltd. Sir William

Este manual del operador contiene instrucciones completas para configurar y usar el
248. La información de servicio para uso de personal debidamente calificado también está disponible.

El 248 está destinado a personas con conocimientos en prácticas de laboratorio seguras. Si el 248 no se
usa de acuerdo con estas instrucciones de uso, la protección provista por el equipo puede verse afectada.

La información contenida en este manual era correcta al momento de la impresión. Sin embargo, la política de
Siemens Healthcare Diagnostics es una de mejora continua del producto y se reserva el derecho de cambiar las
especificaciones, el equipo y los procedimientos de mantenimiento en cualquier momento, sin previo aviso.
 yo

Uso previsto
El 248 está diseñado para la determinación rápida y precisa de pH, pags CO 2 y
pags O 2 en muestras de sangre entera heparinizadas. El volumen mínimo de muestra es 60 μ L (capilar). Los resultados
se muestran en la pantalla alfanumérica en una selección de unidades: pH o H + nmol / L, y mmHg o kPa para pags CO
2 y pags O 2)

El 248 también calcula los siguientes parámetros:

• bicarbonato estándar y real (HCO 3– std y HCO 3– Actuar)
• contenido total de dióxido de carbono ( C tCO 2)

• sangre y exceso de base de líquido celular adicional (BE (B) o BE (ecf))

• saturación de oxígeno (O 2 SE SENTÓ)

• contenido de oxígeno (O 2 CONNECTICUT)

• diferencia de tensión arterial-alveolar de oxígeno ( pags O 2 ( A – a)) y la relación tensión arterial-alveolar

de oxígeno ( pags O 2 ( Automóvil club británico)).

ADVERTENCIA El 248 está diseñado para conectarse a tierra a través del cable de alimentación (cable de línea) para un
funcionamiento seguro. Para la seguridad del personal operativo y el rendimiento óptimo, asegúrese de que el instrumento
solo esté conectado a un enchufe de 3 clavijas (salida) que tenga una conexión a tierra efectiva. Si tiene alguna duda sobre
la seguridad de su sistema de suministro eléctrico, consulte a un electricista competente y calificado. No hay piezas
reemplazables por el usuario dentro del instrumento. No quite la cubierta posterior del 248.

Siemens Healthcare Diagnostics y sus Distribuidores y Agentes autorizados se consideran responsables de los
efectos de seguridad, confiabilidad y rendimiento del 248 solo si:

• Las operaciones de montaje, extensiones, reajustes, modificaciones o reparaciones solo son realizadas por
personas autorizadas por ellos.

• La instalación eléctrica de la sala correspondiente cumple con los requisitos de IEC o el

código reglamentario local.

• El equipo se usa de acuerdo con las instrucciones de uso. El 248 pH / Blood Gas Analyzer está
clasificado como equipo IEC Tipo B (equipo de Clase 1 que proporciona un grado adecuado de protección
contra descargas eléctricas, particularmente con respecto a las corrientes de fuga permitidas y la confiabilidad
de la conexión a tierra de protección).

El 248 está diseñado para un funcionamiento continuo y debe conectarse a la fuente de alimentación en todo momento,
para que siempre esté listo para su uso.

El analizador cumple con IEC 601 para seguridad eléctrica y de operación. No fue diseñado para usarse en un
ambiente que contiene una mezcla anestésica inflamable con aire, oxígeno u óxido nitroso y no está diseñado
para proteger contra la entrada de líquidos.

El Underwriters Laboratories enumera el 248 como que cumple los requisitos de las siguientes
Normas de seguridad.

UL 61010A-1 - Equipo eléctrico para uso en laboratorio; Parte 1: Requisitos generales

CSA C22.2 No. 1010.1 - Requisitos de seguridad para equipos eléctricos de medición, control y
uso en laboratorio, Parte 1: Requisitos generales.
ii 248 Manual del operador

Convenciones utilizadas en este manual

Este manual utiliza las siguientes convenciones de texto y símbolos.

Convención Descripción

Negrita El tipo de negrita dentro del texto indica:

1. Un nombre de pantalla
Por ejemplo, si la palabra 'Listo' aparece como ' Listo ', esto indica que' Listo 'aparece en la parte superior
izquierda de la pantalla como el nombre de la pantalla. o

2. Una tecla en el instrumento Por ejemplo, si el número '1' aparece como ' 1 ', se refiere a la tecla del
instrumento marcada' 1 '.

Las declaraciones de precaución proporcionan información sobre las condiciones que pueden causar daños al producto.

Las declaraciones de riesgo biológico lo alertan sobre condiciones potencialmente biopeligrosas.

Comprender los símbolos

Esta sección describe los símbolos que pueden aparecer en el exterior del sistema o en el paquete. Los símbolos en el
sistema le proporcionan la ubicación de ciertos componentes y advertencias para un funcionamiento correcto. Los símbolos
en el sistema o el paquete le proporcionan otra información importante.

Símbolo Descripción

Muestra la posición de la palanca de la sonda para tomar muestras de jeringas y capilares.

Muestra la posición de la palanca de la sonda para tomar muestras de ampollas y otros recipientes abiertos

Le advierte que no rocíe esta área con soluciones de limpieza u otros líquidos que puedan dañar
las partes sensibles del sistema.

Muestra la dirección de rotación de la bomba.

Le advierte sobre el riesgo de exposición a posibles riesgos eléctricos.

Le alerta sobre información importante sobre los fusibles.

Indica que la electricidad de entrada es corriente alterna

Indica los conectores de gas.

Le alerta sobre información importante sobre la presión de la botella de gas.

248 Manual del operador iii

Comprender los símbolos

Símbolo Descripción

Le recomienda que consulte las instrucciones de uso para obtener información relacionada con la
seguridad.

Indica que el analizador está clasificado como equipo IEC Tipo B (equipo de Clase 1 que proporciona un grado
adecuado de protección contra descargas eléctricas, particularmente con respecto a las corrientes de fuga
permitidas y la confiabilidad de la conexión a tierra de protección)

Indica que el sistema está listado por Underwriters Laboratories como reunión
Requisitos de seguridad de EE. UU. Y Canadá

Indica que el sistema cumple con los requisitos de la Unión Europea.

Indica un in vitro dispositivo médico de diagnóstico

Fabricante

Fecha de manufactura

Representante autorizado

Muestra al fabricante de la placa de serie (Donprint)

Numero de catalogo

Le advierte sobre el riesgo de exposición a riesgos biológicos.

Le aconseja que consulte las instrucciones de funcionamiento para obtener la información necesaria para el
uso adecuado del instrumento.

Muestra el área en la que la fecha se puede escribir con lápiz.

Frágil, manipular con cuidado

Limitación de temperatura (4˚ - 25˚C)

Perjudicial

Mantener seco

Mantener alejado de la luz solar y el calor.

Estéril
iv 248 Manual del operador

Comprender los símbolos

Símbolo Descripción

Código de lote

Número de serie

Usar por

Controlar

Indica el nivel de llenado máximo

No reutilizar

No apilar

No lo use si el paquete está dañado

Sigue así

Por favor recicle este embalaje

Impreso en materiales reciclados.

Indica cumplimiento con los estándares de empaque Green Dot

Indica el cumplimiento de los estándares de embalaje RESY

Este sistema contiene ciertas sustancias o elementos tóxicos o peligrosos. El período de uso de protección
ambiental para este sistema es de 50 años. El sistema puede usarse de manera segura durante su período de
uso de protección ambiental. El sistema debe reciclarse inmediatamente después de que haya expirado su
período de uso de protección ambiental.
 v

Contenido Página

Uso previsto yo

Convenciones utilizadas en este manual ii

Comprender los símbolos ii

1 Comprensión del sistema 1-1

248 pH / Blood Gas Analyzer Descripción general 1-1

El panel frontal 1-1

El panel trasero 1-2

El software 248 1-4

Opciones de configuracion 1-7

Información de muestra 1-9

Reactivos 1-10

Deposito de basura 1-11

Calibración 1-12

Control de calidad 1-13

2 Operando el sistema 2-1

Pantalla lista 2-1

Posición de la palanca de la sonda 2-1

Analizando muestras de jeringas 2-2

Analizando muestras capilares 2-5

Medición de una muestra corta o una muestra con una burbuja 2-8

Solicitar una calibración adicional 2-9

Calibrando el Barómetro 2-9

Recordando los últimos datos de muestra 2-10

Análisis de muestras de control de calidad 2-11

Recordando los últimos datos de control de calidad 2-13

Entrar en modo de espera 2-14

vi 248 Manual del operador

Contenido

3 Mantenimiento del sistema 3-1

Mantenimiento diario 3-1

Mantenimiento semanal 3-2

Mantenimiento trimestral 3-2

Programa de mantenimiento 3-3

Mantenimiento semestral 3-4

Vaciar la botella de residuos 3-4

Cambiar los reactivos 3-5

Desproteinizando los Sensores 3-7

Acondicionamiento de los sensores 3-7

Uso de la rutina de desinfección 3-8

Detención del sistema 248 3-8

Usando la rutina principal 3-9

Comprobación de la presión de gas y cambio de cilindros 3-10

Comprobación del caudal de gas 3-12

Cambiar el tubo de la bomba y limpiar y lubricar los rodillos 3-13

Rellenar o reemplazar los sensores de medición 3-17

Sustitución del cassette del sensor de referencia 3-19

Sustitución del tubo de la botella 3-21

Limpieza o reemplazo de la bandeja de goteo 3-22

Sustitución del papel de la impresora 3-23

Sustitución de la sonda y los tubos y la carcasa de la sonda 3-24

Sustitución del protector de la sonda 3-28

Sustitución del tubo de precalentamiento 3-29

Borrar bloqueos 3-31

Sustitución de un fusible 3-34

Apagando el 248 3-35

Contenido vii

Contenido

4 Solución de problemas del sistema 4-1

Fallas de calibración 4-1

Calibración o deriva de pendiente 4-1

Calibración o pendiente Sin punto final 4-2

Calibración o pendiente fuera del rango 4-4

Falla de fluidos, insuficiente 7.3 / 6.8 / Lavado 4-5

Resultados sospechosos 4-6

Muestra no detectada o falla de muestreo 4-7

Problemas de impresora 4-8

Problemas hidráulicos 4-9

Problemas de calentador 4-10

Uso de las rutinas de solución de problemas 4-10

Rutina de bloque de medida 4-10

Rutina de flujo de muestra 4-12

Rutina del calentador 4-13

Rutina electrónica 4-13

Rollo Impresora Rutina 4-13

Uso de los indicadores de estado 4-14

Otros problemas 4-14

5 Configuración del sistema 5-1

Configuración de funcionamiento 5-1

Establecer rangos de control de calidad 5-1

Establecer rangos de referencia 5-2

Elegir unidades 5-2

Selección del método de calibración e ingreso de valores de gas 5-2

Configuración de opciones de impresora 5-3

viii 248 Manual del operador

Contenido
5 Configuración del sistema

Ajuste de correlación 5-3

Configuración del sistema 5-4

Cambio de fecha y hora 5-4

Configurar las indicaciones de mantenimiento 5-5

Seleccionar parámetros 5-5

Cambio de la opción de busca 5-6

Cambio de opciones de comunicación 5-6

Configuración de seguridad 5-6

Impresión de informe de configuración 5-7

Configuración de servicio 5-7

Introducir información del sistema 5-7

Cambio de idioma 5-7

6 Servicio y suministros 6-1

Información sobre pedidos 6-1

Repuestos 6-1

Reactivos 6-3

Direcciones 6-4

Garantía 6-6

Apéndice A Protéjase de los riesgos biológicos A-1

Apéndice B Precauciones y riesgos B-1

Apéndice C Referencias C-1

Apéndice D Interfaz a dispositivos externos D-1

Apéndice E Especificaciones E-1

Apéndice F Instalación F-1

Apéndice G Principios Operativos G-1

 Página 1-1

1 Comprensión del sistema

248 pH / Blood Gas Analyzer Descripción general

Figura 1-1. Descripción general del analizador 248

(elevada) Papel de imprimir

precalentador
Control de avance
de papel
Control S

frontal del

Sensores

Cubierta

tensor
Palanca de sonda medición Captura y
de bloque
tapa Bloque de
de desecho
sonda
medición Cubierta
bomba Bloque de
Ejemplo de tubo de
de reactivo con

Sonda Funda de Tubo de bomba

Bandeja de goteo

6.8 / 7.3 Reactivo Botella

Tampón de lavado de residuos

El panel frontal
Figura 1-2. El panel frontal

Pantalla fluorescente al
vacío

Avance de
papel

Teclado
Teclas de
numérico
operación

Palanca de la sonda: levante a la primera posición para tomar

muestras de ampollas, recipientes, viales y otros recipientes
con tapa abierta. Levante a la segunda posición para tomar
muestras de jeringas y capilares.
Página 1-2 248 Manual del operador

El panel trasero
Figura 1-3. El panel trasero

Ranura para tarjeta de memoria

Conector de Pendiente
Gas Conector Tubo Cal
alimentación, selector Gas Conector Tubo

de voltaje y fusibles

Estos símbolos aparecen en la parte posterior del instrumento.

Símbolo Descripción

Puerto 1 Puerto de datos 1, línea D de 9 vías

Puerto 2 Puerto de datos 2, línea D de 9 vías

Estado Indicadores de estado

Indicadores

Indica que la electricidad de entrada es corriente alterna

Muestra al fabricante de la placa de serie (Donprint)

Indica un in vitro dispositivo de diagnóstico

Fabricante

Le advierte sobre el riesgo de exposición a posibles riesgos eléctricos.

Le recomienda que consulte las instrucciones de uso para obtener información relacionada con la seguridad.
Entendiendo el sistema Página 1-3

El panel trasero
Símbolo Descripción

Representante autorizado

Número de serie

Le alerta sobre información importante sobre los fusibles.

Indica que el sistema está en la lista de Underwriters Laboratories que cumple con los
requisitos de seguridad de EE. UU. Y Canadá

Indica que el sistema cumple con los requisitos de la Unión Europea.

Indica que el analizador está clasificado como equipo IEC Tipo B (equipo de Clase 1 que proporciona un
grado adecuado de protección contra descargas eléctricas, particularmente con respecto a las corrientes
de fuga permitidas y la confiabilidad de la conexión a tierra de protección)

Indica los conectores de gas.

Página 1-4 248 Manual del operador

El software 248
El 248 es muy fácil de usar, y la pantalla lo guía a través de los pasos necesarios para analizar
muestras o usar cualquiera de las otras funciones. El 248 normalmente mostrará el Listo pantalla.
(Los detalles completos de cómo medir muestras se encuentran en la Sección 2, Operando el
Sistema.)

Estado Listo 10:55:12

Levante la sonda para analizar

Información
muestra de jeringa o presione 1
capilar 2 QC

Instrucción presione # para el menú

La pantalla se divide en 3 partes:

• estado. La línea superior muestra el estado del 248. En esta pantalla, la línea de
estado muestra que el 248 está listo para analizar una muestra.

• información. Esta área proporciona información más detallada, listas

opciones y selecciones, y proporciona campos para la entrada de datos.

• instrucción. Esta línea da instrucciones o acciones alternativas.

* * tecla: inicia el proceso de muestreo durante la medición de la muestra capilar. Procedimientos de salida
donde la salida es posible. Devuelve la visualización a la pantalla anterior cuando se mueve por el menú,
configura las opciones, etc.

# # tecla: selecciona una acción alternativa donde se muestra una. Se mueve alrededor de las pantallas de entrada de
datos.

Elegir opciones
La parte inferior (línea de instrucciones) de la Listo la pantalla dice presione # para el menú.

Desde Listo presione el Menú principal tiene

8 submenús:

Menú principal 1

Calibración ... 5 Configuración de funcionamiento ...

2 Mantenimiento ... 6 Configuración del sistema ...
3 Solución de problemas ... 7 En espera 4 Recuperación
de datos ... 8 Configuración del servicio ...

presione 1-8 o * para salir

La línea de estado muestra dónde se encuentra (Menú principal), el área de información enumera los
submenús y la línea de instrucciones le indica cómo seleccionar su opción y ofrece una acción
alternativa (presione * para Salir). Puede seleccionar cualquiera de los submenús presionando el
número correspondiente en el teclado numérico (para volver al Listo Presione la pantalla *).

prensa 1)
Entendiendo el sistema Página 1-5

Elegir opciones
El menú seleccionado (Calibración) se resalta brevemente, confirmando la pulsación de la tecla. La
pantalla muestra el Calibración menú.

principal → Calibración

1 completo 1 punto 5 pH 1 Punto

2 puntos completos 2 6 pH 2 Punto
3 gas 1 punto 7 barómetro
4 Gas 2 Punto

presione 1 - 7 o * para salir

Como antes, la línea de estado muestra dónde está (Menú principal - Calibración), el área de
información enumera las opciones disponibles en el menú de calibración, y la línea de
instrucciones le indica cómo seleccionar su opción y ofrece una acción alternativa (presione * para
Salir ) Para volver al Listo pantalla desde cualquier lugar de los menús, presione * para retroceder
por las pantallas.

Desde Menú principal → Calibración prensa *. El 248 vuelve al Menú principal pantalla.
Presione * nuevamente, el 248 vuelve al Listo pantalla.

Casillas de verificación
Algunas opciones se muestran como casillas de verificación. Estas opciones también se seleccionan presionando

el número correspondiente en el teclado. Para ver un ejemplo de casillas de verificación:

Desde Listo presione # para menú; 5 5 para seleccionar Configuración de funcionamiento y 3 para seleccionar Unidades.

→ Configuración de funcionamiento → Unidades

pH Gases ctHb
1 unidades de pH 3 mmHg 5 g / dL
2 H + nmol / L 4 kPa 6 g / L 7 mmol /
L

presione 1 - 7 o * para salir del menú

significa que la opción está seleccionada, significa que la

opción no está seleccionada.

Presione el número correspondiente en el teclado para seleccionar opciones alternativas.

Presione * 3 veces para retroceder por las pantallas del menú hasta Listo
pantalla.

Los puntos principales para recordar son:

• Usted elige una opción de la lista que se muestra presionando el número

correspondiente en el teclado.

• Puedes volver al Listo pantalla presionando * para retroceder por las pantallas.
Página 1-6 248 Manual del operador

Ingresando datos
Si elige una opción donde puede ingresar datos, se resalta el área (o campo) para los datos.

Para ver un ejemplo de campos de entrada de datos:

Desde Listo presione # para menú, 6 para seleccionar Configuración del sistema y 2 para seleccionar
Aviso de mantenimiento.

→ Configuración del sistema → Mensaje de mantenimiento

Vacíe la botella de desechos cada 1 dias)

Desproteinizar / acondicionar cada 7 día (s)

presione # para la siguiente entrada o * para salir

los Botella de residuos vacía el campo está resaltado Use el teclado numérico para ingresar un número
aquí.

Para confirmar el número y pasar al siguiente campo, presione #. Para confirmar el número y salir de
la pantalla, presione *. También puede usar # para moverse por los campos en una pantalla de ingreso
de datos sin cambiar ningún número ya ingresado. Por lo tanto, si no desea cambiar el número de días
para el indicador de la botella de residuos, presione # para pasar al siguiente campo. El campo
Desproteinizar / Condición se resalta.

Presione * 3 veces para retroceder por las pantallas del menú hasta Listo
pantalla.

Los puntos principales para recordar son:

• No puede ingresar o cambiar un número a menos que su campo esté resaltado.

• No se ingresa un número hasta que se confirma presionando # o *. Presione # para confirmar y pasar
al siguiente campo, o * para confirmar y salir de la pantalla.

• Puede moverse por los campos en una pantalla de entrada de datos usando #. Los números
ya ingresados ​en estos campos no se cambiarán.

• Puedes volver al Listo pantalla presionando * para retroceder por las pantallas.

• Puede ingresar un número negativo (solo para intercepción de correlación) presionando el C clave
cuando el campo de entrada está vacío (en blanco). presione el C
tecla nuevamente para cancelar el signo menos.
Entendiendo el sistema Página 1-7

Opciones de configuracion

Puede configurar el 248 eligiendo unidades de medida, configurando rangos de referencia, etc. Esto está
cubierto en la Sección 5, Configurando el sistema. La Sección 5 también proporciona las configuraciones
recomendadas donde corresponda. Por supuesto, puede usar el 248 usando las opciones y valores
predeterminados (configurados de fábrica). Estos se dan a continuación.

Configuración de

funcionamiento QC
pH 6.001 - 8.000 (10.0 - 997.7 nmol / L H +)
pags CO 2 5.0 - 250.0 mmHg (0.67 - 33.33 kPa)
pags O 2 0.00 - 749.0 mmHg (0.00 - 99.86 kPa)

Rangos de referencia
pH 7.350 - 7.450 (35,5 - 44,7 H + nmol / L)
pags CO 2 35.0 - 45.0 mmHg (4.67 - 6.00 kPa)
pags O 2 80.0 - 100.0 mmHg (10.67 - 13.33 kPa)

Unidades
pH Unidades de

pH Gases mmHg

C tHb g / dL

Calibración
método e intervalo tiempo flexible, 30 minutos
valores de gas

California 5% de CO 2 12% O 2
Pendiente 10% de CO 2 0% O 2

Opciones de impresora
impresora en

impresión solo resultados

Correlación
pendiente de pH 1.000 PRECAUCIÓN: Estos
valores no deben
Intercepción de pH 0,000
cambiarse sin
pags CO 2 Pendiente 1.000
consultar primero la
pags CO 2 interceptar 0,000 Sección 5,
pags O 2 Pendiente 1.000
pags O 2 interceptar 0,000 Configurando el
sistema.
Página 1-8 248 Manual del operador

Fecha / hora de

configuración del sistema conjunto

Mensaje de mantenimiento
residuos vacíos todos los días

desproteinizar / condicionar cada 7 días

Parámetros
Medido pH pags CO 2 y pags O 2 seleccionado

calculado ninguna seleccionada

Localizador
localizador en

Comunicaciones
Puerto 1 CMSI
Puerto 2 CMSI

Seguridad
contraseña del menú no establecido

Información del

sistema de configuración del servicio

número de serie conjunto

número de servicio no establecido

Selección de idioma
Inglés
Entendiendo el sistema Página 1-9

Información de muestra

La obtención de muestras de sangre debe realizarse bajo la supervisión médica adecuada, incluida la
selección del sitio, los procedimientos específicos utilizados y la documentación de manejo de muestras.
Se requiere una técnica estéril en todo momento para evitar la infección del sitio de punción. Los detalles
específicos de cualquier colección deben ser aprobados por la persona médica responsable.

PRECAUCIÓN: Interprete los resultados de pacientes anestesiados con halotano u óxido nitroso con
cuidado como pags O 2 Los valores pueden no ser confiables.

BIOHAZARD: Todas las muestras deben tratarse con la precaución de acuerdo con las que se sabe que
contienen organismos patógenos.

Tipos de muestra
La sangre arterial ha sido ampliamente recomendada para su uso en estudios de gases en sangre
porque refleja con precisión la fisiología ácido-base y el estado de oxigenación. Rutinariamente, se puede
obtener sangre arterial de las arterias radial, femoral o braquial. Se pueden usar otros sitios después de
un cateterismo o procedimientos quirúrgicos. La sangre venosa puede proporcionar un pH satisfactorio y pags
CO 2 valores; sin embargo, venoso pags O 2 las muestras pueden no ser significativas en el estudio clínico de
rutina sin el estudio simultáneo de arterias pags O 2)

Las muestras venosas se pueden obtener utilizando sistemas de recolección de tubos de vacío, de una vena
anticubital. Se pueden usar otros sitios según sea necesario. Los valores de saturación de oxígeno venoso
informados deben etiquetarse como tales para permitir la interpretación correcta de los resultados.

