103AP v4 Basic Automatic PDF

ELECTROLYTE ANALYZER
OPERATOR´S AND SERVICE MANUAL
DIESTRO 103 AP v4
Auto Basic
V 4.00
Rev. 9, February 2015
RE 0809
DIESTRO 103 AP ELECTROLYTE ANALYZER
CONTENTS
1 - INTRODUCTION .......................................................................................................................................................... 7
2 - SAFETY INSTRUCTIONS ........................................................................................................................................... 8
1. IMPORTANT SAFETY INSTRUCTIONS................................................................................................................ 8
2. SYMBOLS.......................................................................................................................................................... 9
3 - INSTALLATION ......................................................................................................................................................... 11
1. UNPACKING ................................................................................................................................................... 11
2. INSTALLATION REQUIREMENTS .................................................................................................................... 11
3. CONNECTION ................................................................................................................................................. 12
TOUCHSCREEN CALIBRATION ........................................................................................................... 19
4. RETRACTABLE FILL PORT ............................................................................................................................. 19
4.1 Capillary Adapter ..................................................................................................................... 20
4 – CALIBRATING SOLUTION PACK (PACK) .......................................................................................................... 22
1. PACK .............................................................................................................................................................. 22
TWO TYPES AND IDENTIFICATION OF PACKS ...................................................................................... 22
2. PACK OF CALIBRATING SOLUTIONS MICROCHIP (UCHIP) ......................................................................... 23
3. CALIBRATING SOLUTIONS PACK VALIDITY ................................................................................................. 23
4. CALIBRATING SOLUTIONS CONSUMPTION ................................................................................................... 24
5. PACK´S PERFORMANCE ................................................................................................................................. 24
6. REPLACEMENT OF THE PACK ....................................................................................................................... 25
5 - SERUM/PLASMA/WHOLE BLOOD MEASURING .............................................................................................. 28
1. GENERAL COMMENTS ................................................................................................................................... 28
2. SAMPLE FILLING ............................................................................................................................................ 28
3. MEASURING ................................................................................................................................................... 29
4. PRINTED ELECTROLYTE REPORT .................................................................................................................. 32
5. SAMPLE DATA ENTER (OPTIONAL) ............................................................................................................... 32
6 – URINE MEASUREMENT .......................................................................................................................................... 34
2. SAMPLE FILLING ........................................................................................................................................... 34
3. MEASURING ................................................................................................................................................... 34
4. PRINTED ELECTROLYTE REPORT................................................................................................................. 37
5. SAMPLE DATA ENTER (OPTIONAL) .............................................................................................................. 36
7 - CALIBRATION ........................................................................................................................................................... 39
2. ONE POINT CALIBRATION............................................................................................................................. 39
3. TWO POINT CALIBRATION ............................................................................................................................ 39
3.1 Automatic Calibration .............................................................................................................. 39
3.2 On Demand Calibration ........................................................................................................... 39
4. CALIBRATION RESULT .................................................................................................................................. 40
5. PRINTED CALIBRATION REPORT ....................................................................................................... 42
6. SAVED RESULTS ....................................................................................................................................... 42
7. CALIBRATION OPTIONS ........................................................................................................................ 43
7.1 Electrolyte Enabling/Disabling ................................................................................................ 44
7.2 Units Modification .................................................................................................................... 45
7.3 Delta Correction Setting ........................................................................................................... 46
7.4 Delta Correction Rates ............................................................................................................. 48
8. ELECTRODES HISTORY .................................................................................................................................. 40
8.1 General Comments .................................................................................................................... 48
9. INSTALLED PACK HISTORY ........................................................................................................................... 50
9.1 General Comments .................................................................................................................... 50
10. STANDBY FUNCTION .................................................................................................................................... 52
8 – RINSE AND CLEANING ........................................................................................................................................... 53
JS Medicina Electrónica
2
DIESTRO 103 AP ANALIZADOR DE ELECTROLITOS
2. AUTOMATIC RINSE......................................................................................................................................... 53
