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chloride [2025/01/28 06:44] – created adminchloride [2025/01/28 06:46] (current) – admin
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-1.Purpose of Examination: +**1.Purpose of Examination:** 
 To lay down standard operating procedure for serum Chloride by ISE Method in Biochemistry section of LSSTH, Bhavnagar. To lay down standard operating procedure for serum Chloride by ISE Method in Biochemistry section of LSSTH, Bhavnagar.
  
-2.Principle: +**2.Principle:** 
 Ion Selective Electrode. Ion Selective Electrode.
  
-3.Performance:+**3.Performance:**
 Linearity –  70-152 mEq/L Linearity –  70-152 mEq/L
 Precision -  It is determined from 2 runs per day with two replicates per run for 20 days on two AFT 300 Electrolyte Analyzer. Precision -  It is determined from 2 runs per day with two replicates per run for 20 days on two AFT 300 Electrolyte Analyzer.
  
-4.Primary Sample: +**4.Primary Sample:** 
-Plasma or serum +Plasma or serum [[sample_collection_manual|]]
  
-5.Patient Preparation:+**5.Patient Preparation:**
 Verbal consent of patient should be taken before collecting blood sample. Verbal consent of patient should be taken before collecting blood sample.
  
-6.Type of Container:+**6.Type of Container:**
 Plain Vaccute with no additive  Plain Vaccute with no additive
  
-7.Required Equipment:+**7.Required Equipment:**
 Centrifuge, Electrolyte auto analyzer Centrifuge, Electrolyte auto analyzer
  
-8.Safety Precaution:+**8.Safety Precaution:**
 Follow the universal work precautions. Follow the universal work precautions.
  
-9.Calibration Procedure:+**9.Calibration Procedure:**
 Instrument performs auto calibration every four hours Instrument performs auto calibration every four hours
 Manual calibration is done on following circumstances:  Manual calibration is done on following circumstances: 
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   * QC data not satisfactory - QC outlier   * QC data not satisfactory - QC outlier
  
-10.Procedural Steps:+**10.Procedural Steps:**
 Centrifuge the blood sample ,Open the sample door of the instrument, than hold the Vacutte  under the probe to be aspirated Centrifuge the blood sample ,Open the sample door of the instrument, than hold the Vacutte  under the probe to be aspirated
  
-11.Quality Control Procedure:+**11.Quality Control Procedure:**
 The Laboratory runs Internal Quality control level 1, level 2 & level 3 twice a day. Monthly L-J charts are reviewed & for any QC outlier root cause analysis are done & corrective actions are taken according to error. Participated in RIQAS programme. RIQAS report is reviewed and if any result go outlier, than root cause analysis is done & corrective actions is taken according to error.  The Laboratory runs Internal Quality control level 1, level 2 & level 3 twice a day. Monthly L-J charts are reviewed & for any QC outlier root cause analysis are done & corrective actions are taken according to error. Participated in RIQAS programme. RIQAS report is reviewed and if any result go outlier, than root cause analysis is done & corrective actions is taken according to error. 
  
-12.Interferences & Cross-Reactions:+**12.Interferences & Cross-Reactions:**
 Salicylates in high level, Lipemia and Hemolysis Salicylates in high level, Lipemia and Hemolysis
  
-13.Principle of Procedure for Calculating Results:+**13.Principle of Procedure for Calculating Results:**
 Membrane potential is caused by the permeability of certain types of membranes to selected anions or cations. The potential produced at the membrane –solution interface is proportional to the logarithm of the ionic activity or concentration of  Chloride  Ion. Membrane potential is caused by the permeability of certain types of membranes to selected anions or cations. The potential produced at the membrane –solution interface is proportional to the logarithm of the ionic activity or concentration of  Chloride  Ion.
  
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 96-106 mEq/L 96-106 mEq/L
  
-15.Reportable interval of patient examination results:+**15.Reportable interval of patient examination results:**
 80-120  mEq/L 80-120  mEq/L
  
-16.Instruction for determining Quantitative results when a results is not within the measurement+**16.Instruction for determining Quantitative results when a results is not within the measurement**
 Rerun the sample and correlate clinically Rerun the sample and correlate clinically
  
-17.Stability of sample+**17.Stability of sample**
 Serum or plasma-At Room temperature18°–28°C (64°–82°F) stability ≤ 24 hours Serum or plasma-At Room temperature18°–28°C (64°–82°F) stability ≤ 24 hours
 CSF- At Refrigerated 2°–8°C (36°–46°F) stability 3 days CSF- At Refrigerated 2°–8°C (36°–46°F) stability 3 days
  
-18.Storage of sample+**18.Storage of sample**
  2-8° C for 1 days (Retention period for re-examination and/or additional tests is 24 hrs. at (2-8° C).  2-8° C for 1 days (Retention period for re-examination and/or additional tests is 24 hrs. at (2-8° C).
  
-19.Reagent Storage and stability+**19.Reagent Storage and stability**
 Unopened reagents is stable until expiration date when store at 2-8°c.Reagent stability is 30 days if reagent is uncapped and onboard. Unopened reagents is stable until expiration date when store at 2-8°c.Reagent stability is 30 days if reagent is uncapped and onboard.
  
-20.Turn around time (TAT) +**20.Turn around time (TAT)** 
-  6.0 hours after collection, in case of emergency 2.0 hours.+6.0 hours after collection, in case of emergency 2.0 hours.
  
-21.Critical Value:+**21.Critical Value:**
 80-120  mEq/L 80-120  mEq/L
  
-22.Laboratory Interpretation: +**22.Laboratory Interpretation:** 
-High Chloride levels are seen in:+  * High Chloride levels are seen in:
 Dehydration, Cushing’s Syndrome, Hyperventilation and eclampsia Dehydration, Cushing’s Syndrome, Hyperventilation and eclampsia
-Low Chloride levels are seen in:+  * Low Chloride levels are seen in:
 Diarrhoea, Vomitting, Ulcerative colitis, Pyloric Obstruction, Severe burns, Diabetic acidosis, Addison’s disease Diarrhoea, Vomitting, Ulcerative colitis, Pyloric Obstruction, Severe burns, Diabetic acidosis, Addison’s disease
  
-23.Potential source of variation:+**23.Potential source of variation:**
   - Expiry of Kit    - Expiry of Kit 
   - Instrumental Error   - Instrumental Error
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   - Storage condition not proper   - Storage condition not proper
  
-24.Reagent Handling+**24.Reagent Handling**
 Remove any air bubbles present in the reagents with a new applicator stick, or allow the reagents to sit at the appropriate storage temperature to allow the bubbles to dissipate. To minimize volume depletion, do not use a transfer pipette to remove bubbles Remove any air bubbles present in the reagents with a new applicator stick, or allow the reagents to sit at the appropriate storage temperature to allow the bubbles to dissipate. To minimize volume depletion, do not use a transfer pipette to remove bubbles