La sangre capilar, cuando se recoge cuidadosamente en las condiciones adecuadas, se parece

mucho a la sangre arterial y puede usarse para estudios de gases en sangre. El análisis capilar
tiene la ventaja de que solo se necesitan pequeñas cantidades de sangre para la medición. Se
puede obtener sangre capilar del talón, dedo o lóbulo de la oreja. El área elegida debe ser
precalentada o estimulada para promover la circulación arterial antes de la punción. La punción
debe ser lo suficientemente profunda como para garantizar que el flujo sanguíneo sea libre y rápido.

Jeringas
Las muestras de sangre recolectadas en jeringas heparinizadas de Siemens Healthcare Diagnostics o
equivalentes son satisfactorias para usar con el 248. La jeringa debe llenarse completamente ya que un
llenado incompleto elevará el nivel de heparina con respecto a la muestra. Contaminación del aire
ambiente, una preocupación en
pags O 2 determinaciones, pueden minimizarse evitando atraer aire a la muestra.
Inmediatamente después de extraer la muestra, expulse todo el aire de la jeringa, tape bien y
mezcle bien la muestra.

Tubos Capilares
La sangre capilar debe recogerse con tubos capilares de Siemens. El volumen mínimo de
muestra de un capilar es 60 μ L. El tubo capilar debe estar completamente lleno y los
extremos bien tapados. Las muestras deben mezclarse completamente.

PRECAUCIÓN: Si usa una pulga mezcladora, quítela antes de tomar una muestra para evitar
dañar el 248.
Página 1-10 248 Manual del operador

Sistemas de recogida de tubos de vacío

Los sistemas de tubos de vacío que contienen heparina de litio se pueden usar para muestras
venosas. Asegúrese de que el tubo esté completamente lleno y que las muestras estén bien mezcladas
por inversión suave.

Manejo de muestra
Los errores significativos en las mediciones en muestras de sangre completa recolectadas adecuadamente pueden ser
causados ​por:

• cambios metabólicos en la muestra que ocurren entre muestreo y análisis,

• contaminación de la muestra por aire ambiental,

• mezcla inadecuada de la muestra antes de la medición. Minimice los errores debidos a cambios

metabólicos analizando las muestras lo antes posible después de la recolección. Esto es particularmente

importante para pags O 2

muestras, ya que el oxígeno se consume durante el almacenamiento.

La tasa de consumo de oxígeno depende de varios factores; la inicial pags O 2, la temperatura de

almacenamiento, el recuento de glóbulos blancos y el recuento de reticulocitos.

Si las muestras no se analizarán dentro de los diez minutos posteriores a la recolección, colóquelas en
agua helada. Las muestras almacenadas de esta manera pueden conservarse hasta 2 horas sin cambios
significativos en los valores. Las muestras con recuentos altos de glóbulos blancos o recuentos altos de
reticulocitos se deterioran más rápidamente y deben analizarse de inmediato.

La mezcla inadecuada de las muestras antes del análisis puede dar resultados erróneos. Las células sanguíneas
se depositan durante el almacenamiento y, si no se mezclan bien antes del muestreo, los resultados obtenidos
pueden ser mayores o menores que los valores reales. Las jeringas deben enrollarse entre las manos e invertirse
suavemente varias veces. Los tubos de vacío deben invertirse suavemente hasta que la muestra sea homogénea.
Las muestras capilares deben mezclarse completamente rodando hasta que estén homogéneas. La formación de
coágulos puede causar bloqueos en la vía de la muestra.

Reactivos

ADVERTENCIA Use gafas de seguridad, guantes y una bata de laboratorio al manipular los
reactivos.

Los reactivos descritos en esta sección son solo para uso diagnóstico in vitro. Siemens no
puede garantizar el rendimiento del sistema en ninguna de las siguientes situaciones:

• Se utilizan reactivos distintos a los recomendados.

• Se han excedido las fechas de caducidad de los reactivos.

• Se ha excedido la fecha de cambio de reactivo.

• Los reactivos no se usan ni almacenan de acuerdo con las recomendaciones de

Siemens.

• No se siguen las prácticas estándar de laboratorio.

• No se siguen los procedimientos de este manual.

Entendiendo el sistema Página 1-11

Ingredientes activos
Las hojas de datos de seguridad de los materiales para los reactivos 248 son suministradas por su distribuidor local.

Uso previsto
El tampón 7.382 proporciona el punto de calibración para pH de 1 y 2 puntos
calibraciones El tampón 7.382 está tamponado a un pH de 7.382 a 37 ° C y es
NIST rastreable.

6.838 buffer proporciona el punto de pendiente para calibraciones de pH de 2 puntos. 6.838

el tampón está tamponado a un pH de 6.838 a 37 ° C y es NIST rastreable.

Lavar lava la sonda y la ruta de muestra.

El desproteinizador elimina la acumulación de proteínas de la ruta de la muestra. Esta usado

regularmente como mantenimiento preventivo para el 248.

El acondicionador limpia y acondiciona el sensor de pH. Se usa regularmente

como mantenimiento preventivo para el 248.

Almacenamiento
Almacene todos los reactivos lejos de la luz solar directa a 4 - 25 ° C. Deseche los

tampones 7.382 y 6.838 30 días después de la apertura. No utilice reactivos después de

la fecha de caducidad.

Deseche la solución desproteinizadora y acondicionadora después de un solo uso.

Manejo y preparación
7.382 buffer, 6.838 buffer, Wash and Conditioner no requieren preparación antes
de su uso.

Prepare el desproteinizador como se indica en las instrucciones del paquete.

Deposito de basura
BIOHAZARD: Ver Apéndice A, Protegerse de los riesgos biológicos.

Consulte la página 3-4, Vaciar la botella de residuos para obtener instrucciones detalladas sobre el manejo de la
botella de residuos.

Deseche la botella de desechos y su contenido de acuerdo con el protocolo de su laboratorio. La

publicación GP5 de NCCLS brinda pautas detalladas. 25
Página 1-12 248 Manual del operador

Gases de calibración
Se utilizan dos estándares de gas para calibrar el pags CO 2 y pags O 2 sensores Cal Gas

proporciona el punto de calibración para 1 y 2 puntos pags CO 2 y

pags O 2 calibraciones Cal Gas contiene 5.00 ± 0.05% de dióxido de carbono y
12.00 ± 0.05% de oxígeno, equilibrado con nitrógeno y es rastreable por NBS.

Gas de pendiente proporciona el punto de pendiente para 2 puntos pags CO 2 y pags O 2

calibraciones El gas de pendiente contiene 10.00 ± 0,05% de dióxido de carbono
equilibrado con nitrógeno y es rastreable por NBS.

ADVERTENCIA Los cilindros de gas comprimido requieren un manejo cuidadoso. Para evitar daños y
posibles lesiones personales, observe las siguientes precauciones:

• Nunca deje caer cilindros, permita que se golpeen entre sí ni los someta a otros
golpes fuertes.

• Asegure los cilindros a una pared o banco, o colóquelos en un soporte de base para cilindros.

• Nunca arrastre, ruede o deslice los cilindros, incluso para distancias cortas. Use una carretilla de mano
adecuada para mover los cilindros.

• Nunca manipule dispositivos de seguridad en reguladores o cilindros.

• Use estos gases solo para la calibración de instrumentos clínicos y de investigación. La ley de los
Estados Unidos prohíbe dispensar estos gases para el uso de drogas.

• El contenido está bajo presión, no perforar.

• No utilice ni almacene cerca del calor o llamas abiertas.

• No exponga los cilindros a temperaturas superiores a 54 ° C (130 ° F) ya que esto puede hacer que los
contenidos se ventilen o exploten.

• Nunca arroje cilindros al fuego o incineradores. Siga las instrucciones de eliminación en

los cilindros.

Calibración

El 248 se calibra automáticamente utilizando uno de los siguientes métodos seleccionables por el usuario.
Cinco minutos antes del vencimiento de la calibración, aparece un mensaje de cuenta regresiva en el Listo pantalla.
Las muestras aún se pueden medir durante este tiempo.

Horario fijo
El 248 se calibra automáticamente en un intervalo de tiempo especificado. El intervalo es seleccionable
por el usuario y puede ser de 30 o 60 minutos. Se realiza una calibración de 1 punto en cada intervalo.
Se realiza una calibración completa de 2 puntos en cada cuarto intervalo.

Por ejemplo:

Cuando el intervalo se establece en 30 minutos, el 248 realiza automáticamente una calibración

de 1 punto cada 30 minutos y una calibración de 2 puntos cada 2 horas.
Entendiendo el sistema Página 1-13

Calibración

Tiempo flexible
El 248 calibra automáticamente según sea necesario y calcula el tiempo entre calibraciones para
optimizar el rendimiento. El intervalo de tiempo máximo entre calibraciones es seleccionable por el
usuario y puede ser de 30 o 60 minutos. El tiempo entre las calibraciones de 1 punto será entre 10
minutos y el intervalo de tiempo máximo seleccionado. Se realiza una calibración completa de 2 puntos
en cada cuarto intervalo.

Por ejemplo:

Cuando el intervalo se establece en 30 minutos, el 248 realiza automáticamente una calibración de

1 punto al menos una vez cada 30 minutos y una calibración de 2 puntos al menos cada 2 horas.

General
En los métodos de tiempo fijo y flexible, el 248 se calibra automáticamente después
de ciertas rutinas de mantenimiento, por ejemplo, el
Desinfectar, Desproteinizar y Condición rutinas También se calibra si se produce un fallo de
muestreo, por ejemplo, 'Muestra no detectada'.

Control de calidad

Siemens recomienda que se configure un programa de Control de calidad para monitorear el desempeño del
instrumento y del operador. Debido a que las necesidades de cada laboratorio son diferentes, debido al
tamaño de la carga de trabajo, el número de horas trabajadas, las regulaciones legales, etc., no se ha
intentado formular un programa rígido. Los usuarios deben seguir las pautas regulatorias locales para
establecer un programa de control de calidad.

Utilice solo materiales de control de calidad aprobados por Siemens. Si informa sus resultados a un programa
estadístico de control de calidad, asegúrese de que estén informados sobre el analizador - Siemens 248 pH /
Blood Gas Analyzer.

Control de calidad
Los errores significativos en las mediciones de CC pueden ser causados ​por:

• almacenamiento incorrecto y equilibrio de temperatura de la muestra de CC,

• mezcla inadecuada de la muestra de control de calidad,

• contaminación de la muestra de CC por aire ambiental. Siempre siga las instrucciones de uso del
fabricante con cuidado, especialmente con respecto a la temperatura del control de calidad antes del
muestreo. Mezcle bien la ampolla y, una vez abierta, tome una muestra de QC inmediatamente. No
reutilice una ampolla abierta. Coloque la sonda cerca del fondo de la ampolla para obtener una muestra
representativa. Consulte las referencias 1 a 4 para obtener más información sobre el control de calidad.
 Página 2-1

2 Operando el sistema

Pantalla lista

los Listo La pantalla muestra jeringa, capilar o CC en el mensaje principal, dependiendo de la

última muestra medida. Si desea medir un tipo diferente de muestra, presione 1 o 2 para
seleccionar el tipo de muestra apropiado. Por ejemplo, desde la siguiente pantalla:

para medir una muestra de jeringa levante la sonda para medir

una muestra de capilar presione 1

para medir una muestra de control de calidad presione 2

Listo 11:03:48

Levante la sonda para analizar

muestra de jeringa o presione 1
capilar 2 QC

presione # para el menú

Posición de la palanca de la sonda

Hay dos posiciones de palanca de sonda para el muestreo. Para facilitar su uso y obtener un
rendimiento óptimo, es importante que utilice la posición correcta para su dispositivo de muestreo.

La primera posición es para tomar muestras de ampollas y otros recipientes abiertos. En esta
posición, la sonda está más profunda en la solución, lo que permite tomar una muestra más
representativa.

La segunda posición es para tomar muestras de jeringas y capilares. En esta posición, la sonda
no sobresaldrá tanto, disminuyendo la posibilidad de que toque el émbolo de la jeringa.

Figura 2-1. Posiciones de la palanca de la sonda

Cerrado Primera posición Segunda posición

Ampollas Jeringas / Capilares

Si utiliza una posición diferente a la recomendada, el 248 muestra un mensaje de "confirmar tipo
de muestra".
Página 2-2 248 Manual del operador

Analizando muestras de jeringas

BIOHAZARD: Ver Apéndice A, Protegerse de los riesgos biológicos.

1. Si el mensaje principal muestra capilar o muestra de control de calidad, presione 1 para seleccionar
jeringuilla.

Listo 11:03:48

Levante la sonda para analizar

muestra de jeringa o presione 1
capilar 2 QC

presione # para el menú

2. Levante la palanca de la sonda a la segunda posición.

Sonda abierta

Muestra actual

sonda para cancelar

3. Deslice la muestra de la jeringa sobre la sonda y empuje suavemente la funda de la sonda hacia atrás. El 248
emite un pitido cuando el manguito de la sonda está en la posición correcta y comienza a tomar muestras.

PRECAUCIÓN: Intente colocar la sonda para obtener la muestra más representativa; no permita
que la punta de la sonda toque el émbolo de la jeringa.

NOTA: Si tiene una muestra de jeringa muy pequeña, presente la muestra y presione *, luego
confirme la muestra de la jeringa cuando se le solicite.

Muestreo
Mantener muestra
en su lugar

cerrar la sonda para cancelar

4. Mantenga la muestra en su lugar. Los 248 pitidos cuando se completa el muestreo.

Muestreo completo
Retire la muestra y cierre
la sonda

5. Retire la muestra y cierre la sonda.

Muestra en movimiento

por favor espera

presione * para cancelar cerrar la

Operando el sistema Página 2-3

Analizando muestras de jeringas

Si se detecta una burbuja o muestra corta, el 248 lo alertará. Consulte la página 2-8 para
más detalles.

Medición
pH = 7.392
pCO 2 mmHg = 41,7
correos 2 mmHg = 78,4

presione # para ingresar datos del paciente

6. Presione # si desea ingresar datos del paciente.

datos del paciente

ID del operador - - - - - - - - - - - - Temp - -. - ° C Identificación del paciente - - - -

- - - - - - - - ctHb - -. - g / dL
FIO 2 - - - . -%

presione # para la siguiente entrada o * para salir Ingrese los

Puede ingresar hasta 12 dígitos para la identificación del operador y del paciente. Puede usar la tecla de

punto decimal para insertar guiones. Los otros valores que se pueden ingresar son:

• temperatura del paciente 10.0 - 43.9 ° C

• C tHb 2.0 - 25.0 g / dL (20 - 250 g / L o 1.2 - 15.5 mmol / L)

• F yo O 2 15.0 - 100.0%.

El 248 usará los valores ingresados ​para la temperatura del paciente, C tHb y F yo O 2
al calcular los resultados. Si no ingresa los datos del paciente, el 248 usa la temperatura normal
(predeterminada) (37 ° C), C tHb (15 g / dL (150 g / L, 9.6 mmol / L)) y F yo O 2 ( 20.9%) valores en los
cálculos, con las siguientes excepciones:

• O 2 CT no se informará a menos que C Se ingresa tHb, y

• pags O 2 ( Aa) y pags O 2 ( a / A) no se informará a menos que F yo O 2 es ingresado. Los resultados también pueden
corregirse para la temperatura del paciente, C tHb y F yo O 2 después de la medición - ver Recordando los últimos
datos de muestra, Página 2-10.

Resultado de ejemplo. Si los valores medidos están fuera de los rangos de referencia, una flecha indica si
están por encima o por debajo del rango. Si seleccionó los parámetros calculados, se muestran en la
Pantalla 2. (Consulte la Sección 5,
Configurando el sistema, para obtener detalles sobre los rangos de referencia y los parámetros calculados).

resultados - Pantalla 1 medida Corregido

a los 37 ° C a 33,5 ° C
pH = 7.392 7.444
pCO 2 mmHg = 41,7 35,8
correos 2 mmHg = 78,4 ↓ 62,2 ↓

presione # para ver la pantalla 2 o * para salir de los

Page 2-4 248 Operator’s Manual

Analizando muestras de jeringas

7. Presione # si desea ver los parámetros calculados. Se muestran hasta 8 parámetros en la

pantalla 2; Se imprimirán todos los parámetros seleccionados.

Results - Screen 2 HCO 3 act = 24.8 mmol/L ctCO 2

= 26.1mmol/L
BE(ecf) = –0.1 mmol/L pO 2( A-a)(T) = 42.8 mmHg O 2 CT
= 20.2 mL/dL pO 2( a/A)(T) = 0.59
O 2 SAT = 95.5 % press # to see Screen 1 or * to Exit

Ejemplo de impresión

Informe
sangre
gases endesangre
gases
Informe en sangre
deInforme
gases en
de sangre
gases
Informeende
248-9265 10:56 abr 11 1994 Identificación del instrumento, hora y fecha,
Muestra no 5060 Jeringuilla identificación del operador y del paciente,
ID del operador 46 y tipo y número de muestra
ID de paciente 9012

corregido
Corregido 33.5ºC
33.5ºC corregido
corregido 33.5ºC
33.5ºC
pH 7.444
pCO 2 35,8 mmHg Valores corregidos
correos 2 62,2 ↓ mmHg
↑ , ↓ = exterior ref. rango

Medido 37ºC
pH 7.392
pCO 2 41,7 mmHg Valores medidos
correos 2 78,4 ↓ mmHg
↑ , ↓ = exterior ref. rango

referencia
Intervalos de referencia
Intervalos de Intervalos
referencia de
pH 7.350 - 7.450
pCO 2 35,0 - 45,0 Rangos de referencia
correos 2 80.0 - 100.0

Datos calculados Datos calculados

HCO 3 Actuar 24.8 mmol / L
BE (ecf) - 0.1 mmol / L
O Connecticut
2 20.2 mL/dL Calculated parameters
O 2 SAT 95.5 %
ctCO 2 26.1 mmol/L
pO 2( A-a)(T) 42.8 mmHg pO 2( a/A)(T)
0.59

Entered Data Entered Data

Temp 33.5 ° C
ctHb 15.0 g/dL Patient temperature, c tHb and F I O 2
FIO 2 20.9 %

- - - - - - - - - - - - - - -

While the results are displayed and printed, the 248 washes the probe and sample path.
When the wash has finished you can press * to return to the Ready screen.
Operating the System Page 2-5

Analyzing Capillary Samples

BIOHAZARD: See Appendix A, Protecting Yourself From Biohazards.

The minimum sample volume for a capillary sample is 60 μ L.

1. If the main message shows syringe sample press 1 to select capillary, if

the main message shows QC sample press 2 to select capillary.

Ready 11:03:48

Lift probe to analyze

capillary sample or press 1
syringe 2 QC

press # for menu

2. Lift the probe lever to the second position.

Probe open
Present sample then
press *

close probe to cancel

3. Remove the caps from the end of the capillary and carefully fit a capillary adaptor. Slide
the adaptor onto the probe, then press *. The 248 beeps when you press *.

Sampling
Hold sample
in place

close probe to cancel

4. Hold the capillary in place. The 248 beeps when sampling is complete.

Sampling complete
Remove sample and close
probe

5. Remove the capillary and adaptor and close the probe.

Moving sample

Please wait

press * to cancel
Page 2-6 248 Operator’s Manual

Analyzing Capillary Samples

If a bubble or short sample is detected the 248 will alert you. See page 2-8 for
details.

Measuring
pH = 7.392
pCO 2 mmHg = 41.7
pO 2 mmHg = 78.4

press # to enter patient data

6. Press # if you want to enter patient data.

Operator ID - - - - - - - - - - - - Temp - - . - ° C Patient ID - - - - - - - - - - - - ctHb -

- . - g/dL
FIO 2 - - - . - %

press # for next entry or * to Exit Enter Patient Data

You can enter up to 12 digits for operator and patient ID. You can use the decimal point
key to insert dashes. The other values that can be entered are:

• patient temperature 10.0 - 43.9 ° C

• c tHb 2.0 - 25.0 g/dL (20 - 250 g/L or 1.2 - 15.5 mmol/L)

• F I O 2 15.0 - 100.0%.

The 248 will use the values entered for patient temperature, c tHb and F I O 2
when calculating the results. If you do not enter patient data the 248 uses normal (default)
temperature (37 ° C), c tHb (15 g/dL (150 g/L, 9.6 mmol/L)) and F I O 2 ( 20.9%) values in the
calculations, with the following exceptions:

• O 2 CT will not be reported unless c tHb is entered, and

• p O 2( A-a) and p O 2( a/A) will not be reported unless F I O 2 is entered. Results may also be
corrected for patient temperature, c tHb and F I O 2 after measurement - see Recalling Last
Sample Data, Page 2-10.

Example result. If the measured values are outside the reference ranges an arrow indicates if
they are above or below the range. If you selected calculated parameters they are displayed
on Screen 2. (See Section 5,
Configuring the System, for details on reference ranges and calculated parameters.)

Results - Screen 1 Measured

Corrected
at 37 ° C to 33.5 ° C
pH = 7.392 7.444
pCO 2 mmHg = 41.7 35.8
pO 2 mmHg = 78.4 ↓ 62.2 ↓

press # to see Screen 2 or * to Exit

Operating the System Page 2-7

Analyzing Capillary Samples

7. Press # if you want to see the calculated parameters. Up to 8 parameters are shown on
screen 2; all the parameters selected will be printed.

Results - Screen 2 HCO 3 act = 24.8 mmol/L ctCO 2

= 26.1mmol/L
BE(ecf) = –0.1 mmol/L pO 2( A-a)(T) = 42.8 mmHg O 2 CT
= 20.2 mL/dL pO 2( a/A)(T) = 0.59
O 2 SAT = 95.5 % press # to see Screen 1 or * to Exit

Example Printout

Blood Gas Report Blood Gas Report

248-9265 10:59 Apr 11 1994 Instrument ID, time and date,
Sample No. 5061 Capillary operator and patient ID,
Operator ID 46 and sample type and number
Patient ID 9012

Corrected 33.5ºC Corrected 33.5ºC

pH 7.444
pCO 2 35.8 mmHg Corrected values
pO 2 62.2 ↓ mmHg
↑ , ↓ = outside ref. range

Measured 37ºC
pH 7.392
pCO 2 41.7 mmHg Measured values
pO 2 78.4 ↓ mmHg
↑ , ↓ = outside ref. range

Reference Ranges Reference Ranges

pH 7.350 - 7.450
pCO 2 35.0 - 45.0 Reference ranges
pO 2 80.0 - 100.0

Calculated Data Calculated Data

HCO 3 act 24.8 mmol/L
BE(ecf) – 0.1 mmol/L
O 2 CT 20.2 mL/dL Calculated parameters
O 2 SAT 95.5 %
ctCO 2 26.1 mmol/L
pO 2( A-a)(T) 42.8 mmHg pO 2( a/A)(T)
0.59

Entered Data Entered Data

Temp 33.5 ° C
ctHb 15.0 g/dL Patient temperature, c tHb and F I O 2
FIO 2 20.9 %

- - - - - - - - - - - - - - -

While the results are displayed and printed, the 248 washes the probe and sample path.
When the wash has finished you can press * to return to the Ready screen.
Page 2-8 248 Operator’s Manual

Measuring a Short Sample or a Sample with a Bubble

The 248 detects short samples or bubbles in samples and gives you 2 options:

• reposition the sample so there are no air bubbles under the sensors and then continue
with the analysis, or
• flush the sample out of the measurement block ready to repeat the analysis.

The 248 beeps and displays:

Short sample
Reposition sample then
press # to measure

press * to cancel

OR

Bubble in sample
Reposition sample then
press # to measure

press * to cancel

This message is displayed for 1 minute. If no action is taken the 248 flushes the sample out of
the measurement block.

Continuing with the Sample Analysis

1. If you want to measure the sample lift the front cover and look at the measurement block.

2. Turn the sample pump rotor (the sample pump is the lefthand pump) in the direction
indicated, so that the sample is repositioned directly beneath the sensors for which
results are required.