3. ON DEMAND RINSE ........................................................................................................................................ 53
4. AUTOMATIC CLEAN ....................................................................................................................................... 54
5. ON DEMAND CLEAN ....................................................................................................................................... 55
6. SODIUM CONDITIONER .................................................................................................................................. 56
7. CLEAN OF CAPILLARY FOR SAMPLING ........................................................................................................ 57
9 - PURGE ........................................................................................................................................................................... 60
1. GENERAL COMMENTS.................................................................................................................................... 58
2. AUTOMATIC PURGE ....................................................................................................................................... 58
3. ON DEMAND PURGE ....................................................................................................................................... 58
10 – QUALITY CONTROL .............................................................................................................................................. 62
2. QUALITY CONTROL PROCEDURE .................................................................................................................. 62
3. QUALITY CONTROL RESULTS ....................................................................................................................... 63
4. DELTA CORRECTIONS .................................................................................................................................... 65
5. DEFINITIONS ................................................................................................................................................... 65
11 - CLOCK ........................................................................................................................................................................ 67
1. DEFINITION..................................................................................................................................................... 67
2. CLOCK ADJUSTMENT ..................................................................................................................................... 67
12 – RESULT STORAGE .................................................................................................................................................. 69
2. MEASURMENT RESULTS ................................................................................................................................ 69
13 – NON DETECTED SAMPLES................................................................................................................................... 71
2. DISABLING THE SAMPLE SENSOR ................................................................................................................... 72
14 – CONFIGURATION OF PRINTER, SERIAL OUT, LANGUAGE AND LABORATORY´S DATA ............... 73
2. PRINTER, SERIAL OUT AND LANGUAGE CONFIGURATION ............................................................................ 74
15 - ERROR MESSAGES .................................................................................................................................................. 78
1. LIST OF ERRORS ............................................................................................................................................. 78
2. INTERNAL ERRORS 01 OR 02 .......................................................................................................................... 80
16 – MAINTENANCE........................................................................................................................................................ 83
1. DAILY MAINTENANCE.................................................................................................................................... 83
1.1 Analyzer´s Decontamination ............................................................................................................ 83
1.2 Clean ................................................................................................................................................. 84
2. WEEKLY MAINTENANCE ............................................................................................................................... 84
2.1 Sodium Conditioner ......................................................................................................................... 84
2.2 Internal Clean Of the Analyzer ........................................................................................................ 84
3. OTHER MAINTENANCE AND SPARE PARTS OR COMPONENT REPLACEMENT ................................................ 85
4. OPEN THE FRONT PANEL ................................................................................................................................ 85
5. CLOSE THE FRONT PANEL .............................................................................................................................. 85
6. INSTALLATION/REPLACEMENT OF THE DIESTRO FILL PORT CLEANER ..................................................... 86
7. TRANSPORTATION OF THE ANALYZER........................................................................................................... 87
7.1 Transportation within the laboratory............................................................................................... 87
7.2 If tranportation involves large movements, but it will be reinstalled within a day ......................... 87
7.3 If the analyzer will not be installed in more than two days ............................................................. 88
8. DISCARD OF CONSUMABLES ........................................................................................................................... 89
9. FINAL DISCARDING OF THE ANALYZER ......................................................................................................... 89
17 – SERVICE .................................................................................................................................................................... 90
2. ACCESS TO THE SERVICE MENU ..................................................................................................................... 90
3. REVISION AND ASSESSEMENT OF THE STATE OF ELECTRODES .................................................................... 91
JS Medicina Electrónica 3
3.1. Manual Positioning ........................................................................................................................ 91

3.2. Automatic Positioning .................................................................................................................... 92
3.3. Interpretation of the obtained results .................................................................................. 93
4. THRESHOLD OPTION ..................................................................................................................................... 95
5. RETRACTABLE FILL PORT ............................................................................................................................ 96
18 – ELECTRODE REPLACEMENT ............................................................................................................................ 98