Figure 2-2. Repositioning Samples

CAUTION: Do not move samples backwards as KCl from the reference sensor may
contaminate the other sensors.
Operating the System Page 2-9

Measuring a Short Sample or a Sample with a Bubble

CAUTION: Special care must be taken to make sure that the sample is repositioned directly
beneath the sensors for which results are required. For example, for pO 2 and pCO 2 results, the
sample must be positioned under the pO 2 and pCO 2 sensors with no air bubbles present. For
pH results the sample must be positioned under the pH and reference sensors with no air
bubbles present. Air bubbles present under one of the sensors as a result of incorrect sample
repositioning may lead to erroneous results.

3. When you are satisfied that the sample is correctly repositioned press #. The sample
analysis continues. The printout shows ‘Short sample’ or ‘Bubble in sample’.

Cancelling the Sample Analysis

1. If you have enough sample left to repeat the analysis, press *.
2. The sample is flushed out of the measurement block and the display returns to the Ready screen.

Requesting an Additional Calibration

The 248 automatically calibrates using one of the user-selectable methods (see Section 1, Understanding
the System, for details). The Calibration menu allows additional, user-requested calibrations to
be carried out.

1. From Ready press # for menu, and 1 for Calibration.

Main Menu → Calibration

1 Full 1 Point 5 pH 1 Point

2 Full 2 Point 6 pH 2 Point
3 Gas 1 Point 7 Barometer
4 Gas 2 Point

press 1 - 7 or * to Exit

2. Press 1 - 6 to select the type of calibration you want.

The 248 displays each stage of the calibration on the status line. The calibration
results are displayed and the 248 confirms when the calibration is successful.

A successful, user-requested calibration resets the automatic calibration timer.

The 248 will not allow a partial calibration if a full calibration is due. For example, if you
press 1 when a 2 point calibration is due, the 248 displays ‘Full 2 point required’.

Calibrating the Barometer

The Calibration menu also allows you to check the atmospheric pressure and to
recalibrate the internal barometer.
1. From Ready press # for menu, 1 for Calibration and 7 for Barometer.
Page 2-10 248 Operator’s Manual

Calibrating the Barometer

→ Calibration → Barometer

Enter atmospheric pressure

760 mmHg

press * to Exit

The adjustment range for the barometer is the displayed value ± 20 mmHg.

Recalling Last Sample Data

The 248 retains the data for the last sample measured. The Data Recall menu allows:

• data to be recalled,
• patient data to be entered or changed,
• results to be printed.

1. From Ready press # for menu, 4 for Data Recall and 1 for Last Sample
Data.

→ Data Recall → Last Sample Data

1 View Results 2 Enter Patient

Data 3 Print Data

press 1 - 3 or * to Exit

2. Press 1 to recall the results Screen 1 to the display. (The calculated

parameters are also recalled, press # to see Screen 2.)

3. Press 2 if you want to enter or change the patient data. You can enter
patient and operator ID, and patient temperature, c tHb and F I O 2.

You can enter up to 12 digits for operator and patient ID. You can use the decimal point
to insert dashes. The other values that can be entered are:

• patient temperature 10.0 - 43.9 ° C

• c tHb 2.0 - 25.0 g/dL (20 - 250 g/L or 1.2 - 15.5 mmol/L)
• F I O 2 15.0 - 100.0%.

The 248 will use these values for recalculating the results. If you do not enter patient data the
248 uses the values entered previously, or if none were entered normal (default) temperature
(37 ° C), c tHb (15 g/dL (150 g/L, 9.6 mmol/L)) and F I O 2 ( 20.9%) are used, with the following
exceptions:

• O 2 CT will not be reported unless c tHb is entered, and

• p O 2( A-a) and p O 2( a/A) will not be reported unless F I O 2 is entered.

4. Press 3 if you want to print the data. The printout shows the date and
time the sample was analyzed, not the time of recall.
Operating the System Page 2-11

Analyzing QC Samples

BIOHAZARD: See Appendix A, Protecting Yourself From Biohazards.

1. If the main message shows syringe or capillary sample press 2 to

select QC.

Ready 11:03:48

Lift probe to analyze

QC sample or press 1
syringe 2
capillary
press # for menu

2. Lift the probe lever to the first position.

Probe open

Present sample

close probe to cancel

WARNING Open ampules carefully.

Use ampule breakers (Cat. 47860900L) to protect your fingers.

3. Present the QC sample to the probe and gently push the probe sleeve back. The 248
beeps when the probe sleeve is in the correct position and starts sampling.

Sampling
Hold sample
in place

close probe to cancel

4. Hold the sample in place. The 248 beeps when sampling is complete.

Sampling complete
Remove sample and close
probe

5. Remove the sample and close the probe.

Moving sample

Please wait

press * to cancel
Page 2-12 248 Operator’s Manual

Analyzing QC Samples

Measuring Select QC Level

1 Level 1 2
pH = 7.392
Level 2 3
pCO 2 mmHg = 41.7
Level 3 4
pO 2 mmHg = 78.4
Level X press
1–4
press * to cancel

6. Press 1 - 4 to select the QC level. This makes sure the result is

compared to the appropriate QC reference range, and reported correctly on the
printer and DMS systems. If QC level is not selected the 248 assumes Level X,
which has no range checking.

Results - QC Level 1Measured

Range

pH = 7.143 7.127 - 7.167

pCO 2 mmHg = 69.4 67.1 - 77.1
pO 2 mmHg = 66.5 59.4 - 69.4

Example result If the measured values are outside the QC ranges set (see Section 5, Configuring
the System) an arrow indicates if they are above or below the range.

Example Printout

QC Report QC Report
248-9265 11:15 Apr 11 1994 Instrument ID, time and date,
Sample No. 5062 and sample number

Level 1 Level 1
Lot 123456
pH 7.143
pCO 2 69.4 mmHg Measured values
pO 2 66.5 mmHg

Ranges
QC Ranges
QC QC
Ranges
pH 7.127 - 7.167
pCO 2 67.1 - 77.1 QC ranges
pO 2 59.4 - 69.4

- - - - - - - - - - - - - - - -

While the results are displayed and printed the 248 washes the probe and sample path.

When the wash has finished the 248 returns to the Ready screen. The Ready screen main
message will show QC sample for 60 seconds. After this time, the screen reverts to the last
sample type before QC was selected.
Operating the System Page 2-13

Analyzing QC Samples

QC Handling
Significant errors in QC measurements may be caused by:

• improper storage and temperature equilibration of the QC sample,

• improper mixing of the QC sample,

• contamination of the QC sample by room air. Always follow the manufacturer’s

instructions for use carefully, especially regarding the temperature of the QC before
sampling. Mix the ampule thoroughly, and once opened sample the QC immediately. Do not
re-use an opened ampule. Position the probe near the bottom of the ampule to obtain a
representative sample.

Recalling the Last QC Data

The 248 retains the data for the last QC sample measured at each level.

1. From Ready press # for menu, 4 for Data Recall and 2 for QC Data.

→ Data Recall → QC Data

1 Level 1 2
Level 2 3 Level
3 4 Level X

press 1 - 4 or * to Exit

2. Press 1 - 4 to select the QC level.

3. The QC data is recalled to the display.

4. Press # to print the data.

The printout shows the date and time the QC sample was analyzed, not the time of recall.
Page 2-14 248 Operator’s Manual

Entering Standby Mode

This routine conserves reagents. During Standby the sensors are kept wet and the pump
tubes moved from time to time to keep them in good condition. The 248 does not calibrate
while in standby mode, but automatically calibrates as required when restarted, before
allowing sample measurements.

1. From Ready press # for menu and 7 for Standby.

11:03:48
Standby

Press * to restart now

press # to set auto restart time

2. You can restart the 248 from standby mode in two ways:

a. press * to restart the 248 immediately, or

b. set an auto restart time. If a time is set, the 248 automatically restarts at that time.

Setting Auto Restart Time

1. To set the auto restart time press #.

Set Auto Restart Time 11:03:55

Auto restart at
08:30

press * to Exit

2. Enter the time required and press * to Exit. If the time displayed is the time you want for auto
restart, just press *.

Standby 11:04:10

Auto restart at 08:30 press * to

restart now

press # to cancel auto restart

 Page 3-1

3 Maintaining the System

The 248 has been designed to reduce the need for maintenance to an absolute minimum.
However, careful attention to the few regular preventative maintenance routines which are
required will be more than repaid by reliable, troublefree performance. To help with this, a
maintenance schedule is provided (see example on Page 3-3, working copies are inside
the front cover of this manual).

The maintenance frequency is based on analyzing 20 - 30 samples/day. Increase the

maintenance frequency if your laboratory analyzes more than 30 samples/day. We
recommend using the Disinfect routine (Page 3-8) before carrying out the following
maintenance routines:

• replacing the pump tubing, cleaning and lubricating the rollers,

• replacing the reference sensor cassette,
• filling/replacing the pH sensor,
• replacing the p CO 2 and p O 2 sensors,
• replacing the probe and tubing, probe housing and probe protector,
• replacing the pre-heater tube. The Deproteinize, Condition, Prime, Disinfect and

Stop System
routines are in the Maintenance Menu.

Maintenance should be carried out with the instrument functions suspended, using the
Stop System routine.

When replacing the pump tubing kits drain the 248 using the Prime
routine.

Main Menu → Maintenance

1 Deproteinize 5 Stop System

2 Condition 3 Prime
4 Disinfect

press 1 - 5 or * to Exit

Daily Maintenance

Equipment: Buffer Pack, (473496) as required; Wash Pack, (473497) as required; 10% v/v
bleach; clean tissues.

1. Check levels of reagents and replace if necessary. With typical use the reagents will need
replacing every 10 to 14 days. Replace the reagents if 30 days usage has been
exceeded. Agitate the buffer pack daily to incorporate any solution that may have
condensed on the inside of the bottles.

2. Check the waste bottle and empty if necessary (Page 3-4).

3. Wipe the probe sleeve, sample area, reagent compartment and external surfaces with clean
tissues moistened with 10% v/v bleach. Do not spray into the measurement block.
Page 3-2 248 Operator’s Manual

Daily Maintenance
NOTE: Do not use any cleaning material containing alcohol as this could cause certain
components to crack.

4. Clean the drip tray. Check it is located properly and the connector is fitted (Page 3-22).

5. Check there is enough paper in the printer - if the red stripe is showing replace the
paper (Page 3-23).

Weekly Maintenance
Equipment: As for daily maintenance, plus cal gas cylinder (Cat. 001 84 146E, or 477434000
or local equivalent – contact distributor) as required; slope gas cylinder (Cat. 001 84 147F, or
477438000 or local equivalent – contact distributor) as required; pH fill solution (Cat.

478533) and Reference fill solution (Cat. 478822) as required. Carry out daily maintenance

and use the Disinfect routine (Page 3-8), and:

1. Check the level of fill solution in the sensors. The reference sensor should be filled to the
line and the pH sensor should be almost full with only a small bubble at the top. Refill
the sensors if necessary, Pages 3-17 and 3-19.

NOTE: The p CO 2 and p O 2 sensors contain fill solution but cannot be refilled. Slight
discolouration of the fill solution in these sensors is normal.

2. Check the sensors for air bubbles in the fill solution. Remove the sensors and tap to
dislodge air bubbles, Pages 3-17 and 3-19.

3. Deproteinize and condition the sensors. (Deproteinizing and conditioning may be

prompted more frequently than once a week - see Section 5, Configuring the System).

4. Check the reference sensor for bubbles in the fill solution and for crystal growth. If air
bubbles are present, remove the sensor and tap it to dislodge air bubbles. If crystal
growth is present, remove the sensor, empty the fill solution and rinse with deionized
water, then refill the sensor with reference sensor fill solution, Cat. 478822. Clean off
excess fill solution using lint free tissue and deionized water. Push a clot removal line
into the vent hole to clear any fill solution crystals. See Page 3-19, Replacing the
Reference Sensor Cassette for details.

5. Check gas cylinder pressure. Replace cylinder if pressure is less than 300 psi.

Quarterly Maintenance
Equipment: As for daily/weekly maintenance, plus pump tubing kits (Cat. 673254 and 673257
or 673358); screwdriver, supplied with the Spares and Accessories Kit; mild detergent; drip tray
(Cat. 673255) as required. Carry out daily and weekly maintenance and:

1. Replace the pump tubing and the pump rotor mouldings, and clean and lubricate the pump
roller assembly. Date the pump tubing labels a maximum of 3 months ahead, Page 3-13.

NOTE: Under heavier workload conditions it may be necessary to replace the pump
tubing more frequently.

2. Replace the drip tray if it is becoming difficult to clean, Page 3-22.

Maintaining the System Page 3-3

✔ when maintenance has been carried out. Start Date . . . . . . . . . . . . . . .

Daily
• check calibrant levels and ‘change by’ date, shake buffer pack • wipe sample area, drip tray and external surfaces • check drip tray is
fitted and connected properly •

Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Weekly
• check fill solution in pH and reference sensors, and debubble sensors • deproteinize/condition sensors
• check gas cylinder pressure and flow rate •

1 2 3 4 5 6 7 8 9 10 11 12 13

14 15 16 17 18 19 20 21 22 23 24 25 26

27 28 29 30 31 32 33 34 35 36 37 38 39

40 41 42 43 44 45 46 47 48 49 50 51 52

Quarterly
• Use Disinfect routine • replace pump tubing, clean and lubricate rollers • replace drip tray if difficult to clean •

Wk 13 Wk 26 Wk 39 Wk 52

Six-monthly
• replace bottle tubing •

Wk 26 Wk 52
Page 3-4 248 Operator’s Manual

Six Monthly Maintenance

Equipment: As for daily/weekly/quarterly maintenance, plus Bottle tubing kit (Cat.
673250).

Carry out daily/weekly/quarterly maintenance and:

1. Replace the bottle tubing.

Emptying the Waste Bottle

BIOHAZARD: see Appendix A, Protecting Yourself from Biohazards.

Equipment: Disinfectant or sodium hypochlorite.

The display prompts you to empty the waste bottle. You can choose how often you want the
prompt to appear (see Page 5-5, Setting the Maintenance Prompts).

Ready 11:55:12

Lift probe to analyze

Empty waste bottle
syringe sample or press 1
then press *
capillary 2 QC

press # for menu

1. Stop the 248 system:

a. From Ready press # for menu, 2 for Maintenance and 5 for Stop
System.

2. Remove the waste bottle.

a. Lift the front cover.
b. Carefully pull the waste bottle forwards, tilting the top slightly away from you.

3. Dispose of the waste in accordance with your laboratory guidelines.

4. The Wash bottle and the 7.3 buffer bottle from the Buffer Pack can both be used as new
waste bottles when they are empty.

a. Peel off the top label from the top righthand corner to expose the waste label. To use
the 7.3 buffer bottle separate the label at the perforation. Slide the 6.8 buffer bottle off
and discard.

Figure 3-1. Separating Buffer Bottles

Maintaining the System Page 3-5

Emptying the Waste Bottle

NOTE: Siemens Healthcare Diagnostics recommends that approximately 10 mL of disinfectant

or sodium hypochlorite is put into the waste bottle before placing it in position.

5. Replace the waste bottle:

a. Tilt the top of the bottle away from you and slide the bottle into position.

b. Check that the neck of the waste bottle is positioned underneath the rubber cap. The
waste cap spout should be inside the neck of the waste bottle.

Figure 3-2. Replacing the Waste Bottle

Waste Cap Spout

6. Lower the cover.

7. Press * to restart the 248. Press * twice more to exit to the Ready
screen. The 248 will calibrate.

8. When the Ready screen reappears, press * to cancel the waste

bottle prompt.

Changing the Reagents

Check the reagent levels and ‘change by’ date regularly. If either the Buffer Pack or Wash
bottle is empty, or if the Buffer bottle is past the ‘change by’ date replace it as follows.

1. Stop the 248 system: From Ready press # for menu, 2 for Maintenance and 5 for Stop
System.

2. Raise the front cover and remove the empty bottle. The Wash bottle and the 7.3 buffer
bottle from the Buffer Pack can both be used as new waste bottles.

a. Peel off the top label from the top righthand corner to expose a waste label. To use
the 7.3 buffer bottle separate the label at the perforation. Slide the 6.8 buffer bottle
off and discard.

3. Remove the cap from the replacement bottle.

4. Feed the bottle tubing into the neck of the bottle and into the solution.
Page 3-6 248 Operator’s Manual

Changing the Reagents

5. Tilt the top of the bottle slightly away from you and slide into position.

Figure 3-3. Positioning the Reagents

6. Press the cap firmly onto the neck of the bottle.

7. If you are changing the buffer bottles, date the label 30 days ahead.

Figure 3-4. Dating the Buffer Label

8. Lower the front cover and press * to restart the 248.

9. From Maintenance press 3 for Prime.

The Prime routine pumps the new reagent through the system.

10. When the Prime routine has finished, press * twice to exit. The 248
calibrates on return to the Ready screen.
Maintaining the System Page 3-7

Deproteinizing the Sensors

Equipment: Deproteinizer/Conditioner pack or Deproteinizer (Cat. 105610).

1. Activate the Deproteinizer by mixing D1a and D1b.
a. Tap the vial (D1b) before opening to return all the pepsin powder to the bottom of the
vial.
b. Gently add solution D1a.
c. Cap and shake the vial until the powder has dissolved, this will take a few seconds.
The powder must be completely dissolved before the solution is used.

Figure 3-5. Activating the Deproteinizer

2. From the Ready screen press # for menu, 2 for Maintenance and 1
for Deproteinize.

3. Following the instructions on the screen, lift the probe to the first position and present the
deproteinizing solution. Hold the solution in place until prompted to remove it, then
close the probe.

4. The Deproteinizer is left in contact with the sensors for 5 minutes, and the screen shows
the time remaining. When deproteinizing is finished, the 248 washes and will calibrate
on return to the Ready
screen.
You can cancel the Deproteinize routine to measure a sample by pressing *. The
248 washes and will calibrate on return to the
Ready screen.

Conditioning the Sensors

Equipment: Deproteinizer/Conditioner pack or Conditioner (Cat. 478701).

1. From the Ready screen press # for menu, 2 for Maintenance and 2
for Condition.

2. Following the instructions on the screen, lift the probe and present the conditioning
solution.
Hold the solution in place until prompted to remove it, then close the probe.

3. The Conditioner is left in contact with the sensors for 5 minutes, and the screen shows the
time remaining. When conditioning is finished, the 248 washes and will calibrate on
return to the Ready
screen.
You can cancel the Condition routine to measure a sample by pressing *. The 248
washes and will calibrate on return to the
Ready screen.
Page 3-8 248 Operator’s Manual

Using the Disinfect Routine

BIOHAZARD: See Appendix A, Protecting Yourself From Biohazards.

CAUTION: Disinfectant should be used in accordance with the manufacturer’s

instructions.
We have tested the following disinfectants for compatability with our sensors:
• 2% activated glutaraldehyde solution
• 1% or 2% Virkon
• 10% v/v bleach
2% activated glutaraldehyde solution has no detrimental effect on the sensors, and is
available from Siemens as Cat. 673390.
CAUTION: Both Virkon and 10% v/v bleach affect the reference sensor. To prevent damaging
the reference sensor if you use either of these two disinfectants, you must remove it and
replace it with an old sensor. Alternatively, use a Test blank sensor - ref (TB5), Cat.
673396000. Equipment: Bleach or Virkon or Activated glutaraldehyde solution (Cat. 673390);
Test blank sensor (Cat. 673396000) as required. The Disinfect routine allows disinfectant to
be pumped through the probe and sample path and left in place for 10 minutes. It should be
carried out before replacing the pump tubing, sensors or the probe and tubing. It should also
be carried out after analyzing a sample known or suspected to contain dangerous pathogens.

NOTE: To prevent protein fixation, we recommend deproteinizing the system (Page 3-7)
before using the Disinfect routine.
1. From Ready press # for menu, 2 for Maintenance and 4 for Disinfect.
2. Following the instructions on the screen, lift the probe to the first position and present the
disinfectant.
Hold the solution in place until prompted to remove it, then close the probe.
3. The Disinfectant is left in the measurement block for 10 minutes, and the screen shows the
time remaining. When the routine is finished, the 248 washes and will calibrate on return
to the Ready screen. You can cancel the Disinfect routine to measure a sample by
pressing *. The 248 washes and will calibrate on return to the Ready screen.

4. You can remove the probe and tubing and measurement block tubing, Page 3-24, and
sample pump tubing, Page 3-13, and soak for 10 minutes in 10% v/v bleach.

CAUTION: Always observe good laboratory practices when handling any component of the 248
under biohazardous conditions. Siemens is unable to accept responsibility for the effectiveness
of the disinfectant used or of the Disinfect routine.

Stopping the 248 System

This routine suspends instrument functions, for example, calibrations, while you are carrying
out routine maintenance such as changing the reagents, sensors, tubing, gas cylinders and
pump tubing, or while clearing blockages.

If Beeper On is selected (see Page 5-6, Changing Beeper Option) the 248 will beep after 30
minutes in Stop System. Press # to cancel the beeper. Do not leave the 248 system stopped
for longer than necessary, as this may damage the sensors and pump tubing.
Maintaining the System Page 3-9

Stopping the 248 System

1. From Ready press # for menu, 2 for Maintenance and 5 for Stop
System.

System stopped

Press * to restart

2. Carry out the maintenance task.

3. Press * to restart the 248 system. The 248 calibrates on return to

the Ready screen.

Using the Prime Routine

This routine drains and pumps solution through the 248 and should be used when replacing
the pump tubing, changing reagents or pumping disinfectant through the manifold.

Draining the 248

1. Raise the front cover and remove the Buffer pack and Wash bottle. Do not remove the
Waste bottle. Place tissues under the bottle tubes to catch any spillage.

2. From Ready press # for menu, 2 for Maintenance and 3 for Prime.

→ Maintenance → Prime

Priming please
wait

3. The 248 pumps and drains the system.

Priming the 248

1. Follow the appropriate maintenance procedure, then from Ready
press # for menu, 2 for Maintenance and 3 for Prime.

2. The 248 primes the system.

→ Maintenance → Prime

Priming please
wait

If necessary, repeat the routine to thoroughly prime the system.

3. Press * twice to return to the Ready screen.

Page 3-10 248 Operator’s Manual

Checking the Gas Pressure and Changing the Cylinders

Checking the Gas Pressure

1. Check the main cylinder and second stage pressure.

Figure 3-6. Checking the Gas Pressure

Main Cylinder
Second Stage Pressure Gauge
Pressure Gauge

The main cylinder pressure must be higher than 300 psi. The second stage
pressure must be 4 ± 1 psi.

2. If the main pressure is less than 300 psi, check that the cylinder valve is open. If it is and
the pressure is low, the cylinder is empty. Change the cylinder.

Changing the Cylinders

CAUTION: The instructions given are for Siemens gas cylinders and regulators and we
recommend the use of these at all times. If you use other cylinders and regulators they
must meet the following specfication:

• Only certified value gas cylinders should be used.

For calibration gas the value should be 5% CO 2 ( acceptable range 4 to 6%) and 12%
O 2 ( acceptable range 10 to 14%), balance N 2.

For slope gas the value should be 10% CO 2 ( acceptable range 8 to 12%) and 0% O 2 ( acceptable
range 0 to 2%), balance N 2.

The gas values used must be entered (see Section 5, Configuring the System).

• The regulator must have a low diffusion diaphragm to prevent selective diffusion and
alteration of the gas values. All fittings must be leak free. The regulator must have a low
flow precision needle valve for gas flow adjustment and supply 4 ± 1 psi at a flow of up to
20 cc/minute. When the needle valve is closed the output psi must not rise by more than
2 psi compared to the ‘open’ output.

• The tubing used must not allow selective diffusion of CO 2, O 2 or N 2.

Siemens tubing is designed to maximize through-flow rates, reducing the diffusion
rates. The accuracy of the 248 is adversely affected by the use of diffusive tubing.

• Siemens assumes no liability for performance when non-standard equipment is used.

Maintaining the System Page 3-11

Changing the Cylinders

WARNING Compressed gas cylinders require careful handling. To prevent damage and
possible personal injury, observe the following precautions:

• Never drop cylinders, allow them to strike each other or subject them to other strong
shocks.

• Secure cylinders to a wall or bench, or place in a cylinder base support stand.

• Never drag, roll or slide cylinders, even for short distances. Use a suitable hand truck
to move cylinders.

• Never tamper with safety devices in regulators or cylinders.

• Use these gases for the calibration of clinical and research instrumentation only. US
Law prohibits dispensing these gases for drug use.

• The contents are under pressure – do not puncture.

• Do not use or store near heat or open flame.

• Do not expose cylinders to temperatures above 54 ° C (130 ° F) as this may cause the
contents to vent or explode.

• Never throw cylinders into fire or incinerators. Follow the disposal instructions on the
cylinders.

Equipment: Cal gas cylinder; Slope gas cylinder, as required.

1. Stop the 248 system, Page 3-8

2. Remove and dispose of the empty cylinder:

Figure 3-7. Changing the Gas Cylinder

Gas Cylinder Seal

Needle Valve
Yoke Screw

Cylinder Valve

a. Close the cylinder by turning the cylinder valve clockwise.

b. Unscrew the yoke screw to disconnect the gas regulator.

c. Remove the cylinder to a well-ventilated, open area.

d. Position the valve outlet so that it is facing down, away from people and loose
objects.

WARNING Avoid contact with the gas stream. Gas under pressure can cause bodily
injury or damage to property.

e. Slowly turn the cylinder valve anticlockwise to release the cylinder contents.
Page 3-12 248 Operator’s Manual

Changing the Cylinders

f. When the cylinder is completely vented, and the pressure is reduced to zero,
label the cylinder ‘empty’ and dispose of it according to your laboratory
protocol.

3. Install the new cylinder. Make sure you replace the cylinder with the correct type.

a. Place the gas cylinder into its final position and secure.

b. Remove the plastic protective wrapping from the valve assembly.

c. Check the gas cylinder seal is in place on the regulator.

d. Attach the gas regulator to the cylinder with the regulator nipple engaging the opening
in the cylinder valve.

e. Tighten the yoke screw firmly.

f. Slowly open the cylinder valve until the pressure gauge indicator stops rising
(approximately 3/4 of a turn, average psi is 2000).

g. Open the cylinder valve one more turn.

h. Listen carefully for any gas leakage. Use soapy water to check for bubbles.

CAUTION: The needle valve is easily damaged. Turn the valve gently when
opening.

i. Check the needle valve is fully open.

j. If the gas will not be used for an extended period of time, close the cylinder by
turning the cylinder valve clockwise, otherwise continue.

4. Restart the 248 system.

Checking the Gas Flow Rate

1. Initiate a full 2 point calibration: From Ready press # for menu, 1 for Calibration and 2 for
Full 2 Point.

2. The gas flow rate is checked while the gas is being measured:

a. When the calibration gas values appear on the display lift the probe lever to the
first position.

b. Fit a capillary adaptor to the end of the probe (this makes the bubbles easier to
count).

c. Present a small beaker of deionized water to the probe. The bubbles should
flow at a rate of no less than 2 per second.

d. Remove the capillary adaptor and close the probe.

3. Repeat for the slope gas:

a. When the slope gas values appear on the display lift the probe and repeat steps 2b
to 2d.

4. If either of the gas flow rates is incorrect contact your Siemens distributor.
Maintaining the System Page 3-13

Changing the Pump Tubing, and Cleaning and Lubricating the Rollers

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards

Equipment: Pump tubing kits (Cat. 673254 and 673257 or 673358); screwdriver, supplied
in the Spares Kit; mild detergent; disinfectant (for example, Cat. 673390).

The 248 has two sets of pump tubes. The lefthand set is the sample pump tubing and
has two tubes. The righthand set is the reagent tubing and has three tubes. For optimum
performance both pump tubing kits should be changed together.

Change the pump tubing on or before the dates shown on the label.

Changing the Pump Tubing

1. Use the Disinfect routine and drain the 248, Pages 3-8 and 3-9. Stop
the 248 system, Page 3-8.

2. Raise the front cover.

Sample Pump
Remove the tubing:

a. Remove the waste bottle.

b. Disconnect the waste cap connector from the manifold.

c. Disconnect the sample tube from the measurement block tube, and the waste tube
from the manifold.

d. Release the tension on the tubes by pulling each tube down and to the side until the
lug is clear of the tensioner.

e. Remove the pump tubing.

Figure 3-8. Removing the Sample Pump Tubing

Tensioner

Block Tube

Measurement

Waste Tube
Connector Lug

Waste Cap

Reagent Pump
Remove the tubing:

a. Disconnect the rubber connector from the manifold.

b. Release the tension on the tubes by pulling each tube down and to the side until the
lug is clear of the tensioner.

c. Remove the pump tubing.

Page 3-14 248 Operator’s Manual

Reagent Pump

Figure 3-9. Removing the Reagent Pump Tubing

Connector

Cleaning and Lubricating the Rollers

1. Remove the finger screw holding the pump rotor in place and slide the rotor off the
moulding. Rubber

NOTE: The drive pin may drop out - if you lose it there is a spare in the Spares box.

Figure 3-10. Removing the Pump Rotor

Drive Pin

2. Remove the pump rotor mouldings:

a. Pull the pump rotor ends apart and wash the rollers in mild detergent solution,
rinse and dry with tissues.

Figure 3-11. Removing the Pump Rotor Mouldings

Maintaining the System Page 3-15

Cleaning and Lubricating the Rollers

3. With the grease supplied, lightly lubricate each roller at the points shown. Re-assemble the
rotor using the new pump rotor mouldings.

Figure 3-12. Lubricating the Rollers

Lubrication Points

4. Replace the pump rotor. Make sure the drive pin is located correctly.

Installing New Pump Tubing

1. Install the new pump tubing:

a. Date the label a maximum of 3 months ahead.

Figure 3-13. Dating the Pump Tubing Label

Sample Pump
2. Install the new sample pump tubing:

a. Connect the waste cap connector to the manifold. Push firmly into position.

b. Place the pump tubes over the rotor knob.

c. Connect the front tube to the measurement block tube, and the back tube to the
manifold.

d. Pull the tube lugs underneath the tensioners.

e. Replace the waste bottle.

Reagent Pump
3. Install the new reagent pump tubing:

a. Loop the pump tubes over the rotor.

b. Pull the tube lugs underneath the tensioners.

Page 3-16 248 Operator’s Manual

Reagent Pump
c. Connect the rubber connector to the manifold. Push firmly into position.

d. Refer to Figure 3-14 to make sure the tubes are fitted correctly.

Figure 3-14. Reagent Pump Tubing Correctly Installed

✗ ✔
4. Make sure none of the pump tubes are kinked or twisted, refer to Figure 3-15.

Figure 3-15. Example of Twisted Tube

5. Replace the reagent bottles, lower the front cover and restart the 248 system.

6. Prime the 248, Page 3-9.

Maintaining the System Page 3-17

Refilling or Replacing the Measurement Sensors

BIOHAZARD: See Appendix A, Protecting Yourself From Biohazards.

Equipment: pH fill solution (Cat. 478533) as required; replacement sensors, as required;

disinfectant (for example, Cat. 673390).

NOTE: Although the p CO 2 and p O 2 sensors contain fill solution they cannot be refilled. To
replace the p CO 2 and p O 2 sensors, follow the instructions in steps 1 - 4 and 6 - 8.

1. Use the Disinfect routine and then stop the 248 system, Page 3-8.

2. Raise the front cover.

3. Slide the measurement block catch down and raise the block cover.

Figure 3-16. Opening the Measurement Block Cover

4. Swing and hold the tensioner to the right and remove the appropriate sensor.

Figure 3-17. Removing a Sensor

5. Refilling the pH sensor:

CAUTION

• Make sure you use pH fill solution. Do not use reference sensor fill solution.

• Do not touch the inner electrode as it is fragile and easily damaged.

a. Unscrew the inner electrode and set aside on lint-free tissue.

b. Empty the fill solution out of the sensor.

Page 3-18 248 Operator’s Manual

Refilling or Replacing the Measurement Sensors

c. Fit a needle to the fill solution container, rinse out the sensor body with a few drops of
fill solution and refill the sensor almost full, leaving a small bubble at the top. Tap the
sensor during filling to dislodge air bubbles.

d. Replace the inner electrode - screw down tightly. Be careful not to cross-thread the
electrode. Shake the sensor down like a thermometer to dislodge air bubbles at the
sensor capillary.

Figure 3-18. Refilling the pH Sensor

e. Wipe the sensor with dry, lint-free tissue and check that the ‘O’ ring is in position on the
lefthand side, and is in good condition.

6. Tap the sensor to release any trapped air bubbles.

7. Install the sensor top first, aligning the sensor contacts. Press the bottom of the sensor into
position. Gently release the tensioner and push it firmly home to make a good seal.
Lower the block door, snapping it into place. Lower the front cover.

8. Press * to restart the 248 system. The 248 calibrates on return to the Ready screen.

NOTE: Siemens recommends that you use the condition routine after refilling or replacing a
pH sensor. If a new sensor is installed we recommend waiting up to 90 minutes for the
system to stabilize. If you want to use the system during this settling in time frequent
calibrations are necessary. Running 10 QC samples before use will promote stability.
Maintaining the System Page 3-19

Replacing the Reference Sensor Cassette

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards.

Equipment: Reference sensor cassette (Cat. 478498) as required; Reference inner (Cat.
478509) as required; disinfectant (for example, Cat. 673390); clot removal line (Cat.
478645).

1. Use the Disinfect routine and stop the 248 system, Page 3-8.

2. Raise the front cover.

3. Slide the measurement block catch down and raise the block cover.

Figure 3-19. Opening the Measurement Block Cover

4. Swing and hold the tensioner to the right and remove the reference sensor.

Figure 3-20. Removing the Reference Sensor

5. Replace the reference sensor cassette:

CAUTION: Make sure you use reference fill solution. Do not use pH sensor fill solution.

a. Break the top off the reference fill solution container, and fit the needle.

b. Slowly inject solution into the internal reference compartment of the new cassette.
Continue filling until the liquid level is flush with the sensor reservoir.
Page 3-20 248 Operator’s Manual

Replacing the Reference Sensor Cassette

Figure 3-21. Filling the Internal Reference Compartment

New Cassette

NOTE: Use the hex tool supplied to remove the reference electrode inner and reservoir cap.

CAUTION: Do not touch the reference electrode inner as it is fragile and easily damaged.

c. Remove the electrode inner from the old cassette, or, if you are installing a new
reference inner remove it from its container, and screw into the new internal reference
compartment. Do not cross-thread the electrode inner.

Figure 3-22. Changing the Reference Inner

Old Cassette New Cassette

d. Inject the remaining solution into the reservoir up to the fill line, and replace the
reservoir cap until finger tight.

Figure 3-23. Filling the Reference Reservoir and Replacing the Cap

e. Tilt the reference cassette and tap the front with your knuckle to remove air bubbles.
Maintaining the System Page 3-21

Replacing the Reference Sensor Cassette

f. Carefully clean off any excess fill solution using clean, lint-free tissue and deionized
water. Push the clot removal line through the vent hole to clear any fill solution
crystals.

6. Check that ‘O’ rings are fitted to each side of the sensor and are in good condition.

7. Refit the reference sensor top first, aligning the sensor contacts. Press the bottom of the
sensor into position. Make sure all the sensors are seated correctly, then push the
tensioner firmly home to make a good seal. Lower the block cover, snapping it into place.

8. Lower the front cover and restart the 248 system. The 248 calibrates on return
to the Ready screen.

NOTE: Following a change of reference sensor cassette it is normal for the 248 to require a
stabilization period of 30 minutes before optimum performance is obtained. If an over or
under range condition is present on the pH channel there is probably an air bubble trapped in
the reference sensor. Remove the sensor and tap it until the air bubble has been dislodged.
Re–install the sensor.

Figure 3-24. Trapped Air Bubble in Reference Sensor

Vent Hole

Trapped Air Bubble

Replacing the Bottle Tubing

Equipment: Bottle tubing kit (Cat. 673250).

1. Drain the 248 and stop the system, Page 3-9.

2. Disconnect the three sets of bottle tubing from the manifold.

3. Install the new bottle tubing.

NOTE: If you break or lose a bottle tubing connector there is a spare in the Spares box.

4. Replace the Buffer Pack and Wash bottle:

a. Feed the bottle tubing into the neck of the bottles and into the solution.

b. Tilt the top of the bottle slightly away from you and slide into position.

c. Press the cap firmly onto the neck of the bottles.

5. Lower the front cover and press * to restart the 248.

6. Prime the 248, Page 3-9.

Page 3-22 248 Operator’s Manual

Cleaning or Replacing the Drip Tray

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards.

Equipment: Drip tray (Cat. 673255); disinfectant

1. Stop the 248 system, Page 3-8.

2. Raise the front cover.

3. Lift the probe lever to the second position.

4. Disconnect the drip tray connector from the manifold.

5. The drip tray is held in place by a magnet and you will feel some resistance as you
remove it.
Hold the drip tray at the bottom and pull upwards and out.

Figure 3-25. Removing the Drip Tray

Drip Tray Connector

CAUTION: The drip tray is not designed to be autoclaved and reused.

6. Clean the drip tray with disinfectant. Replacement drip trays are available (see Section 6, Service
and Supplies) if it becomes difficult to clean.

7. Refit the drip tray. Make sure the connector is reconnected to the manifold.

WARNING The drip tray is designed to contain any blood drips, and to keep the probe clean.
Failure to install it could result in a build up of blood deposits, and a potentially biohazardous
situation. Do not
operate the 248 without the drip tray in place.

8. Lower the front cover and restart the 248.

Maintaining the System Page 3-23

Replacing the Printer Paper

Equipment: Printer paper (Cat. 673252).

CAUTION: Only use Siemens printer paper. Other paper may affect print quality or
damage the printer.

Replace the printer paper when the red stripe appears or when prompted by the
display.

1. Tilt the paper cover backwards.

2. Tear off any remaining paper, and remove the old paper roll.

3. Make sure the end of the new paper roll is square. Hold the new paper roll in one hand with
the paper coming from the bottom of the roll and towards you. Bend the end of the paper
back slightly.

CAUTION: Make sure you feed the paper in correctly. If the paper is fed in incorrectly the
printer will not print, and it may cause paper jams.

Figure 3-26. Loading the Printer Paper

4. Feed the paper down into the paper slot, and press the key
until the feed mechanism takes up the paper and pulls it.

Figure 3-27. Feeding the Printer Paper into the 248

5. Place the paper roll in the holder. Close the paper cover.

6. Press the key again until the paper appears through the tearer
at the front of the 248.

7. Test the printer, to check that the printout is clear, Page 4-13.
Page 3-24 248 Operator’s Manual

Replacing the Probe and Tubing and Probe Housing

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards.

Equipment: Probe and tubing kit (Cat. 673251) or Probe and housing kit (Cat. 673253), as
required; disinfectant (for example, Cat. 673390).

1. Use the Disinfect routine and stop the 248 system, Page 3-8.

2. Raise the front cover.

3. Lift the probe lever to the second position.

4. Push the probe connector to the left and pull it out of the reagent inlet connector.

Figure 3-28. Disconnecting the Probe Connector

Connector

5. Lift the probe lever past the second position and hold in place.

Figure 3-29. Probe Lever Positions

Closed First Position Second Position Holding past the second position Probe
Maintaining the System Page 3-25

Replacing the Probe and Tubing and Probe Housing

6. Carefully hold the probe sleeve and pull firmly to remove the probe housing. Release the
probe lever.

Figure 3-30. Removing the Probe Housing

7. If you are replacing both the probe and the housing go to step 12. If not continue with step
8.

8. If you want to clean the probe and housing:

• Soak the assembly for 10 minutes in 10% v/v bleach.
• Rinse with deionized water and gently dry with tissues.
• Lightly grease the probe shaft mechanism (use the grease supplied in the
Spares box).

Figure 3-31. Greasing the Probe Shaft Mechanism

Probe Shaft Mechanism

9. Disconnect the probe tubing from the housing. Pull the probe out of the housing. Discard
the old part.

WARNING Make sure the old probe is disposed of safely, in accordance with your laboratory
guidelines.
Page 3-26 248 Operator’s Manual

Replacing the Probe and Tubing and Probe Housing

Figure 3-32. Disconnecting the Probe Tubing from the Probe Housing

Figure 3-33. Removing the Probe from the Probe Housing

10. Using replacement parts as required, feed the probe down through the hole in the probe
sleeve. Make sure it is seated correctly.

Figure 3-34. Probe Sleeve Hole

11. Connect the probe tubing to the housing.

12. Lift the probe lever past the second position and hold in place.

13. Hold the probe sleeve and slide the probe housing up the lever guides into position in the
lever. Release the probe lever.
Maintaining the System Page 3-27

Replacing the Probe and Tubing and Probe Housing

Figure 3-35. Replacing the Probe Housing

14. If necessary, fit ‘O’ rings to the probe connector. (Spare ‘O’ rings are in the Spares box.)

15. Slide the probe connector back into the reagent inlet connector.

16. Lower the probe lever.

17. Remove the reference sensor, Page 3-19 steps 3 and 4.

18. Disconnect the measurement block tube from the sample pump tubing.

Figure 3-36. Disconnecting the Measurement Block Tube

19. Remove the measurement block tube and discard.

Figure 3-37. Removing the Measurement Block Tube

Page 3-28 248 Operator’s Manual

Replacing the Probe and Tubing and Probe Housing

CAUTION: Take care when handling the measurement block tube as the residue from some
protective gloves can adhere to the tube and therefore affect the fluid detector (FD2).

20. Fit the new measurement block tube and reconnect the sample pump tubing.

21. Replace the reference sensor, Page 3-21 step 7.

22. Lower the front cover and restart the 248.

23. To promote good flushing characteristics:

a. Raise the probe lever to the first position.

b. Immerse the tip of the probe in a small beaker of strong soap solution for 10 to 15
seconds.

c. Lower the probe lever and Prime the 248, Page 3-9.

Replacing the Probe Protector

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards.

Equipment: Probe protector, supplied in Spares box, Probe and tubing kit, Probe and
housing kit, and as Cat. 673373.

1. Remove the probe housing and probe, Page 3-24 steps 1 to 6. Do not discard the probe or
housing.

2. Remove the probe protector from the probe housing.

Figure 3-38. Removing the Probe Protector

3. Fit a new probe protector.

4. Re-assemble the probe and housing, Page 3-26, steps 12 to 16.

5. Lower the front cover and restart the 248.

Maintaining the System Page 3-29

Replacing the Pre-heater Tube

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards.

Equipment: Pre-heater tube kit (Cat. 673256); cross-headed screwdriver;

disinfectant (for example, Cat. 673390).

1. Use the Disinfect routine and then stop the 248 system, Page 3-8.

2. Remove the probe and probe housing, Page 3-24, steps 2 to 6.

3. Remove the p O 2 and p CO 2 sensors, Page 3-17, steps 3 and 4.

4. Disconnect the reagent manifold connector.

Figure 3-39. Pre-heater Components

Sample Detector
Cover

Pre-heater
Cover

Reagent Manifold
Connector

5. Remove the sample detector cover.

6. Remove the screw from the pre-heater cover and remove the cover.

Figure 3-40. Removing the Sample Detector Cover

CAUTION: Handle the pre-heater tube carefully as it is quite fragile and can easily be kinked.

7. Slide the reagent inlet connector towards you. Ease the pre-heater tube from the groove in
the pre-heater.

8. Carefully push the tube towards the measurement block to free the block connector.
Page 3-30 248 Operator’s Manual

Replacing the Pre-heater Tube

Figure 3-41. Removing the Pre-heater Tube

Pre-heater Tube

Plastic Moulding

Reagent Inlet Block Connector

Connector

9. Ease the pre-heater tube under the plastic moulding.

10. Re-assemble using the new pre-heater tube assembly. Make sure that:

• The pre-heater tube is in the pre-heater groove, and the block connector is in
place.

• The reagent inlet connector is in place.

• The pre-heater cover and sample detector cover are replaced.

• The reagent manifold connector is connected.

• The sensors are replaced and seated correctly, and the block cover is closed.

11. Replace the probe and probe housing, Page 3-26, steps 12 - 16.

12. Lower the front cover and restart the 248.

Maintaining the System Page 3-31

Clearing Blockages

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards.

Always wear protective gloves when carrying out this procedure, and avoid spray
contamination when clearing blockages with water.

Equipment: Clot removal line (Cat. 478645); 1 mL syringe, as required.

CAUTION: Only use Siemens clot removal line as other materials may damage the 248.

1. Stop the 248 system, Page 3-8.

Clearing a Blockage in the Probe

2. Remove the probe and housing, Page 3-24 steps 2 to 6.

3. Carefully thread the clot removal line up the probe until it appears through the probe
connector, then pull the line through.

Figure 3-42. Clearing a Blockage in the Probe

Clearing a Blockage in the Pre-heater

4. Remove the pre-heater tube assembly, Page 3-29 steps 3 to 9.

5. Pass the clot removal line through the pre-heater tube then pull the line through the reagent
inlet connector.

Figure 3-43. Clearing a Blockage in the Pre-Heater

Page 3-32 248 Operator’s Manual

Clearing Blockages

Clearing a Blockage in the Sensors

6. Remove the sensors, Page 3-17 steps 3 and 4.

7. Use the syringe filled with deionized water to carefully inject water through the sensors but
apply only very gentle pressure.

Figure 3-44. Clearing a Blockage in the Sensors

8. Pass the clot removal line through the grounding block. Do not pass the clot removal line
through the sensors.

Figure 3-45. Clearing a Blockage in the Grounding Block

Clearing a Blockage in the Drip Tray Connector Drain Hole

9. Remove the drip tray, Page 3-22 steps 3 to 5.

10. Carefully inject water into the ports in the back of the drip tray connector.

WARNING Point the drip tray away from you while you do this.

Figure 3-46. Clearing a Blockage in the Drip Tray Connector Drain Hole
Maintaining the System Page 3-33

Clearing Blockages

Clearing a Blockage in the Measurement Block Tube

11. Disconnect the measurement block tube from the sample pump tubing connector.

Figure 3-47. Disconnecting the Measurement Block Tube

12. Thread the clot removal line up the measurement block tube until it appears in the
measurement block. Pull the line through.

Figure 3-48. Clearing a Blockage in the Measurement Block Tube

13. Carefully inject water into the sample pump tubing, until water appears at the waste
cap.

Figure 3-49. Clearing a Blockage in the Sample Pump Tubing

14. Reconnect the sample pump tubing to the measurement block tube.
Page 3-34 248 Operator’s Manual

Clearing Blockages

Clearing a Blockage in the Manifold

15. Disconnect the waste tube from the manifold.

Figure 3-50. Clearing a Blockage in the Manifold

Drip Tray
Drain Hole

16. Gently inject water into the waste tube port until it appears at the drip tray drain hole. Hold
tissues against the drain hole to catch the drips.

17. Re-assemble the 248, restart the system and deproteinize the sensors, Page 3-7.

Replacing a Fuse

Equipment: Fuses (Cat. 478648 or 478916).

CAUTION: For continued protection against fire hazard use only the same type and rating of
fuse that was fitted originally to the 248 - refer to instrument rear panel.

1. Remove the power supply cord.

2. Open the voltage selector cover with the screwdriver supplied in the Spares box.

Figure 3-51. Opening the Voltage Selector Cover

3. Remove the fuse holders and replace the fuse(s).

Maintaining the System Page 3-35

Replacing a Fuse

Figure 3-52. Replacing Fuses

4. Close the voltage selector cover. Make sure that the voltage selector bobbin is set to the
correct voltage for the local power supply.

NOTE: If you have a 230V supply, use the 240V setting on the voltage selector bobbin.

CAUTION: Do not rotate the voltage selector bobbin when it is fitted as this will damage the
contacts.

Figure 3-53. Checking the Voltage Setting

Voltage Setting

5. Reconnect the power supply cord.

Shutting Down the 248

BIOHAZARD: See Appendix A, Protecting Yourself from Biohazards.

Wear gloves while carrying out the following procedures. Siemens recommends that the 248
is connected to the a.c. supply at all times so it is always ready for immediate use. However,
if it is necessary to disconnect the a.c. supply this procedure should be followed to prevent
damage to the instrument. Equipment: Disinfectant (for example, Cat. 673390); tissues.

1. Print out the Setup report and retain so that you have a record of all the settings, Page
5-7.

2. Use the Disinfect routine, Page 3-8.

Page 3-36 248 Operator’s Manual

Shutting Down the 248

3. Disinfect the manifold and bottle tubing, and drain the system.

CAUTION: To prevent damaging the reference sensor if you use Virkon or 10% v/v
bleach, you must remove the sensor and replace it with an old sensor, or a test blank
sensor - ref (TB5) Cat. 673396000.

a. Remove the Buffer pack and Wash bottle and replace with a beaker of
disinfectant. Do not remove the waste bottle.

b. From the Maintenance menu press 3 for Prime.

c. When the Prime routine finishes, remove the disinfectant and replace with a beaker
of deionized water.

d. Press 3 to prime the 248 again. This flushes the system with
water.

e. When the Prime routine finishes remove the beaker of water. Place tissues under
the bottle tubes to catch any drips.

f. Press 3 to prime the 248 again. This drains the system.

g. Remove the waste bottle and cap it.

4. Turn the gas cylinder valves clockwise to close the cylinders.

5. Disconnect the line cord from the power supply socket.

6. Remove the probe and housing and immerse in 10% v/v bleach for 10 minutes, Page
3-24. Rinse with deionized water, then gently wipe dry. If necessary, grease the probe
shaft lightly with the grease supplied in the Spares box.

7. Remove the pH, p CO 2 and p O 2 sensors, Page 3-17.

8. Remove the reference sensor, Page 3-19. If you are removing the reference sensor
from the 248 for more than 12 hours follow this procedure to prevent damage to the
Nafion inner:

a. Remove the electrode inner and store it in its container in saturated KCl. Do not
leave the inner out of solution for longer than 10 minutes.

b. Shake out the remaining KCl solution from the sensor cassette and rinse with
deionized water. Flush the reference sensor sample path with deionized water, and
allow the cassette to dry. (To reactivate the reference sensor follow the procedure for
installing a new sensor cassette.)

9. Wipe the measurement block to remove any reference fill solution.

10. De-tension the pump tubes.

11. Clean the drip tray.

12. Wipe the external surfaces with tissues and 10% v/v bleach.
 Page 4-1

4 Troubleshooting the System

The 248 continually performs self-diagnostic tests to maintain integrity of results. If the
instrument detects an abnormality, setup options may be reset to default and the 248 will
display Check Setup. You can still use the 248 but the data relating to the result will be default
(factory set) values. If Check Setup is displayed check the setup options in Operating Setup, Page
5-1, System Setup, Page 5-4 and Service Setup, Page 5-7. You will also need to check the
barometer calibration setting, Page 2-9. When you have checked all the setup options, exit to
the Ready screen and press * to clear the Check Setup message. If the 248 does not respond
to any user input refer to Page 4-14, Using the Status Indicators, and check status indicator 1,
microprocessor. If the roll printer is off, select On and Results + Cals ( Page 5-3) as the
printout may give further details of the problem.

Calibration Failures

The possible causes for standardization failure have been grouped together under the
following headings: calibration or slope drift ( ↑, ↓ on display and printout), calibration or slope
no endpoint (* on display and printout), calibration or slope outside range (! on display and
printout), fluidics failures.

Calibration or Slope Drift New

Sensors Installed
If a new sensor has been installed, allow up to 90 minutes for it to stabilize. If the calibration
still fails after this time either wait a further 90 minutes or run 10 samples using the
Measurement Block - Run Test Sample routine to promote stability, Page 4-11. (This
diagnostic routine has to be used to measure as the 248 has not calibrated successfully -
do not use the results.)

Reference Sensor (pH drift)

Bubble in reference sensor
De-bubble the sensor.

Nafion inner is dry due to a large bubble, or not screwed down properly, or poorly fitting

Replace Nafion inner if dry, or refit correctly. Sensor is clogged with crystals
caused by poor filling, or bubbles creating crystal growth

Empty sensor cassette and refill carefully with reference sensor fill solution. Vent hole
blocked

Unblock the vent hole in the reservoir cap. Failed

membrane
Replace sensor cassette. See
Page 3-19.
Page 4-2 248 Operator’s Manual

Calibration or Slope Drift pH

Sensor
Sensor needs deproteinizing/conditioning
Deproteinize/condition sensor, Page 3-7.
Bubbles in fill solution, or insufficient or concentrated fill solution
Debubble sensor, or empty and refill, Page 3-17. The problem may
also be caused by the reference sensor.

pCO 2/ pO 2 Sensor
Sensor needs deproteinizing
Deproteinize sensor, Page 3-7.
Sensor failure (confirm by measurement block routine, Page 4-10)
Replace sensor.

System
Dampness around the sensors
Dry off measurement block and sensors. Check sensor ‘O’ ring seals and replace if
necessary. Check sensors are seated properly, and the tensioner is pushed firmly
home. See Pages 3-17 and 3-19. Partial blockage in sensors

Clear blockage, Page 3-31.

Gas pressure incorrect/gas flow rate incorrect/leaks in gas system/gas cylinders connected
incorrectly
Check gas pressure and flow rate/cure leaks/check gases connected correctly (cal to
cal, slope to slope). See Page 3-10.

Incorrect gas values entered

Enter correct values, Page 5-2. Barometric
pressure incorrect or changed
Enter correct barometric pressure, Page 2-9.

Calibration or Slope no Endpoint

All calibrations and sample measurements must be carried out with the front cover lowered.

Reference Sensor (pH no endpoint)

Bubble in reference sensor
De-bubble reference sensor.
Nafion inner is dry due to a large bubble, or not screwed down properly, or poorly fitting

Place Nafion inner if dry, or refit correctly. Sensor is clogged with crystals
caused by poor filling, or bubbles creating crystal growth

Empty sensor cassette and refill carefully with reference sensor fill solution. Vent hole
blocked
Unblock the vent hole in the reservoir cap. Failed
membrane
Replace sensor cassette. See
Page 3-19.
Troubleshooting the System Page 4-3

Calibration or Slope No Endpoint pH

Sensor
Sensor needs deproteinizing/conditioning
Deproteinize/condition sensor, Page 3-7.

Bubbles in fill solution, or insufficient or concentrated fill solution

Debubble sensor, or empty and refill, Page 3-17. The problem may

also be caused by the reference sensor.

pCO 2/ pO 2 Sensor
Sensor needs deproteinizing
Deproteinize sensor, Page 3-7.

Sensor failure (confirm by measurement block routine, Page 4-10)

Replace sensor.

System
Dampness around the sensors
Dry off measurement block and sensors. Check sensor ‘O’ ring seals and replace if
necessary. Check sensors are seated properly, and the tensioner is pushed firmly
home. See Pages 3-17 and 3-19. Partial blockage in sensors

Clear blockage, Page 3-31.

Gas pressure incorrect/gas flow rate incorrect/leaks in gas system/gas cylinders connected
incorrectly
Check gas pressure and flow rate/cure leaks/check gases connected correctly, Page
3-10.

Bubble in sample path - specifically under the reference sensor

Repeat measurement and watch the solution being aspirated to determine the
cause of the bubble.

Very occasionally worn pump tubing may cause instability on one or more channels

Replace tubing, Page 3-13.

Very occasionally, dampness around the pre-heater, or at the insulating bushes at either end
of the sample path may cause instability
Clean/dry areas carefully.
Page 4-4 248 Operator’s Manual

Calibration or Slope Outside Range Reference

Sensor (pH outside range)

Bubble in reference sensor
Debubble sensor.

Nafion inner is dry due to a large bubble, or not screwed down properly, or poorly fitting

Replace Nafion inner if dry, or refit correctly. Sensor is clogged with crystals
caused by poor filling, or bubbles creating crystal growth

Empty sensor cassette and refill carefully with reference sensor fill solution. Vent hole
blocked

Unblock the vent hole in the reservoir cap. Failed

membrane
Replace sensor cassette. See
Page 3-19.

pH Sensor
Sensor needs conditioning
Condition sensor, Page 3-7.

Bubbles in fill solution, or insufficient or concentrated fill solution

Debubble sensor, or empty and refill, Page 3-17. Sensor failure (confirm by

measurement block routine, Page 4-10)

Empty and refill sensor. If problem is not solved, replace sensor.

pCO 2/ pO 2 Sensor
Sensor needs deproteinizing
Deproteinize sensor, Page 3-7.

Sensor failure (confirm by measurement block routine, Page 4-10)

Replace sensor.

System
Measurement block assembly and sensors are wet
Dry off sensor block assembly and sensors. Check sensor ‘O’ ring seals and
replace if necessary. Check sensors are seated properly, and the tensioner is pushed
firmly home. See Pages 3-17 and 3-19. Worn pump tubing

Replace tubing, Page 3-13.

Gas pressure/gas flow rate incorrect/leaks in gas system/gas cylinders connected

incorrectly
Check pressure and flow rate/cure leak/check gases connected correctly, Page
3-10.
Troubleshooting the System Page 4-5

Fluidics Failure - Insufficient 7.3/6.8/Wash

Run 7.3 or 6.8 buffer in the Measurement Block Routine, Page 4-10, to help diagnose the
fault.

Reagents
Buffer or Wash bottles are empty
Replace buffers or Wash. Bottle tubes do

not reach the solution

Feed the tubes through the connector caps into the solutions. See Page 3-5.

System
Blockage in sample path
Clear blockage, Page 3-31. Leaks

in sample path
Cure leaks. Check sensor ‘O’ ring seals and make sure sensors are seated correctly,
Page 3-17. Sucking in air on calibrant line

Cure leak.

New/greasy probe
Raise probe lever and immerse tip of probe in a strong soap solution for 10 to 15 seconds.
Lower the probe lever and Prime the 248, Page 3-9. Damaged seal in probe sleeve caused
by bent probe
Replace probe and housing, Page 3-24.

Pump Tubing
Insufficient “pull” on calibrant line
Check reagent pump tubing is tensioned. Check rubber connector is
pushed firmly onto manifold. Replace tubing, Page 3-13. Tubing is blocked

Clear blockage, Page 3-31. If fault persists replace tubing.

Mechanical
Pump rollers are dirty
Remove pump rollers, clean, grease and re-assemble, Page 3-13. Probe is

misaligned
Realign or replace probe.

Solenoid(s) inoperative
Contact your Siemens Healthcare Diagnostics distributor.

Fluid Detector
Sample detector cover not fitted
Fit cover, Page 3-29. Ambient light affecting

fluid detector
Position 248 out of direct sunlight. Dirty

tubing
Replace probe tubing and measurement block tube, Page 3-24. Detector failure

(confirm using Sample Flow Routine, Page 4-12)

Replace detector. See instructions on detector packaging.
Page 4-6 248 Operator’s Manual

‘Suspect Results’

Patient Results
‘Suspect results’ may be caused by a poorly maintained reference sensor, for example,
protein build up on the reference sensor membrane, bubbles in the fill solution, or crystal
growth. Under these conditions aqueous solutions (for example, QC material) diffuse across
the reference sensor membrane at a different rate to non-aqueous solutions (for example,
patient samples), and therefore QC results may not be affected. If the system reports patient
results that are suspect include the following troubleshooting steps:

Deproteinize the sample path.

Check for air bubbles in the reference sensor, and remove. Check for crystals in the
reference sensor, and remove. If the problem still exists after these steps have been
taken replace the reference sensor cassette.

Reference Sensor
Crystals in the bottom of the sensor
Empty sensor cassette, remove crystals and refill using reference sensor fill solution.
Leaking membrane

Replace sensor cassette. See

Page 3-19.

System
Correlation factors changed
Reset to correct factors, Page 5-3. Calibrants

used for longer than 30 days

Replace Buffer Pack.

Gas pressure/gas flow rate incorrect/leaks in gas system

Check pressure and flow rate/cure leak, Page 3-10. Incorrect gas

values entered
Enter correct values, Page 5-2. Barometric

pressure incorrect/changed
Enter correct barometric pressure, Page 2-9. Sample creep caused by blockage

(e.g. fibrin clot in sample path)

Clear blockage, Page 3-31.

Bubbles in sensor fill solution

Debubble sensors, Page 3-17 and 3-19.

Sample
Sample improperly collected or stored
Follow the instructions in Sample Handling and Storage, Section 1.

QC
Problem could be caused by: abnormal pH/interfering ions/wrong matrix/ wrong assigned
values/use of other aqueous standards/improper handling
Use only recommended QC materials and follow the instructions in QC Handling, Section
1. If problem persists, follow maintenance procedures.
Troubleshooting the System Page 4-7

‘Suspect Results’

Capillary Samples
Small bubbles which are not detected
Take care when aspirating capillary samples.

Sample Not Detected or Sampling Fault

Pump Tubing
No “pull” on sample line
Check pump tubing is tensioned.
Check measurement block tube is connected to the pump tubing. Replace pump
tubing. See Page 3-13.

System
No sample in measurement block
Repeat sample measurement.

Blockage in sample path

Clear blockage, Page 3-31.

Segments of Wash solution in sample path causing false ‘sampling complete’ or ‘bubble
in sample’ indications
Clear blockages in drip tray/manifold/pump tubing, Page 3-31. Leaks in sample

path
Check sensor ‘O’ rings and replace if necessary, Pages 3-17 and 3-19. Check sensors
are seated correctly, and the sensor tensioner is pushed firmly home, Page 3-17.

Check probe connector ‘O’ rings and replace if necessary, Page 3-24. Sucking in air on

sample line
Cure leak.

Fluid Detector
Sample detector cover not fitted
Fit cover, Page 3-29. Ambient light affecting

fluid detector
Position 248 out of direct sunlight.

Detector failure - confirm by Sample Flow Routine, Page 4-12.

Replace detector. See instructions on detector packaging. Dirty tube

Replace probe tubing and measurement block tube.

Page 4-8 248 Operator’s Manual

Printer Problems

No Printout
Printer on not selected
Select printer on in Print Options routine, Page 5-3. Paper loaded

wrong way round

Load paper correctly, Page 3-23.

Printer failure - confirm by Roll Printer routine, Page 4-13

Contact your Siemens distributor.

Paper Jammed
Equipment: Screwdriver, supplied in Spares box.

1. Tilt the paper cover backwards.

2. If the paper has jammed at the end of the roll, hold one end of the paper and rotate the
paper core to free the other end. If this does not free the paper continue with step 3.

3. Lift the paper roll and cut the paper.

4. Gently try pulling the end of the paper through the tearer. If this does not free the paper
continue with step 5.

5. Use the screwdriver to gently prise the paper cradle away from the front panel.

Figure 4-1. Separating the Paper Cradle From the Front Panel

6. Lift the paper cradle clear of the front panel.

Figure 4-2. Removing the Paper Cradle

7. Gently pull the paper free. You can turn the printer mechanism wheel with the screwdriver
to manually advance the paper through the mechanism.
Toubleshooting the System Page 4-9

Paper Jammed

Figure 4-3. Turning the Printer Mechanism Wheel

8. Reload the paper roll following the instructions on Page 3-23.

Hydraulic Problems

There are six solenoid valves in the 248 analyzer. Failure of any one solenoid will affect
system performance.

Wash Solenoid
Failure will result in wash solution problems during a wash cycle.

Vent Solenoid
Failure will cause calibration problems on the p CO 2 and p O 2 channels.

Gas/Calibrant Select Solenoid

Selects gas or calibrant. Failure will cause problems during a calibration cycle.

Gas Select Solenoid

Selects calibration or slope gas. Failure will cause calibration problems on the p CO 2 and p O 2 channels.

pH Cal Solenoid
Delivers 7.382 buffer to the sensors. Failure will cause calibration problems on the pH
channel.

pH Slope Solenoid
Delivers 6.838 buffer to the sensors. Failure will cause slope problems on the pH channel.
Page 4-10 248 Operator’s Manual

Heater Problems

The 248 has two heater systems, one to maintain the sensor block at 37 ° C, and one to
preheat samples and reagents to 37 ° C.

Sensor Block Heater

If the sensor block temperature is outside the correct limits during sample measurement, the
temperature is printed as part of the sample result. If the heater fails the display shows Heater
Failed and the 248 does not allow calibrations or sample measurement.

Pre-heater
If the pre-heater fails the display shows Heater Failed and the 248 does not allow calibrations
or sample measurement. Use the Heater routine, Page 4-13, to determine which heater has
failed, and contact your Siemens distributor.

Using the Troubleshooting Routines

From Ready press # for menu and 3 for Troubleshooting.

Main Menu → Troubleshooting

1 Measurement Block… 5 Roll Printer 2 Sample Flow 3 Heater 4

Electronics

press 1 - 5 or * to Exit

Measurement Block Routine

This routine measures and displays the sensor output in mV or pA. By comparing the
readings to the values given you can see if the sensors require maintenance, or if they
should be replaced.

NOTE: Channels that have been turned off, Page 5-5, are still measured and displayed in this
routine.

1. From Troubleshooting press 1 for Measurement Block.

2. Select the buffer or gas you want to run. The 248 displays the measurement in mV/pA in
addition to the normal measurement units.

3. Compare the mV/pA readings with these values*:

7.3 Buffer pH (mV) 6.8 Buffer pH (mV)

Nominal mV + 300.0 + 330.0

Total pull in range 200.0 to 400.0 24.5 to 38.0 above

7.3 buffer mV value

Action limits <270.0 or >330.0 <27 or >35 above

7.3 buffer mV value
Troubleshooting the System Page 4-11

Measurement Block Routine

Cal Gas p CO 2 ( mV) Slope Gas p CO 2 ( mV)

Nominal mV – 170.0 – 151.0

Total pull in range - 300.0 to +100.0 12.8 to 21.1 above cal

gas mV value

Action limits < -270.0 or >+80.0 <13.5 or >20.2 above cal gas
mV value

Cal Gas p O 2 ( pA) Slope Gas p O 2 ( pA)

Nominal pA + 764.0 + 80.0

Total pull in range 171 to 1961 above – 100.0 to +250.0

slope gas pA value

Action limits <300 or >1600 above <–50 or >200

slope gas pA value

Action: pH - may be caused by the reference sensor, see Pages 4-1 and 4-2. If
problem persists condition or refill the pH sensor. If the problem is still apparent, replace
the pH sensor.
p CO 2/ p O 2 - deproteinize/replace sensor

* at 760 mmHg atmospheric pressure, using standard gases (Cal: 5% CO 2,

12% O 2 and Slope: 10% CO 2 and 0% O 2)

4. Stability – for 7.3 Buffer and Cal Gas a typical sensor will show the following performance:

pH p CO 2 p O2
Noise - after 15 seconds the
display will not change by more
than: 0.2 mV/10 secs 1.0 mV/10 secs 2 pA/10 secs

Drift - after 15 seconds the

display will not change
unidirectionally by more than:
1.0 mV 5.0 mV 15 pA
during the remainder of the measurement.

Instability on the pH channel may be caused by the reference sensor. De-bubble the
reference sensor and repeat the test.

5. Press * to cancel the test.

Run Test Sample

1. You can use the run test sample option to:

a. Measure a sample with a known mV value (for example, run 7.3 or 6.8 buffer as a
sample).

b. Run QC samples to promote stability after installing a new sensor.

NOTE: You cannot use capillary samples with the Run Test Sample routine.
Page 4-12 248 Operator’s Manual

Sample Flow Routine

This routine checks the sample pathway from probe to waste bottle. It also checks the fluid
detectors.

1. From Ready ( or Not Ready) press # for menu and 3 for

Troubleshooting. From Troubleshooting press 2 for Sample Flow.

2. Lift the probe lever.

→ Troubleshooting → Sample Flow

Lift probe to test

sample flow

press * to Exit

3. Present a test sample (for example, a QC sample). To start the sampling press and
hold # .

4. Watch the sample as it goes through the pre-heater. When the sample reaches the first
fluid detector check that the FD1 box on the display changes from empty to solid.

Figure 4-4. Location of Fluid Detectors

FD 1

FD 2

5. Watch the sample as it goes through the measurement block. When the sample reaches the
second fluid detector check that the FD2 box on the display changes from empty to solid.

6. Continue pressing # and remove the sample from the probe. Watch the trailing edge of the
sample as it goes through the pre-heater.

7. When the trailing edge of the sample reaches the first fluid detector check that the FD1 box
on the display changes from solid to empty.

8. Watch the trailing edge as it goes through the measurement block. When it reaches the
second fluid detector check that the FD2 box on the display changes from solid to empty.

9. By presenting and removing the sample you can repeat the test.

10. Press * to cancel the test.

11. If either of the fluid detectors fail the test replace them following the instructions on the
packaging.
Troubleshooting the System Page 4-13

Heater Routine
The Heater routine displays the system temperature, the temperature of the pre-heater and
the temperature of the sensors.

1. From Ready ( or Not Ready) press # for menu and 3 for

Troubleshooting. From Troubleshooting press 3 for Heater.

If the temperature is outside specification the 248 will display ‘Warming up’ or
‘Heater failed’. If ‘Warming up’ is constantly displayed, or if ‘Heater failed’ is
displayed contact your Siemens distributor.

Electronics Routine
The Electronics routine checks the instrument functions. The tests are:

Electronics 1 (system RAM tests)

Electronics 2 (ADC, voltage reference buffer, voltage offset DAC,
motor DAC, comparitor port)
Electronics 3 (display RAM) Heater
BP sensor Probe Real time clock
Fluid detectors

1. From Ready ( or Not Ready) press # for menu and 3 for

Troubleshooting. From Troubleshooting press 4 for Electronics.

When the 248 completes this routine it confirms that the testing was successful. If any of
the tests fail, testing stops, and the test name is displayed with a failed message. Contact
your Siemens distributor.

Roll Printer Routine

The Roll Printer routine checks the internal printer.

1. From Ready ( or Not Ready) press # for menu and 3 for

Troubleshooting. From Troubleshooting press 5 for Roll Printer.

2. The printer prints the following test set:

12345678901234567890123456789012
34567890123456789012345678901234
56789012345678901234567890123456
78901234567890123456789012345678
90123456789012345678901234567890
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

3. If the 248 does not print the test set, check you have loaded the paper correctly, Page
3-23. If the 248 still does not print, contact your Siemens distributor.
Page 4-14 248 Operator’s Manual

Using the Status Indicators

There are six LEDs (Light Emitting Diodes), located behind a grille on the rear panel. These
will help you diagnose faults. From left to right (viewed from the rear) these LEDs are:

LED Check

1 microprocessor 2
– 12V 3
+ 12V 4
– 5V analog 5
+ 5V analog 6
+ 5V digital
Check that:

1. LEDs 2 to 6 are on. If any of these LEDs are off contact your Siemens distributor.

2. LED 1 is flashing. If it is not flashing:

a. disconnect and reconnect the line cord.

b. check the memory card is installed correctly (refer to fitting instructions).

If LED 1 still does not flash contact your Siemens distributor.

Other Problems

Clock appears as dashes

Clock has failed. Contact your Siemens distributor. Maintenance

prompts do not appear

Prompts not set, Page 5-5. Clock
has failed.

No data shown for measured parameters, on display or printout

Parameter has not been selected, Page 5-5. No data shown for calculated

parameters, on display or printout

Maximum of 8 parameters are shown on display, but all selected parameters are
printed.
Parameter has not been selected, Page 5-5. Parameter has been selected, but
appropriate measurement channels have not been selected; or ctHb and F 1 O 2 are not
available. Beeper sounds during data entry

Entry field is full, and number key pressed. Entry field is

empty and C key pressed. Data entered is invalid.
Atmospheric pressure cannot be changed

Entered value differs from the displayed value by more than

± 20 mmHg.
BP sensor is faulty - contact your Siemens distributor.
 Page 5-1

5 Configuring the System

The 248 can be used with the default (factory set) options and values, but there are several
setup options available on the 248 which allow you to customize the 248 for your
laboratory. Where applicable, we have recommended settings.

Full instructions on how to choose options and enter data is given in Section 1, Understanding
the System. If data is entered which is outside the allowable range, or incorrect with respect to
values already entered, the data entry field flashes and the value reverts to the previous value
to allow you to enter the data again. The setup options are available in 3 menus:

• Operating Setup

• System Setup

• Service Setup

When you have configured the 248, print the Setup Report, Page 5-7, so you have a record of
the options selected.

Operating Setup

From Ready press # for menu and 5 for Operating Setup.

Main Menu → Operating Setup

1 QC Ranges… 5 Printer Options

2 Reference Ranges… 6 Correlation 3 Units 4 Calibration…

press 1 - 6 or * to Exit

Setting QC Ranges
QC ranges can be set for three levels of QC. (Level X has no ranges). If a QC
measurement is outside these ranges the result is flagged on the display and on the
printout.

To set QC ranges: From Ready press # for menu, 5 for Operating Setup and 1 for QC
Ranges.

Select the QC level then enter the lot number and ranges given in the QC product insert.

Maximum range that can be entered is the instrument measurement range.

Default setting: instrument measurement range.

Page 5-2 248 Operator’s Manual

Setting Reference Ranges

Reference ranges can be set for pH, p CO 2 and p O 2.

If a sample measurement is outside these ranges the result is flagged on the display and on
the printout.

Individual reference values may vary according to a number of factors such as age, posture,
diet, exercise and site of blood collection. We have taken these factors into account when
establishing the default values for the 248. Default setting:

pH 7.350 - 7.450 (35.5 - 44.7 H+ nmol/L)

p CO 2 35.0 - 45.0 mmHg (4.67 - 6.00 kPa)
p O2 80 - 100 mmHg (10.67 - 13.33 kPa)

Each laboratory should establish its own reference ranges.

To set reference ranges: from Ready press # for menu, 5 for

Operating Setup and 2 for Reference Ranges.

Maximum range that can be entered is the instrument measurement range, Page E-1. Set
the ranges to the maximum instrument measurement range if you do not want to use the
reference range facility.

Choosing Units
You can choose the units of measure for parameters. The choices

are:

• pH units or H+ nmol/L

• mmHg or kPa for gases

• g/dL, g/L or mmol/L for c tHb.

To choose units: from Ready press # for menu, 5 for Operating Setup
and 3 for Units.
selected not

selected

Default setting: pH units, mmHg and g/dL.

Selecting Calibration Method and Entering Gas Values

The calibration option allows you to :

• choose how the 248 calibrates and select the maximum time interval between
calibrations (see Page 1-10 for details). Siemens Healthcare Diagnostics recommends
that the calibration interval is set to 30 minutes.

• enter non-Siemens gas values (see Page 3-10 for specifications of the gas).
Configuring the System Page 5-3

Selecting Calibration Method and Entering Gas Values

To select calibration option: from Ready press # for menu, 5 for
Operating Setup and 4 for Calibration.

To choose calibration method and interval press 1.

selected not selected To

enter gas values press 2.

The maximum ranges available for gas values are:

cal gas 4 - 6% CO 2 10 - 14% O 2

slope gas 8 - 12% CO 2 0 - 2% O 2.

Default settings: flexible time, interval = 30 minutes. Gas values Cal 5%

CO 2, 12% O 2; Slope 10% CO 2, 0% O 2.

Setting Printer Options

The roll printer can be turned on or off, and can be set to print results only, or results and
calibrations.

To set printer options: from Ready press # for menu, 5 for

Operating Setup and 5 for Printer Options.
selected not

selected

Default setting: printer on, print results only.

Adjusting Correlation
The 248 is set during manufacture to give results which correlate with tonometered blood. If
you wish to change the values to correlate with another blood gas analyzer, you must use the
following procedure:

1. The correlation factors in the 248 must be reset to: pH, p CO 2 and p O 2 slope
= 1.000 pH, p CO 2 and p O 2 intercept = 0.000

2. Use a large sample population covering the physiological range – minimum 50 samples,
preferably 100 – to generate a random distribution of values (not just normal values).

3. Make sure that the 248 and the reference analyzer are calibrated following the
manufacturer’s instructions, and are operating within specifications.

4. Samples should be stored iced, and measured within 30 minutes of collection. Samples
should be analyzed in duplicate on both analyzers, with no more than 5 minutes
between analysis on the 248 and analysis on the reference analyzer.

5. Remove outliers from the data (means of duplicates values outside

± 3SD, or duplicates which differ).
Page 5-4 248 Operator’s Manual

Adjusting Correlation
6. Perform a linear regression analysis. We recommend the Deming method, which accounts
for errors on both axes. The linear regression should be performed using a regression
program on a calculator or computer. The 248 should be treated as the dependent
variable (Y-axis), or the variable on the left hand side of the equation.

NOTE: The X variable should be the reference analyzer.

7. The intercept and slope values obtained can then be entered using the Correlation
routine.

NOTE: Values can only be entered into the Correlation routine in pH units and mmHg. If you
use H+ nmol/L or kPa for measurement, these values must be converted into pH units and
mmHg before entering. To convert from H+ nmol/L to pH:

pH = 9.0 - log 10( H+ nmol/L) To

convert to mmHg from kPa:

mmHg = kPa x 7.50062

To adjust the correlation: from Ready press # for menu, 5 for

Operating Setup and 6 for Correlation.

Default setting: pH, p CO 2, p O 2 slope = 1.000 pH, p CO 2, p O 2

intercept = 0.000

System Setup

From Ready press # for menu and 6 for System Setup.

Main Menu → System Setup

1 Date and Time 5 Communications

2 Maintenance Prompt 6 Security 3 Parameters
7 Print Setup Report
4 Beeper

press 1 - 7 or * to Exit

Changing Date and Time

The 248 shows the time and date of calibrations and measurements on the printout.

To change the date and time: from Ready press # for menu, 6 for
System Setup and 1 for Date and Time.

Default setting: Date and time set.

Configuring the System Page 5-5

Setting the Maintenance Prompts

The 248 displays prompts on the Ready screen to empty the waste bottle and to
deproteinize and condition the sensors. The prompts appear at approximately 6.00 am
at the intervals you select.

To set the maintenance prompts: from Ready press # for menu, 6 for System Setup and
2 for Maintenance Prompt.

The prompts can be set between 0 and 9 days. To cancel the prompts press C to clear the
value or enter 0. Default setting:
empty waste bottle every day deproteinize/condition
sensors every 7 days

Selecting Parameters
You can choose parameters for measurement and for calculation.

To select parameters: from Ready press # for menu, 6 for System Setup and 3 for Parameters.

To select measured parameters press 1. Choose from:

• all three channels selected
• any two of the three channels selected
• any one of the three channels selected.
selected not

selected

NOTE: The 248 will not allow you to turn off all three channels.

NOTES: Calculated parameters will only be displayed if all three

measurement channels are selected. O 2 CT will only be displayed if c tHb is
entered. p O 2( A-a) and
p O 2( a/A) will only be displayed if F I O 2 is entered. To select

calculated parameters press 2. Choose from:

• HCO 3– actual
• HCO 3– standard
• BE(ecf) (formerly BE(vv)
• BE(B) (formerly BE(vt)
• O 2 CT
• O 2 SAT
• c tCO 2
• p O 2( A-a) (formerly A-aDO 2)
• p O 2( a/A) (formerly a/A ratio).
selected not

selected

Default setting: all three measurement channels selected, no calculated

parameters selected.
Page 5-6 248 Operator’s Manual

Changing Beeper Option

You can turn the system beeper on or off.

To change the beeper: from Ready press # for menu, 6 for System Setup and 4 for Beeper.

Select beeper on or off.

selected not selected

Default settings: beeper on.

Changing Communication Options

The 248 has two data ports. You can configure both ports to your requirements. See
Appendix D, Interfacing to External Devices for detailed information.

To configure the data output ports: from Ready press # for menu, 6 for System Setup and 5
for Communications.

Choose from:

• CMSI

• LIS 1

• LIS 3.
selected not

selected Default setting:

CMSI.

Setting Security
You can protect access to the Main Menu. This guards against unauthorized or accidental
changing of setup options. The security password only protects the Main Menu. The 248 will
allow sample and QC measurement, and will calibrate as required. If the security option is
used, an overlay appears on the Main Menu screen prompting you to enter the password.
Menu access is prevented until the password has been entered correctly. You can return to
the

Ready screen without entering the password.

To set security: from Ready press # for menu, 6 for System Setup
and 6 for Security.

Enter a password. The password can be up to eight digits; you can use the decimal point
key to insert dashes.

NOTE: If you forget the password you can use the master password (0066838).

Default setting: security off.

Configuring the System Page 5-7

Printing Setup Report

If you select this option the 248 prints out all the setup options.

To print the Setup Report: from Ready press # for menu, 6 for
System Setup and 7 for Print Setup Report.

Service Setup
From Ready press # for menu and 8 for Service Setup.

Main Menu → Service Setup

1 System Information 2 Language

Selection

press 1 - 2 or * to Exit

Entering System Information

System information keeps a record of the 248 serial number, software revision and service
contact telephone number.

To enter system information: from Ready press # for menu, 8 for

Service Setup and 1 for System Information.

You can only enter the 248 serial number (4 digits) and the service telephone number (up to
12 digits). You can use the decimal point key to insert a dash.

The 248 automatically records the software revision. Default setting: serial number
entered, service contact telephone number not entered.

Changing Language
You can change the language on the 248 display and printer. The list of available languages
includes:
• English
• French
• German
• Italian
• Japanese
• Polish
• Portuguese
• Russian
• Spanish

To change the language: from Ready press # for menu, 8 for Service Setup and 2 for Language
Selection.

Default setting: English.

 Page 6-1

6 Service and Supplies

This section gives a list of supplies for the 248, the Siemens Healthcare Diagnostics
addresses for obtaining service and technical information, and warranty information.

Ordering Information

Please give the following information to your Siemens distributor when ordering supplies:

1. 248 serial number

2. article number of part

3. description

4. quantity required

This will make sure your order is dealt with quickly and efficiently. The number shown in the
Quantity column is the number of items supplied against that catalog number. If the quantity is
more than 1, only multiples of that number can be supplied. For a comprehensive list of service
spares, see the Service Manual.

Spares
Description Quantity Catalog Article
Number Number

Reference electrode inner, with KCl

fill solution 1 478509 09388182
Reference sensor refill, contains reference
sensor cassette, KCI fill solution and ‘O’ rings
1 kit 478498 04273425
Probe and tubing kit 1 kit 673251 05738022
Probe and housing kit 1 kit 673253 06152072
Probe protectors, pack of 10 1 pack 673373 06565849
Bottle tubing kit 1 kit 673250 02660073
Sample pump tubing kit 1 673254 04282319
Reagent pump tubing kit 1 673257 05440120
Sample and reagent pump tubing kit 1 673358 09799603
Clot removal line, 0.5 m (19 1/2 inches) 1 pack 478645 07110136
Drip tray 1 673255 03521867
pH sensor plus ‘O’ ring 1 476267 07173251
p CO 2 sensor plus ‘O’ ring 1 476247 02671199
p O 2 sensor plus ‘O’ ring 1 476246 06462640
Reference sensor, contains reference
sensor cassette, reference electrode inner,
KCl fill solution and ‘O’ rings 1 kit 476273 05719400
Page 6-2 248 Operator’s Manual

Spares
Description Quantity Catalog Article
Number Number

Test blank sensor - ref (TB5) 1 673396000 08053446

Grounding block 1 673272 06405809
Pre-heater tube kit 1 673256 08721783
Fluid detector 1 1 673266 00659477
Fluid detector 2 1 673359 06864900
Fuse, 1A, slo-blo 2 478648 03934185
Fuse, 1A, time delay 2 478916 09991431
Voltage selector bobbin 1 478937 01652336
Fuseholder 1 478936 00119979
Power supply cord, without plug 1 001 42 498X 05357096
Power supply cord, with USA style plug 1 858 040 001 03628246
Power supply cord, with European plug 1 001 71 415A 06048720
Power supply cord, with UK plug 1 001 71 416X 06139440
Printer paper 5 rolls 673252 01150195
Ampule breakers, pack of 1000 1 pack 47860900L 09894142
Service manual 1 673259 00156483
Operator’s Manual, English 1 673258 00142423
Operator’s Guide, English 1 673347 03579199
Operator’s Manual, French 1 — 04919031
Operator’s Guide, Japanese 1 673348 04964460
Operator’s Manual, Spanish 1 — 04917624
Operator’s Guide, Spanish 1 673351 08107414
Operator’s Manual, Italian 1 — 04917772
Operator’s Guide, Polish 1 570012 04850961
Operator’s Manual, Portuguese 1 — 05038802
Operator’s Manual, German 1 — 04919597
248 Interface Manual 1 570030 00305144
pH/blood gas blood collection capillary tubes
100 x 100 μ L capillaries 1 pack 478600 04996974
Caps for capillary tubes 478600,
pack of 200 1 pack 478601 01687040
pH/blood gas blood collection capillary tubes
100 x 100 μ L capillaries 1 pack 471836 08851318
Multicap blood collection kit, containing
50 x 100 μ L capillary tubes 1 pack 673394 05974729
Multicap blood collection kit, containing
500 x 100 μ L capillary tubes 1 pack 108758 05614986
Caps for capillary tubes 673394 and
108758, pack of 100 1 pack 478605 01558100
Caps for capillary tubes 673394 and
108758, pack of 200 1 pack 478527 08685906
Mixing kit for blood collection capillary
tubes containing 1 magnet and 100
mixing fleas 1 kit 478606 04019456
Adaptors for capillaries, pack of 100 1 pack 478647 09851273
Service and Supplies Page 6-3

Spares
Description Quantity Catalog Article
Number Number

Calibration gas cylinder, 40 cu. ft.

(5% CO 2, 12%O 2)
(contact distributor for local equivalent) 1 001 84 146E 09361861
Cal calibration gas (5% CO 2, 12%O 2)
(USA only) 1 477434000 04934960
Slope gas cylinder, 40 cu. ft.
(10% CO 2, 0%O 2) ( contact distributor for local
equivalent) 1 001 84 147F 04464247
Slope calibration gas (10% CO 2, 0%O 2)
(USA only) 1 477438000 03294747
Two stage regulator for use with above
(contact distributor for local equivalent) 1 001 08 547A 05186720
Gas tubing kit, 2 metres 2 packs 473755 07140531
Interface cable, 248 to 800 ticket printer,
201 ticket printer and 270 CO-oximeter 1 673365 04993010
Interface cable, 248 to 2500 CO-oximeter 1 570011 02376472
Interface cable, 248 to DataMate ™,
Complement ™ 2 and Expert datacare DMS
sysems 1 673379 05047747

Reagents
Description Quantity Catalog Article
Number Number

6.8/7.3 Buffer Pack, contains: 4 Buffer

Packs 1 pack 473496 03788731
Wash Pack, contains: 4 Wash bottles
and 4 Deproteinizer/Conditioner Packs 1 pack 473497 02436114
Deproteinizer, pack of 10 1 pack 105610 08915030
Conditioner, pack of 5 1 pack 478701 02578644
Activated glutaraldehyde solution,
pack of 5 1 pack 673390 03027315
pH sensor fill solution, pack of 3,
plus ‘O’ ring 1 pack 478533 06386650
Reference sensor fill solution, pack of 4,
plus ‘O’ ring 1 pack 478822 02563698
RapidQC Plus, Level 1,
30 x 25 mL ampules 1 pack 478941 05977442
RapidQC Plus, Level 2,
30 x 25 mL ampules 1 pack 478942 07185624
RapidQC Plus, Level 3,
30 x 25 mL ampules 1 pack 478943 01241743
Calibration Verification Material (CVM),
4 x 2.5 mL ampules each level 1 pack 473959000 09985563
Page 6-4 248 Operator’s Manual

Addresses

For technical assistance contact your local authorized representative. For customer service
or additional information contact your local authorized distributor.

Authorized Representative:
Siemens Healthcare Diagnostics Ltd.
Sir William Siemens Square, Frimley, Camberley, GU16 8QD, UK

Manufactured by:
Siemens Healthcare Diagnostics Inc. Tarrytown,
NY 10591-5097 USA

Siemens Healthcare Diagnostics Pty Ltd ABN 65 007

436 651 885 Mountain Highway Bayswater Victoria
3153 Australia

[Link]\diagnostics
Service and Supplies Page 6-5

Standard Instrument Warranty and Service Delivery Policy

Siemens and its authorized distributors provide customers who acquire new Siemens
instruments with a one-year comprehensive, but limited, warranty. This limited warranty is
designed to protect customers from the cost associated with repairing instruments that exhibit
malfunctions due to defects in materials and/or workmanship during the warranty period.

Warranty Period
The warranty period commences upon installation at the customer’s location and extends for a
period of one year thereafter. The customer, with some exceptions, may purchase additional
service coverage beyond the one year warranty period as part of the original instrument
acquisition for second or subsequent years beyond the original installation date. The
customer’s original Purchase Invoice or appropriate Agreement Addendum must indicate the
term in months for additional service coverage.

Warranty Service During Normal Hours

The customer may obtain warranty service for instruments during normal business hours by
contacting the Siemens location or authorized distributor. Refer to the list of Siemens locations
in this section.

Extent of a Warranty Service Call

During the warranty period, Siemens (or an authorized distributor) will repair the instrument
during normal business hours, at their expense, subject to the exclusions listed below.
Siemens or an authorized distributor will initiate a warranty field service call when notified. The
call will be considered complete when the instrument is again operating to its published
specifications and the customer, or the customer’s representative, has agreed by signing the
appropriate Field Service Report. When service is complete, the customer will receive a copy
of the Field Service Report detailing all work performed by the Siemens representative.

Warranty Service Outside Normal Hours

Customers, with some exceptions, may also request warranty service to be delivered outside
of normal business hours, including evenings, weekend days, or nationally observed holidays
by contacting the Siemens location or authorized distributor. Warranty service performed at
these times is subject to a surcharge unless the customer has purchased a service product
option that provides warranty service outside normal hours.
Page 6-6 248 Operator’s Manual

Replacement of Parts
In performing warranty service under this agreement, Siemens or its authorized distributors
will provide appropriate parts to repair the instrument at no charge with the exception of
certain parts or subassemblies that are considered Customer Maintenance Items. Customer
Maintenance Items include, but are not limited to, the following items: lamps, electrodes or
sensors (which are covered by a separate warranty), Siemens reagents and calibrators,
controls, pump tubing kits, paper and pens. Consult the appropriate operator’s manual for a
complete list of maintenance items for any specific model of instrument.

Design Changes and Retrofitting of Instruments

During the warranty period, Siemens reserves the right to change the design or construction of
specific models of instruments without incurring any obligation to make such changes available
to an individual instrument. If Siemens notifies customers of a change that improves the
performance or reliability of their instrument, and requests to retrofit that instrument, customers
must agree to allow Siemens or an authorized distributor, at Siemens expense, to retrofit
components or make design changes, which will not adversely affect the instrument’s
performance characteristics.

Key Operator Designation

Customers will designate a key operator who will be available to Siemens representatives to
describe instrument malfunctions by telephone and/or to perform simple adjustments and
corrections as requested. If a key operator is not designated or is unavailable when the
customer requests service, the delivery of warranty service may be delayed.

OSHA Requirements (US only)

When service is required at a customer location, the customer must provide the Siemens
representative with adequate facilities that comply with the regulations of the Secretary of
Labor under the Occupational Safety and Health Act (OSHA) of 1970, as amended.

Warranty Exclusions
Siemens or its authorized distributors will provide warranty service to customers during the
warranty period, which includes appropriate parts, travel to the location of the instrument, and
on-site labour during normal business hours. In addition, Siemens or its authorized distributors
will provide warranty service during the warranty period only, and instrument repairs, labour or
replacement parts, as provided during the original warranty period, will not extend the original
warranty period.
Service and Supplies Page 6-7

Warranty Exclusions
This warranty will not apply if any of the following occurs:

1. Repairs or modifications have been made to the instrument by other than an

authorized Siemens representative.

2. The instrument has been operated using other than Siemens brand accessories, or
consumable supplies and/or reagents not having the same grade, quality, and
composition as defined by Siemens.

3. The instrument has not been installed within 90 days of shipment to the customer’s facility
unless otherwise specified.

4. The customer has not performed appropriate customer maintenance procedures, as

outlined in the instrument operator’s manual.

5. The instrument has been misused or used for a purpose for which it was not intended.

6. The instrument has been damaged in transit to the customer or damaged by the
customer while moving or relocating it without supervision by a Siemens
representative.

7. Damage was caused by floods, earthquakes, tornadoes, hurricanes or other natural or

man-made disasters.

8. Damage was caused by Acts of War, vandalism, sabotage, arson, or civil commotion.

9. Damage was caused by electrical surges or voltages exceeding the tolerances outlined in
the instrument operator’s manual.

10. Damage was caused by water from any source external to the instrument.

11. The customer has purchased an alternative agreement whose terms of warranty
supersede this agreement. Siemens or its authorized distributors will invoice customers, at
current standard labour and parts rates, for instruments repaired to correct damage or
malfunctions due to any of the reasons listed above.

Limitations of Siemens Original Warranty

Siemens warrants to all customers that service will be performed in a professional manner
consistent with the industry. If the instrument is not performing according to its specifications,
Siemens will, at its option, repair or replace the instrument. This is the customer’s sole and
exclusive remedy for breach of warranty.

Other than as stated above, there are no other warranties, express or implied, accompanying
either the leasing of the equipment or its sale to the customer at the expiration or termination
of this agreement. In addition, the warranties of merchantability and fitness for a particular
purpose are disclaimed. In addition, Siemens shall not be liable for any damages caused by
delay in providing repair service from any cause. Siemens liability for breach of this warranty
shall be limited to the repair or replacement of defective equipment and shall not include any
incidental, contingent, or consequential damages.
 Page A-1

Appendix A Protecting Yourself From

Biohazards
This appendix summarizes the established guidelines for handling laboratory biohazards. The
summary is based on the guidelines developed by the National Institute of Health (NIH) and
Centers for Disease Control (CDC), the guidelines for NCCLS Document M29, Protection of
Laboratory Workers from Infectious Disease Transmitted by Blood and Tissue and Document
I17, Protection of Laboratory Workers from Instrument Biohazards 8,9.

Use this summary for general information only. It is not intended to replace or supplement
your laboratory or hospital biohazard control procedures.

By definition, a biohazardous condition is a situation involving infectious agents that are

biological in nature, such as the hepatitis B virus (HBV), the human immuno-deficiency virus
(HIV), or the tuberculosis bacterium. These infectious agents may be present in human
blood and blood products and in other body fluids. The major sources of contamination
when handling potentially infectious agents are:

• hand-to-mouth contact

• hand-to-eye contact

• direct contact with superficial cuts, open wounds, and other skin conditions that may
permit absorption into subcutaneous skin layers

• splashes or aerosol contact with skin and eyes To prevent accidental contamination
in a clinical laboratory, strictly adhere to the following procedures:

• Wear gloves while servicing parts of the instrument that have contact with body
fluids such as whole blood.

• Wash your hands before going from a contaminated area to a non contaminated area,
or when gloves are removed or changed.

• Perform procedures carefully to minimize aerosol formation.

• Wear facial protection when splatter or aerosol formation is possible.

• Wear protective clothing such as labcoats or aprons when working with possible
biohazard contaminants.

• Keep your hands away from your face.

• Cover all superficial cuts and wounds before starting any work.

• Dispose of contaminated materials according to the biohazard control procedures

established for your laboratory.

• Keep your work area disinfected.

• Disinfect tools and other items that have been near any part of the instrument sample
path or waste area with 10% v/v bleach.
Page A-2 248 Operator’s Manual

Appendix A Protecting Yourself From

Biohazards
• Do not eat, drink, smoke, or apply cosmetics while in the laboratory.

• Do not mouth pipet any liquid, including water.

• Do not place tools or any other items in your mouth.

• Do not use the biohazard sink for personal cleaning such as rinsing coffee cups or
washing hands.

To prevent needlestick injuries, needles should not be recapped, purposely bent,

cut, broken or otherwise manipulated by hand.
 Page B-1

Appendix B Precautions and Hazards

Operating Precautions
• The 248 is designed to be left connected to an a.c. supply. To prevent damage to
the instrument do not leave it switched off unless the shutdown procedure
(Section 3) has been followed.

• Never turn the pump rotors anticlockwise. If a bubble is detected samples should be
moved forwards until there are no air bubbles beneath the sensors.

• Use Siemens Healthcare Diagnostics collection devices as the heparin coating

has been specially formulated.

• Use only Siemens approved QC materials.

• Only Siemens reagents and supplies should be used with the 248 (with the possible
exception of gas/regulator, Page 3-10). Do not use reagents after the expiry date shown
on the label. Do not use 7.382 and 6.838 buffer for longer than 30 days once opened. Do
not decant solutions from one bottle to another as this can cause contamination. Agitate
the Buffer Pack daily, to incorporate any solution that may have condensed on to the
inside surface of the bottles. It is advisable to empty the waste bottle daily and add
approximately 10 mL of disinfectant or sodium hypochlorite to the bottle. When replacing
the Buffer Pack or Wash bottle always remove the waste bottle and put the empty 7.3
Buffer or Wash bottle in its place. Siemens recommends that approximately 10 mL of
disinfectant or sodium hypochlorite is put into the empty bottle before placing it in position
as the new waste bottle.

• When sampling from syringes position the probe to obtain the most representative
sample - do not allow probe tip to touch the syringe plunger. Obstructing the probe tip
can cause sampling faults, and, in extreme cases, calibration instability.

If you suspect the probe tip was obstructed during sampling, we recommend cancelling
the sample analysis, and calibrating the 248, Page 2-9.

• Do not release the measurement block catch unless the instrument has been stopped
using the STOP SYSTEM routine.

• Make sure that routine maintenance is carried out at the intervals stated in Section 3.

• Make sure the drip tray is always in place and is correctly connected.

• The maximum non-destructive voltage that can be applied to the data ports is ± 12V
d.c. to pins 3 and 8 (data receive and clear to send connections), Page D-1.
Page B-2 248 Operator’s Manual

Hazards
Compressed gas cylinders require careful handling. To prevent damage and possible
personal injury, observe the following precautions:
• Never drop cylinders, allow them to strike each other or subject them to other strong
shocks.
• Secure cylinders to a wall or bench, or place in a cylinder base support stand.

• Never drag, roll or slide cylinders, even for short distances. Use a suitable hand
truck to move cylinders.
• Never tamper with safety devices in regulators or cylinders.
• Use these gases for the calibration of clinical and research instrumentation only. US
Law prohibits dispensing these gases for drug use.

• The contents are under pressure – do not puncture.

• Do not use or store near heat or open flame.
• Do not expose cylinders to temperatures above 54 ° C (130 ° F) as this may cause
the contents to vent or explode.
• Never throw cylinders into fire or incinerators. Follow the disposal
instructions on the cylinders.

• Take care when opening ampules. Use ampule breakers to protect your fingers.

• Do not remove the rear cover from the 248. There are no user replaceable parts
within the instrument.

• All samples should be treated with the caution accorded to those known to contain
pathogenic organisms. Gloves should always be worn when handling samples and
waste materials.

• Make sure that before handling the component parts of the 248 (such as the probe,
sensors, measurement block, pump tubing and waste bottle) you have used the Disinfect
routine, see Section 3,
Maintaining the System. Gloves should always be worn when carrying out any
maintenance to the 248.

• Siemens Conditioner contains 0.1M ammonium bifluoride (ammonium hydrogen

difluoride) which is toxic if swallowed and will cause burns if it comes into contact with
the skin. In case of contact with eyes rinse immediately with plenty of water and seek
expert medical advice. Clear up spillages immediately and wash with plenty of water.

• Make sure that the manufacturer’s directions for use are followed when using
disinfectant.

• The 248 weighs approximately 9 kg (20 lb). Observe safe lifting procedures.

• Do not move the 248 with the reagent and waste bottles in place.
 Page C-1

Appendix C References
1. National Committee for Clinical Laboratory Standards. Blood gas preanalytical
considerations: specimen collection, calibration, and controls. NCCLS Document
C27–A. Villanova (PA): NCCLS; 1993.

2. Moran RF, Bradley F. Blood gas systems - major determinants of performance.

Laboratory Medicine 1981; 12 (6) 353–358.

3. Beetham R. A review of blood pH and blood gas analysis. Ann Clin Biochem 1982; 19:
198–213.

4. Vedda GL, Holbeck CC. Properties of commercially available control materials for pH, p CO 2 and
p O 2. Clin Chem 1980; 26: 1366–7.

5. Tietz NW ed. Fundamentals of clinical chemistry. 3rd ed. Philadelphia: WB

Saunders, 1987; 864–891.

6. Weisberg HF. Acid-Base pathophysiology in the neonate and infant. Annals of Clinical and
Laboratory Science 1982; 12(4)249.

7. Lentner C ed. Geigy scientific tables. Vol 3, 8th ed. Basle: Ciba- Geigy Ltd., 1984;
82–83.

8. National Committee for Clinical Laboratory Standards. Protection of laboratory workers from
infectious disease transmitted by blood and tissue; tentative guideline. 2nd ed. NCCLS
Document M29–T2. Villanova (PA): NCCLS; 1991.

9. National Committee for Clinical Laboratory Standards. Protection of laboratory workers

from instrument biohazards. NCCLS Document I17. Villanova (PA): NCCLS; 1991.

10. Siggaard-Anderson O. Electrochemistry. In: Tietz NW editor. Fundamentals of

clinical chemistry. 3rd ed Philadelphia: WB Saunders, 1987. 87–100.

11. Siggaard-Anderson O, Durst RA, Maas AHJ. Physicochemical quantities and units in
clinical chemistry with special emphasis on activities and activity coefficients. Pure Appl
Chem 1984; 56: 567–594.

12. Severinghaus JW, Bradley AF. Electrodes for blood p O 2 and p CO 2

determination. J Appl Physiol 1968; 13:515–520.

13. Clark LC Jr. Monitor and control of blood and tissue oxygen tensions. Trans Am
Soc Artif Intern Organs 1956; 2: 41–56.

14. Shapiro BA, Harrison RA, Cane RD, Templin R. Clinical application of blood gases.
4th ed. Chicago: Year Book Medical Publishers, 1989. 270–272.

15. Moran R, Cormier A. The blood gases: pH, p O 2, p CO 2. Clin Chem

News 1988; 14(4/5): 10–12.

16. National Committee for Clinical Laboratory Standards. Definitions of quantities and
conventions related to blood pH and gas analysis. NCCLS Document C12–A. Villanova
(PA): NCCLS; 1994.

17. VanSlyke DD, Cullen GE. Studies of acidosis 1. The bicarbonate concentration of blood
plasma, its significance and its determination as a measure of acidosis. J Biol Chem 1917;
30:289–346.
Page C-2 248 Operator’s Manual

Appendix C References
18. National Committee for Clinical Laboratory Standards. Fractional oxyhemoglobin, oxygen
content and saturation, and related quantities in blood: terminology, measurement, and
reporting; tentative standard. NCCLS Document C25–T. Villanova (PA): NCCLS; 1992.

19. Martin L. Abbreviating the alveolar gas equation: an argument for simplicity. Respir Care
1985; 30(11):964–967.

20. Peris LV, Boix JH, Salom JV, Valentin V, et al. Clinical use of the arterial/alveolar oxygen
tension ratio. Crit Care Med 1983; 11(11): 888–891.

21. Kirchoff JR, Wheeler JF, Lunte CE, Heineman WR. Electrochemistry: principles and
measurements. In: Kaplan LA, Pesce AJ editors. Clinical Chemistry: theory,
analysis, and correlation. 2nd ed. St. Louis: CV Mosby, 1989. 213–227.

22. Douglas IHS, McKenzie PJ, Leadingham I, Smith G. Effect of halothane h. on p O 2 electrode.
Lancet 1978: (Dec. 23 and 30).

23. Thomas LJ. Algorithms for selected blood acid-base and blood gas calculations. J Appl
Physiol 1972; 33:154–158.

24. National Committee for Clinical Laboratory Standards. Internal quality control testing:
principles and definitions. NCCLS Document C24–A. Villanova (PA): NCCLS; 1991.

25. National Committee for Clinical Laboratory Standards. Clinical laboratory waste
management. NCCLS Document GP5–T Villanova (PA): NCCLS; 1991.
 Page D-1

Appendix D Interfacing to External Devices

The 248 has two data ports – Port 1 and Port 2.

Figure D-1. Port 1 (Female) Figure D-2. Port 2 (Male)

5 1 1 5

9 6 6 9

Pin 1 Not used Pin 1 Not used

Pin 2 Tx data (transmitted) Pin 2 Tx data (transmitted)
Pin 3 Rx data (received) Pin 3 Rx data (received)
Pin 4 DTR (data terminal ready) Pin 4 DTR (data terminal ready)
Pin 5 0V digital Pin 5 0V digital
Pin 6 Not used Pin 6 Not used
Pin 7 Not used Pin 7 Not used
Pin 8 CTS (clear to send) Pin 8 CTS (clear to send)
Pin 9 Not used Pin 9 +5V digital

For full details on interfacing to external devices, refer to the 248 Interface Manual
(Cat. 570030).

The 248 supports three data communication protocols on both ports.

CMSI

CMSI allows communication with Ciba Corning Diagnostics instrumentation, for example the
270 CO-oximeter, 2500 CO-oximeter and the Complement data management system. A
current loop convertor is required for interfacing with some of these systems.

NOTE: When communicating with these older systems the 248 emulates a 178 blood gas
analyzer. As such, QC samples are reported as syringe samples.

Data Format
Baud rate 7200 Start bit

Stop bits 2

Data bits 7

Parity ON EVEN
Page D-2 248 Operator’s Manual

LIS 1

LIS 1 allows communication to external printers, for example the 800 series ticket printer, or
to data collection systems which accept asynchronous, unidirectional data transmission.

Data Format
Baud rate 9600 Start bit

Stop bit 1

Data bits 8

Parity OFF

The transmitted data will have the same format as the data sent to the internal printer.

LIS 3

LIS 3 allows communication to Complement 2, and HIS and LIS systems.

Data Format
Baud rate 9600 Start bit

Stop bit 1

Data bits 8

Parity OFF

The transmitted data will have the format and protocol defined in the 248 Interface Manual.

Connecting to a 270

Equipment: 270 interface cable (Cat. 673365). Select CMSI

on the 248.

Following the instructions in the 270 Operator’s Manual, connect the

248, as a 200 series instrument, to the 270.

Connecting to Complement 2

Equipment: Complement 2 interface cable (Cat. 673379). Select LIS 3 on

the 248.

Following the instructions in the Complement 2 Manual, connect the

248.
 Page E-1

Appendix E Specifications

Measurement Range

Measured Parameters
pH 6.001 - 8.000 (10.0 - 997.7 nmol/L H+)
p CO 2 5.0 - 250.0 mmHg (0.67 - 33.33 kPa)
p O2 0.0 - 749.0 mmHg (0.00 - 99.86 kPa)
p Atm 400 - 825 mmHg (53.3 - 110.0 kPa)

Calculated Parameters
HCO 3– ( act and std) 0.0 - 60.0 mmol/L
BE (ecf and B) ± 29.9 mmol/L
c tCO 2 0.0 - 60.0 mmol/L
O 2 SAT 0.0 - 100.0%
O 2 CT 0.0 - 40.0 mL/dL
p O 2( A-a) 0.0 - 749.0 mmHg (0.00 - 99.86 kPa)
p O 2( a/A) 0.00 - 1.00

Method Comparison

A comparison of whole blood samples run on four 248 analyzers and the Ciba Corning Model
R for pH, and tonometered precision gases for
p CO 2 and p O 2 was performed.

The linear regression analysis equation is y = mx + b. C of C is the

coefficient of correlation.

pH
n Range Equation C of C
335 6.776 - 7.614 M248 = Model R x 1.015 - 0.107 0.995

pCO 2
n Range Equation C of C
338 14.2 - 250.0 M248 = Tonometry Gas Value x 1.008 - 0.304 0.999

pO 2
n Range Equation C of C
297 28.6 - 640.7 M248 = Tonometry Gas Value x 1.006 - 0.195 0.999
Page E-2 248 Operator’s Manual

Precision and Recovery on Whole Blood

Whole blood was tonometered at 37 ° C and run on four 248 pH/Blood Gas Analyzers.

Analyte n WRSD Expected Observed %Recovery %CV

Level 1
pH 15 0.008 7.502 7.491 99.9 0.10
p CO 2 15 0.435 21.3 21.7 102.0 2.00
p O2 15 2.819 376.3 368.5 97.9 0.77

Level 2
pH 17 0.006 7.377 7.371 99.9 0.09
p CO 2 17 0.454 35.4 35.6 100.5 1.28
p O2 17 1.139 85.1 84.4 99.2 1.35

Level 3
pH 20 0.008 7.300 7.299 100.0 0.11
p CO 2 20 0.522 49.6 49.0 98.7 1.07
p O2 20 0.301 49.8 49.8 100.0 0.60

Level 4
pH 19 0.010 7.073 7.064 99.9 0.14
p CO 2 19 2.081 99.1 98.9 99.8 2.10
p O2 19 2.309 148.6 147.4 99.2 1.57

Level 5
pH 19 0.007 6.972 6.972 100.0 0.10
p CO 2 19 0.737 148.6 148.5 99.9 0.50
p O2 19 1.252 106.2 104.8 98.7 1.19

WRSD = within-run standard deviation

Precision on Controls

Data was collected from nine runs across four 248 pH/Blood Gas Analyzers over nine days.

pH
Level n Mean WRSD TotSD %CV

1 108 7.141 0.002 0.006 0.08

2 108 7.403 0.002 0.009 0.12
3 108 7.610 0.002 0.012 0.15
Specifications Page E-3

Precision on Controls

pCO 2 ( mmHg)
Level n Mean WRSD TotSD %CV

1 108 73.5 0.49 2.24 3.04

2 108 45.1 0.34 0.82 1.83
3 108 23.0 0.25 0.47 2.03

pO 2 ( mmHg)
Level n Mean WRSD TotSD %CV

1 108 53.8 2.78 2.49 4.63

2 108 93.8 1.16 1.88 2.00
3 108 139.5 2.21 3.32 2.38

WRSD = within-run standard deviation Tot SD =

total standard deviation

Measurement Time

Results are displayed within 45 to 120 seconds of returning the probe (typically less than 60
seconds).

Heater

The sensor operating temperature is 37.0 ° C ± 0.15 ° C. The pre-heater

temperature is 37 ° C ± 1 ° C.

Samples

Whole blood, properly collected, refer to Page 1-7. Free from hemolysis, and if not analyzed
immediately, stored as stated on Page 1-8. Fresh samples can be analyzed at a temperature
of up to 40 ° C. QC material, Siemens Healthcare Diagnostics recommended. Calibration
verification material, Siemens recommended.

Sample Volume
85 μ L (syringe) nominal, minimum 60 μ L (capillary).
Page E-4 248 Operator’s Manual

Display and Printer

Display
256 x 64 pixel vacuum fluorescent display.

Printer
32 character thermal printer.

Warm Up

The 248 is designed to be connected to an a.c. supply at all times, and, when used as
recommended will not require a warm-up period. However, if the analyzer must be
disconnected from the a.c. supply, follow the shutdown procedure as detailed on Page 3-35.

Environmental Conditions

Operation
Temperature range 15 ° C to 32 ° C
Maximum relative humidity 85% at 32 ° C (non-condensing) Barometric pressure
range 400 to 825 mmHg
Maximum ambient light 8000 lux

Transportation
Temperature range 4 ° C to 37 ° C
Maximum relative humidity 95% at 37 ° C

Storage
Temperature range 4 ° C to 25 ° C
Maximum relative humidity 95% at 25 ° C

Power Requirements

Fuse rating Two 1A fuses (time delay or slo-blo)

Power rating 80VA

Voltage 100V (85 to 110V) 120V

(102 to 132V) 50/60Hz
220V (187 to 242V) 240V
(204 to 264V)

Leakage current <0.5mA

Specifications Page E-5

Size

Width 386 mm (15 1/4 inches)

Depth 321 mm (12 5/8 inches)
Height 371 mm (14 5/8 inches)
Weight 9.1 kg (20 lb) 248 only

Reagents

Please refer to Section 6 for a complete list of reagents for use with the 248. Solutions should
be stored at 4 to 25 ° C away from direct sunlight.
 Page F-1

Appendix F Installation
Your 248 pH/Blood Gas Analyzer should be installed by an authorized Siemens Healthcare
Diagnostics representative.

Environmental Specifications

The 248 requires the following location:

248 Dimensions
Width: 386 mm (15 1/4 inches) Depth:
321 mm (12 5/8 inches)
Height: 371 mm (14 5/8 inches) Weight: 9.1
kg (20 lb)

Power Requirements
100V (85 to 110V) 120V
(102 to 132V) 50/60Hz
220V (187 to 242V) 240V
(204 to 264V)

NOTE: If you have a 230V supply, use the 240V setting on the voltage selector bobbin.

Power Rating 80VA Leakage current <0.5mA Ambient Operating Temperature

15 - 32 ° C
Ambient Operating Relative Humidity 5 - 85%, non-condensing
Ambient Light 8000 lux maximum
Ambient Operating Barometric Pressure 400 - 825 mmHg The 248 should be placed on a level
surface and not be exposed to direct sunlight. Clear access to the rear panel power connector
should be available.
Page F-2 248 Operator’s Manual

Installation Procedure
Use the following procedure to install your 248 only if you are located in a region where
Siemens Field Service Representatives do not perform installation.

For detailed information on the operating system, refer to Section 1,

Understanding the System, and Section 2, Operating the System. Refer to Section 3, Maintaining
the System, for figures.
1. Inspect the packing case and report any damage to the shipper. Notify your Siemens
representative at installation.
2. Unpack the accessories and check against the following list:
Cat Description Qty
473755 Gas Tubing Kit 2
673252 Printer Paper, 5 rolls 2 packs
473496 Buffer Pack 1
473497 Wash/CD Pack 1
476267 pH Sensor 1
476247 pCO 2 Sensor 1
476246 pO 2 Sensor 1
476273 Reference Sensor 1
Power Supply Cord 1

3. The Spares box contains the following items

Description Qty
Clot removal line 1 pack
Fuse, 1A, time delay 2
OR Fuse, 1A, slo-blo 2
‘O’ rings 2
Probe and tubing 1
Screwdriver 1
Grounding block 1
Voltage selector bobbin 1
Probe protectors 3
Pump roller 1
Pump roller drive pin 1
Grease 1 vial
Sample detector cover 1
Sample detector cover screw 1
Bottle tubing connector 2

WARNING The 248 weighs approximately 9 kg (20 lb). Observe safe lifting procedures.

4. Remove the 248 from the shipper and place on the work surface, with the rear panel
accessible.
5. Select the voltage required for your power supply, and slide the voltage selector
bobbin (from the Spares box) into the voltage selector so that the selected voltage
is visible when the voltage selector cover is closed.

6. If necessary, connect a suitable plug to the power supply cord. Follow the plug
manufacturer’s instructions.
7. Insert the power supply cord into the power connector on the rear panel.

CAUTION: Do not connect the power supply cord to the power supply.
Installation Page F-3

Installing the pH, pCO 2 and pO 2 Sensors

1. Check the level of solution in the pH sensor. It should be full, with a small air space at the
top.
If necessary, empty and refill using pH sensor fill solution. Follow the instructions on the
fill solution pack. Make sure there are no air bubbles trapped in the bottom of the sensor.

NOTE: The gas sensors are sealed and cannot be refilled. Tap them to release any
trapped air bubbles before installation.

2. Raise the front cover. Slide the measurement block catch down and raise the block cover.

3. Insert the sensors in the following order:

p O 2 p CO 2 grounding block pH

NOTE: The grounding block is in the Spares box. Slide the sensors into place, making

sure that the sensor contacts align with the contacts in the block.

Installing the Reference Sensor

1. Refer to the reference sensor package insert for filling instructions. It is particularly
important to make sure there are no air bubbles trapped in the left chamber of the
sensor cassette immediately above the sample pathway. Do not overfill the righthand
reservoir chamber.

2. Swing the block tensioner to the right and insert the reference sensor from the side. Push
the bottom of the sensor to click it into place. Make sure all the sensors are seated
correctly, then push the tensioner firmly home to make a good seal. Lower the block
cover, snapping it into place.

Connecting the Pump Tubing

1. Tension the sample pump tubes (lefthand pump) by pulling the tube lugs under the
tensioners.

2. Connect the sample tube to the measurement block tube, and the waste tube to the
manifold.

3. Connect the rubber connector to the manifold.

4. Tension the reagent pump tubes (righthand pump) by pulling the tube lugs under the
tensioners.

5. Connect the rubber waste cap connector to the manifold.

6. Make sure there are no kinks in the pump tubing.

7. Date the pump tubing labels a maximum of three months ahead.

Page F-4 248 Operator’s Manual

Installing the Reagents

1. Remove the caps from the 6.8 and 7.3 bottles.

2. Insert the tubing connectors into the bottles and push the caps onto the bottles.

3. Place the bottle assembly in the lefthand side of the reagent compartment feeding the
tubes through the caps into the solutions.

4. Date the buffer pack label a maximum of 30 days ahead.

5. Remove the CD pack from the neck of a wash bottle. Remove the bottle cap.

6. Insert the tubing connectors into the bottle and push the cap onto the bottle.

7. Place the bottle to the right of the buffer bottles feeding the tube through the cap into
the solution.

8. Check that the waste bottle is in position.

9. Check that the neck of the waste bottle is positioned underneath the rubber cap. The
waste cap spout should be inside the neck of the waste bottle.

Installing the Gas Cylinders

CAUTION: The instructions given are for Siemens gas cylinders and regulators and we
recommend the use of these at all times. If you use other cylinders and regulators they
must meet the following specfication:

• Only certified value gas cylinders should be used.

For calibration gas the value should be 5% CO 2 ( acceptable range 4 to 6%) and 12%
O 2 ( acceptable range 10 to 14%), balance N 2.

For slope gas the value should be 10% CO 2 ( acceptable range 8 to 12%) and 0% O 2 ( acceptable
range 0 to 2%), balance N 2.

The gas values used must be entered (see Page 5-2, Entering Gas Values).

• The regulator must have a low diffusion diaphragm to prevent selective diffusion and
alteration of the gas values. All fittings must be leak free. The regulator must have a low
flow precision needle valve for gas flow adjustment and supply 4 ± 1 psi at a flow of up to
20 cc/minute. When the needle valve is closed the output psi must not rise by more than
2 psi compared to the ‘open’ output.

• The tubing used must not allow selective diffusion of CO 2, O 2 or N 2.

Siemens tubing is designed to maximize through-flow rates, reducing the diffusion
rates. The accuracy of the 248 is adversely affected by the use of diffusive tubing.

• Siemens assumes no liability for performance when non-standard equipment is used.

Installation Page F-5

Installing the Gas Cylinders

WARNING Compressed gas cylinders require careful handling. To prevent damage and possible
personal injury, observe the following precautions: Compressed gas cylinders require careful
handling. To prevent damage and possible personal injury, observe the following precautions:

• Never drop cylinders, allow them to strike each other or subject them to other strong
shocks.

• Secure cylinders to a wall or bench, or place in a cylinder base support stand.

• Never drag, roll or slide cylinders, even for short distances. Use a suitable hand truck
to move cylinders.

• Never tamper with safety devices in regulators or cylinders.

• Use these gases for the calibration of clinical and research instrumentation only. US
Law prohibits dispensing these gases for drug use.

• The contents are under pressure – do not puncture.

• Do not use or store near heat or open flame.

• Do not expose cylinders to temperatures above 54 ° C (130 ° F) as this may cause the
contents to vent or explode.

• Never throw cylinders into fire or incinerators. Follow the disposal instructions on the
cylinders.

1. Place the gas cylinders into their final position and secure.

2. Remove the plastic protective wrapping from the valve assemblies.

3. Fit the gas cylinder seals on the regulators.

4. Attach the gas regulators to the cylinders with the regulator nipple engaging the opening in
the cylinder valve.

5. Attach and tighten the yoke screws firmly.

6. Attach and tighten the tubing adapter fitting into the needle valves.

7. Connect one end of the lengths of cylinder connecting tubing to the regulator fittings.

8. Slowly open the cylinder valves until the pressure gauge indicator stops rising
(approximately 3/4 of a turn, average psi is 2000 - minimum working pressure is 300 psi).
Open the cylinder valves one more turn.

CAUTION: The needle valve is easily damaged. Turn the valve gently when opening.

9. Open the needle valve fully and allow the gas to flow for a few seconds.

10. Connect the tubing from the calibration gas cylinder to the cal gas connector tubing on the
rear of the 248. Connect the tubing from the slope gas cylinder to the slope gas connector
tubing on the rear of the
248. Make sure there are no kinks or other restrictions in the lines.

11. Listen carefully for any gas leakage. Use soapy water to check for bubbles.

12. Check that the regulator outlet gauges read 4 ± 1 psi.

13. Lower the front cover.

Page F-6 248 Operator’s Manual

Powering-Up the 248

1. Connect the power supply cord to the power supply. The 248 begins the power-up
sequence:

a. The 248 checks the RAM, ADC, voltage reference buffer, voltage offset DAC, motor
DACs, comparitor port, RTC, battery backed RAM, probe, printer hardware and fluid
detectors and then displays
Warming Up.

2. While the 248 is warming up you can:

a. Prime the 248 to remove bubbles from the calibrant lines:

1. Press # for menu, 2 for Maintenance and 3 for Prime.
2. If necessary, repeat the routine to thoroughly prime the system.

b. Condition the sensors:

1. From Maintenance press 2 for Condition.

c. Initiate a 2-point calibration:

1. From Maintenance press 1 for Calibration and 2 for Full 2 Point.
The data from this calibration will not be used.

d. Configure the 248:

1. Refer to Section 5, Configuring the System.

3. When the 248 reaches operating temperature it will carry out two full 2 point calibrations
10 minutes apart.

4. When the 248 displays Ready perform the appropriate quality control
procedures.

5. Your 248 installation is complete.

 Page G-1

Appendix G Operating Principles

The 248 measurement technology is based on electrochemistry. Electrochemistry is the
measurement of current, or voltage, occurring in an electrochemical cell, between a chemical
and an electrical system. Each electrode, or sensor, is designed to selectively measure the
activity of a specific substance. Many elements in a sample may interact with a sensor, but the
sensor is highly selective for one substance over others. The potential generated at the sensor
is converted into an electronic signal by a transducer mechanism. The 248 uses potentiometry
and amperometry. Potentiometry measures the potential that develops at the sensor.
Amperometry involves applying a voltage to the sensor and then measuring the current
generated.

The electronic signal is filtered and smoothed, and converted into a concentration
measurement expressed in standard units.

Potentiometry

During sample analysis, a potential develops at the sensor as a result of the interaction with
the analyte (ion). The potential is related to the amount of analyte in the sample.

The reference sensor provides a fixed potential, which is independent of analyte activity, and is
used to compare the measured potential. The sensor potential corresponds to the analyte
activity, and is directly related of the concentration of the analyte in solution. The potential is
expressed by the Nernst equation:

E cell = K + (2.3RT/ZF) log a i

where: E cell = electrochemical cell potential

K = a constant (produced by various sources such as the liquid
junction) R = gas constant T
= absolute temperature Z = ionic
charge F = Faraday’s constant a i

= activity of the ion in the sample

This equation shows that the potential is logarithmically related to the activity of the analyte in
the sample.

However, the sensor actually measures the activity of the analyte in solution. In clinical
chemistry results are typically expressed as concentration rather than activity. The activity of
an ion is equivalent to the concentration (mol/L) multiplied by the activity coefficient (the
degree with which the ion interacts with other ions in solution). The activity coefficient
depends on the ionic strength of the solution, and generally decreases with increasing ionic
strength 10.
Page G-2 248 Operator’s Manual

Potentiometry

Using an established convention, the activity of ions as measured by the sensors can be
expressed as concentration. Ionic strength is the primary variable affecting the activity
coefficient of ions in solution. The normal ionic strength of blood plasma water is 160 mmol/kg 11.
Controlling the ionic strength of calibrating solutions to 160 mmol/kg sets the activity
coefficients of ionic species in the calibrations equal to those of blood plasma water at ionic
strengths close to normal. Both calibrations and measurements may then be expressed in units
of concentration rather than activity.

Amperometry

Amperometry is an electrochemical technique used to determine the amount of analyte in

solution by applying a fixed voltage between two electrodes in an electrochemical cell, then
measuring the current flowing. The measuring electrode is negatively charged and serves as a
cathode in the electrical system. The reference electrode is positively charged, and serves as
the anode. Both electrodes are attached to an external voltage source.

As the sample comes into contact with the two electrodes, a known voltage is applied to the
cathode. This voltage attracts molecules from the analyte in solution to the cathode causing a
chemical reaction (reduction) that uses electrons. The electrons are replaced immediately in
the sample solution by a separate reaction (oxidation) that takes place at the anode. The two
reactions result in a current flow that can be measured. The current measured is directly
proportional to the concentration of analyte (reacting at the cathode) present in the sample.

Sensors

Reference Sensor
The reference sensor contains a silver (Ag) wire, coated with layer of silver chloride (AgCl)
surrounded by a saturated potassium chloride (KCl) solution. By making sure that the
concentration of chloride ions (Cl-) remains unchanged in the solution, the reference sensor
maintains a constant electrical potential. KCl is added to the reference sensor solution
chamber to maintain a saturated solution of KCl at 37 ° C. A permeable cellulose membrane
separates the KCl solution from the sample. During analysis a diffusion potential, created
between the sample and KCl solution, provides the fixed half-cell potential required for
measurement.

The Ag wire conducts the potential to the measurement device where it is compared to the
potential of the measuring sensor. The potential difference measured reflects the concentration
of analyte in the sample.
Operating Principles Page G-3

Reference Sensor
Figure G-1. Reference sensor (cutaway view)

Vent Hole

Reservoir
Sensor Contact

Inner Electrode

O-Rings

Sample Path

pH Sensor
The pH sensor is based on ion selective electrode (ISE) technology and is a half-cell that
forms a complete cell with the external reference sensor. It contains a silver/silver chloride wire
(Ag/AgCl) surrounded by a buffer solution of fixed hydrogen ion concentration. A glass
membrane, highly sensitive and specific for hydrogen ions, separates the sample from the
solution.

As the sample comes into contact with the membrane of the pH sensor, a potential develops
due to the exchange of hydrogen ions in the membrane. The silver/silver chloride wire
conducts the potential to a voltmeter where it is compared to the constant potential of the
reference sensor. The final measured potential reflects the hydrogen ion concentration of the
sample, and is used to calculate the pH value.

Figure G-2. pH sensor (cutaway view)

Sensor Contact

Inner Electrode

Fill Solution

Sample Path

O-Rings
Page G-4 248 Operator’s Manual

pCO 2 Sensor
The p CO 2 sensor is based on the electrode described by Severinghaus and Bradley 12 and
consists of a measuring electrode and an internal reference electrode. The measuring
electrode, which is a pH electrode, is surrounded by a chloride-bicarbonate solution. A
membrane permeable to gaseous CO 2
separates this solution from the sample. The internal reference electrode contains a
silver/silver chloride electrode surrounded by the chloride- bicarbonate solution, and provides a
fixed potential. As the sample comes into contact with the membrane, CO 2 diffuses into the
chloride-bicarbonate solution causing a change in the hydrogen ion concentration.

The internal pH electrode generates a potential which is compared to the fixed potential of the
internal reference electrode. This results in a measurement that reflects pH change in the
chloride-bicarbonate solution. The change in pH is proportional to the log of the partial
pressure of p CO 2.

Figure G-3. pCO 2 sensor (cutaway view)

Sensor Contacts

Sample Path

O-Ring

pO 2 Sensor
The p O 2 sensor is based on the electrode described by Clark 13 and uses amperometric
technology. The sensor consists of a platinum (Pt) cathode, a silver (Ag) anode, an electrolyte
solution and a gas permeable membrane. A constant voltage, called a polarizing voltage, is
maintained between the anode and the cathode. As dissolved oxygen from the sample passes
through the membrane into the electrolyte solution it is reduced at the cathode. The circuit is
completed at the anode, where the Ag is oxidised. The amount of oxygen reduced is directly
proportional to the number of electrons gained at the cathode. Therefore, by measuring the
change in current (electron flow) between the anode and the cathode, the amount of oxygen in
the sample can be determined 14.
Operating Principles Page G-5

pO 2 Sensor

Figure G-4. pO2 sensor (cutaway view)

Sensor Contacts

Sample Path

O-Ring

Measuring pH and Blood Gases

pH
pH expresses the hydrogen ion activity in a solution as the negative logarithm of the
hydrogen ion concentration:

pH = –log c H+

where c H+ is the molar concentration of hydrogen ions. The hydrogen ion is the determinant
of the acidity of blood or plasma. Normal cellular metabolism requires an exacting
environment where hydrogen ion concentration must be maintained within narrow limits.
Hydrogen ion activity reflects the acid-base balance within blood. Acids donate hydrogen ions;
bases remove hydrogen ions. The lungs, kidneys and blood all work to maintain the acid-base
status within the strict limits necessary.

The Henderson-Hasselbalch equation describes how pH expresses the interaction of acid

and base in blood:

base
pH = pK + log acid

where K is the dissociation constant, which describes the ability of a solution to release
hydrogen ions. Since K, and therefore pK, is a constant, this equation can be used to
demonstrate that pH is proportional to the acid-base concentrations in blood. pH is clinically
significant as a means to determine acid-base disturbances. Acid-base disorders can result in
several pathological conditions. An acid-base disorder resulting initially from ventilatory
dysfunction is called a primary respiratory acidosis or alkalosis, while one due to renal or
gastrointestinal inadequacy is referred to as metabolic acidosis or alkalosis. Using acceptable
therapeutic ranges, a pH less than 7.3 indicates acidosis, and a pH greater than 7.5 indicates
alkalosis 15.
Page G-6 248 Operator’s Manual

pCO 2
Carbon dioxide (CO 2) is produced during normal cell metabolism and is released into the blood
stream where it is transported to the kidneys and lungs for excretion. CO 2 is transported
through the blood as bicarbonate (HCO 3–), dissolved CO 2, and carbonic acid (H 2 CO 3).

The levels of HCO 3-, H 2 CO 3, and dissolved CO 2 play a major role in maintaining the pH in
blood. pH is proportional to the acid-base relationship.

Although other acids and bases are present in the blood, the H 2 CO 3/ HCO 3– relationship
is sensitive and dynamic and typically reflects other acid-base changes.

When the measurement of the partial pressure of carbon dioxide ( p CO 2)

in the blood is combined with the measured pH, the values can be incorporated into the
Henderson-Hasselbalch equation to determine the HCO 3– in addition to the c tO 2. Since the p CO 2
value is proportional to the content of dissolved CO 2/ HCO 3–, the value for p CO 2 can be used with
pH not only to calculate HCO 3–, but also to aid in the differentiation of acid-base abnormalities.
The measurement of p CO 2 is essential in determining ventilatory status. Because the lungs are
primarily responsible for controlling p CO 2

levels, changes in p CO 2 reflect respiratory status. For example, an increase in CO 2 indicates

decreased ventilation as CO 2 is retained, and a decrease in CO 2 indicates increased ventilation
(hyperventilation) as CO 2 is expired from the lungs. Together, pH and p CO 2 provide a more
definitive diagnostic tool in assessing respiratory function. An increase in the p CO 2 value and a
decrease in pH indicates respiratory acidosis - a condition where CO 2 is retained by the lungs.
A decrease in the p CO 2 value and an increase in pH indicates respiratory alkalosis - a
condition where the lungs are expiring too much CO 2 relative to the amount produced.

pO 2
Oxygen (O 2) is essential for cell and tissue metabolism in the body. The cardiopulmonary
system is responsible for transporting oxygen to the cells. Oxygen transport involves four
major steps: convection and diffusion from the air into the pulmonary circulation, combination
of O 2
from the lungs with haemoglobin in red blood cells, transportation of the O 2 through the
arteries to the cell, and finally the release into the tissues and utilization of O 2 at cellular
level.

Since it is not possible to measure intra-cellular oxygen tension, arterial p O 2 has become a
standard for clinical evaluation of arterial oxygenation status. p O 2( A) measurement, which
indicates the oxygen tension in arterial blood, reflects the pressure or driving force for
moving oxygen from one location to the next due to pressure differential. Although not a
measurement of the O 2 content, this provides a measurement tool to evaluate the pulmonary
gas exchange efficiency from an arterial blood sample.
Operating Principles Page G-7

pO 2
Complete laboratory evaluation of oxygenation requires much more than simple blood gas
measurements. Assessment of ventilatory system and acid-base status is essential to properly
interpret clinical significance of arterial oxygenation status. However, many patients can be
evaluated and treated successfully using blood gases alone if clinical observations and patient
history are taken into account 14.

The measurement of p O 2 is significant in evaluating the degree of hypoxemia (a

deficiency of O 2 in arterial blood) present in a patient.

Calculated Parameters

The 248 calculates other parameters of interest to clinicians, and uses several different
equations to provide these parameters. Unless otherwise noted, all measured values used in
equations are at 37 ° C.

Bicarbonate Ion (HCO 3–)

Bicarbonate (HCO 3–) is the major buffer substance present in the body, and plays a major role in
maintaining the pH level in blood. It is present in large amounts in the blood as a result of the
dynamic state of CO 2 in the blood. The majority of CO 2 is transported as HCO 3–.

The kidneys are the major controller of bicarbonate ion. Bicarbonate levels are clinically
significant in helping to determine the non-respiratory, renal (metabolic) component in
acid-base disorders. Changes in HCO 3– levels along with pH values can help determine if
acidosis or alkalosis disorders are of metabolic origin. In metabolic acidosis, HCO 3– levels
decrease causing an increase in H+ which leads to a decrease in pH. Conversely, in metabolic
alkalosis, HCO 3– levels increase, causing a decrease in H+ which leads to an increase in pH.

There are two versions of bicarbonate, the actual value and the standard value, available in
the System Set Up menu.

Actual Bicarbonate (HCO 3– act)

Based on the National Committee for Clinical Laboratory Standards (NCCLS)
recommendations 16

c HCO 3–act = 0.0307 x p CO 2 x 10( pH – 6.105)

Standard Bicarbonate (HCO 3– std)

The equation described by VanSlyke and Cullin 17 is used for calculating standard bicarbonate

c HCO 3–std = 24.5 + 0.9A + (A–2.9) 2 ( 2.65 + 0.31 c tHb)/1000 where A = BE(B) – (0.2 c tHb(100–O

2 SAT)/100) If no c tHb value has been entered, a value of 15g/dL is assumed.

Page G-8 248 Operator’s Manual

Base Excess
Base excess is an empirical expression that approximates the amount of acid or base required
to titrate one litre of blood back to a normal pH of 7.4. The base excess in blood with a pH of
7.4, p CO 2 of 40 mm Hg (5.33 KPa), total haemoglobin of 15 g/dL and a temperature of 37 ° C is
zero. Base excess is useful in the management of patients with acid-base disorders as it allows
the estimation of the number of equivalents of sodium bicarbonate or ammonium chloride
required to correct the patient’s pH to normal. There are two versions of base excess, available
in the System Set Up menu.

Base Excess of Extracellular Fluid (BE(ecf))

The base excess of extracellular fluid, formerly known as in vivo base excess, reflects only the
non-respiratory component of pH disturbances

BE(ecf) = c HCO 3–act – 24.8 + 16.2 (pH – 7.4)

Base Excess of Blood (BE(B))

The base excess of blood, formerly known as in vitro base excess, is calculated from the
following equation

BE(B) = (1 – 0.014 c tHb) ( c HCO 3–act – 24.8 + (1.43 c tHb + 7.7) (pH – 7.4)) If no c tHb value

has been entered, a value of 15g/dL is assumed.

Oxygen Content (O 2 CT)

Oxygen content is the concentration of the total oxygen carried by the blood, including
oxygen bound to haemoglobin as well as oxygen dissolved in plasma and in the fluid within
red cells.

Oxygen content is calculated, using NCCLS recommendations 18, as follows:

O 2 CT = (1.39 c tHb x O 2 SAT/100) + (0.00314 p O 2)

where c tHb is expressed in g/dL. If no c tHb value has been entered, O 2 CT is not
calculated. Clinically, dissolved oxygen is for most situations analytically unimportant.
However, at very low levels of haemoglobin or in patients receiving hyperbaric oxygen
therapy, dissolved oxygen may be a very significant contributor to oxygen transport.
Operating Principles Page G-9

Oxygen Saturation (Estimated)

Oxygen saturation (O 2 SAT) is a ratio, expressed as a percentage of the volume of oxygen
carried to the maximum volume that can be carried. Knowledge of oxygen saturation is useful
for predicting the amount of oxygen actually available for the tissues and can be used to
determine the effectiveness of oxygen therapy.

NOTE: Clinically significant errors can result from incorporating an estimated O 2 SAT value in
further calculations, such as shunt fraction (Qsp/ Qt), or by assuming that the value obtained is
equivalent to fractional oxyhaemoglobin 18.

N 4 – 15N 3 + 2045N 2 + 2000N

O 2 SAT = x 100
N 4 – 15N 3 + 2400N 2 – 31,100N + (2.4 x 10 6)

where N = p O 2 x 10[ 0.48(pH–7.4) – 0.0013 BE(B)]

Because oxygen saturation also depends on the level of carbon monoxide and 2,3
diphosphoglycerate (2, 3 DPG) in the blood, the calculated value for oxygen saturation may not
be equal to that actually measured for patients showing abnormal levels of 2, 3 DPG or carbon
monoxide. The equation does not account for these variations, therefore the oxygen saturation
that is reported should only be used as an estimate of the actual value.

Total Carbon Dioxide (ctCO 2)

Total carbon dioxide ( c tCO 2), in combination with pH and p CO 2, is useful in distinguishing
between metabolic and respiratory acid-base disorders. Carbon dioxide exists in several forms
in blood plasma, but only two forms, dissolved CO 2 and HCO 3– are quantitatively significant.
Based on NCCLS recommendations 16, the following equation is used:

c tCO 2 = c HCO 3–act + ( 0.0307 x p CO 2)

Patient Temperature Correction

All measurements and calculations are based on a standard temperature of 37 ° C. Actual
patient temperature values can be entered during sample analysis which allows the 248 to
provide temperature corrected results. The following equations, based on NCCLS
recommendations 16, are used:

pH(T) = pH – (0.0147 – 0.0065 x (7.4 – pH)) x (T – 37)

p CO 2( T) = p CO 2 x 10( 0.019 x (T – 37))

p O 2( T) = p O 2 x 10( A x (T – 37))

where A =5.49 x 10 –11 x p O 23.88 + 0.071

9.72 x 10 –9 x p O 23.88 + 2.3

and where T = 37 ° C if not entered.

Page G-10 248 Operator’s Manual

Gas Exchange Indices

Gas exchange indices are a quick way to estimate the relationship between pulmonary
dysfunction and hypoxia, and to quantitatively determine the degree of pulmonary shunting.
However, they do not have a high level of correlation with the actual measurement of arterial
and mixed venous blood and should be used with discretion. The gas exchange indices are
provided for convenience. Final judgment of their use is in the hands of the physician. The gas
exchange indices require an arterial sample and use measured values at patient temperature.

Alveolar O 2
Alveolar O 2, referred to as p O 2( A) or p A O 2, is the partial pressure of oxygen in alveolar gas. It is a
primary component in the detection of gas exchange indices. The following equation 14,19 is used
to estimate the alveolar O 2:

p O 2( A)(T) = F I O 2/ 100 x ( p Atm – p H 2 O) – p CO 2( T) x (1.25 – 0.25 x F I O 2/ 100)

where T = patient temperature ( ° C)

p H 2 O = 10( 0.0244 x T + 0.7655) + 0.4

Arterial-Alveolar Oxygen Tension Difference

The arterial-alveolar oxygen tension difference ( p O 2( A–a)), (or A–aDO 2)
is useful as an index of gas exchange within the lungs if c tO 2
measurements are not available. The following equation 14,19 is used:

p O 2( A–a)(T) = p O 2( A)(T) – p O 2( a)(T)

where p O 2( A)(T) is the temperature corrected oxygen tension of alveolar gas, and p O 2( a)(T) is
the temperature corrected oxygen tension of arterial blood.

Arterial-Alveolar Oxygen Tension Ratio

The arterial-alveolar oxygen tension ratio ( p O 2( a/A)), (or a/A ratio) provides an index of
oxygenation that remains relatively stable when
F I O 2 changes. It is useful in predicting oxygen tension in alveolar gas. The following
equation 20 is used:

p O 2( a)(T)
p O 2( a/A)(T) = p O 2( A)(T)

where p O 2( A)(T) is the temperature corrected oxygen tension of alveolar gas, and p O 2( a)(T) is
the temperature corrected oxygen tension of arterial blood.

NOTE: If F I O 2 value is not entered, the gas exchange indices will not be calculated.
248 Operator’s Manual Page G-11

The algorithms used for Calculated Parameters are those currently recommended by
NCCLS. Algorithms used in our earlier instruments are given here for reference:

Actual Bicarbonate (HCO 3– act)

HCO 3–act = 0.031 x p CO 2 x 10( pH - 6.1)

Standard Bicarbonate (HCO 3– std)

No change

Base Excess of Extracellular Fluid (BE(ecf))

Formerly BE(vv)

BE(ecf) = (1 - 0.004 c tHb) x (HCO 3–act - 24) + (9 + 0.3 c tHb) x (pH - 7.4) -
0.3 c tHb x (100 - O 2 SAT)/100

Base Excess of Blood (BE(B))

Formerly BE(vt)

BE(B) = (1 - 0.014 c tHb) x (HCO 3–act - 24) + (9.5 +1.63 c tHb) x (pH - 7.4)

Oxygen Content (O 2 CT)

O 2 CT = 1.39 c tHb x O 2 SAT/100 + 0.003 p O2

Oxygen Saturation (Estimated)

No change

Total Carbon Dioxide (ctCO 2)

c tCO 2 = 0.031 p CO 2 + HCO 3–act

Patient Temperature Correction

pH(T) = pH - 0.015 x (T - 37)

p CO 2 no change
p O 2( T) = p O 2 x 10( A x (T - 37))
where A = 0.0052 + 0.027 x (1 - 10( –0.13 x (100 - O 2 SAT)))

Arterial-Alveolar Oxygen Tension Difference

No change

Arterial-Alveolar Oxygen Tension Ratio

No change