19 – ELECTROLYTE EXPANSION ............................................................................................................................. 100
1. GENERAL COMMENTS ................................................................................................................................. 100
2. INSTALLATION IN THE ANALYZER OF THE ELECTRODE/S AND ACCESSORIES THAT MAKE UP THE
EXPANSION ................................................................................................................................................................................ 100
2.1 Expansion enabling in the software ................................................................................... 100
2.2 Contact the Manufacturer and report the generated code ................................................ 100
2.3 Enabling the new electrode ................................................................................................ 100
20 – REPLACING THE PRINT PAPER ...................................................................................................................... 103
21 – PERISTALTIC PUMP TUBING REPLACEMENT ........................................................................................... 104
22 – CAPILLARY FOR SAMPLING REPLACEMENT ............................................................................................ 105
1. CAPILLARY FOR SAMPLING REPLACEMENT ............................................................................................... 105
2. FILL PORT REPLACEMENT .......................................................................................................................... 105
2.1 Dismounting the Fill Port ................................................................................................... 105
2.2 Installing the Fill Port ........................................................................................................ 105
23 – REPLACEMENT/INSTALLATION OF THE BACKUP BATTERY ............................................................... 106
24 – REFERENCE VALUES .......................................................................................................................................... 107
1. ELECTROLYTE RANGE................................................................................................................................. 107
2. ELECTRODE SPAN (mV) .............................................................................................................................. 107
25 - CABLES .................................................................................................................................................................... 108
26 - DIAGRAMS .............................................................................................................................................................. 109
27 – TECHNICAL SPECIFICATIONS ........................................................................................................................ 113
1. SIZE AND WEIGHT ....................................................................................................................................... 113
1.1 Size and Weight of the box ................................................................................................. 113
2. ENVIROMENTAL CONDITIONS OF OPERATION ........................................................................................... 113
3. ENVIROMENTAL CONDITIONS OF STORAGE AND TRANSPORT.................................................................... 113
4. LINE VOLTAGE REQUIRED.......................................................................................................................... 113
5. POWER SUPLY SPECIFICATIONS .................................................................................................................. 113
6. SAMPLES/ HOUR .......................................................................................................................................... 113
7. MAXIMUM SAMPLE VOLUME...................................................................................................................... 113
8. MINIMUM SAMPLE VOLUME....................................................................................................................... 113
9. RANGE AND MEASURING PERFORMANCE ................................................................................................... 113
10.ELECTRODES………………………..…………………. ……………..........…… …………………… ….113
11. ELECTRODE SLOPE RANGE....................................................................................................................... 113
12. BATTERY .................................................................................................................................................... 113
13. EXTERNAL BARCODE READER SPECIFICATIONS ...................................................................................... 113
14. GEL BATTERY ............................................................................................................................................ 113
ANNEX I - CLINICAL SIGNIFICANCE OF SERUM/PLASMA/BLOOD ELECTROLYTES............................ 114
POTASSIUM CONCENTRATION: CK+ ............................................................................................................... 114
SODIUM CONCENTRATION: CNA+ ................................................................................................................... 115
CHLORIDE CONCENTRATION: CCL- ............................................................................................................... 116
CALCIUM CONCENTRATION: CCA++ .............................................................................................................. 117
LITIUM CONCENTRATION: CLI+ ..................................................................................................................... 117
ANNEX II – CLINICAL SIGNIFICANCE OF URINARY ELECTROLYTES ....................................................... 119
ANNEX III – WORKING PRINCIPLE ........................................................................................................................ 121
ANNEX IV – ADVANTAGES OF THE NEW V4.00 SOFWARE VERSION ........................................................... 123
EXTERNAL BARCODE READER AND EXTERNAL KEYBOARD. ......................................................................... 123
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QUADRATIC ECUATION CORRECTION FOR MEASURMENTS IN SERUM AND URINE. ....................................... 124
Entering Delta correction (Constant value) ............................................................................. 124
Entering quadratic and lineal values ........................................................................................ 125
RANGE OF NORMAL VALUES FOR SERUM AND URINE MEASUREMENTS.......................................................... 127
SCREEN MEASUREMENT TIME CONFIGURABKE AND OPTION TO REMOVE BEEPER. ...................................... 130
NA CLEAN REQUEST EVERY 7 DAYS. ............................................................................................................... 131
SERIAL OUTPUT FOR NET CONNECTIONS (LIS) ............................................................................................... 132
Serial output configuration: .................................................................................................................................. 133
Setting Baud rate, Flow control, Carriage return and Line Feed. ....................................................................... 133
Network delivery of results from memory.............................................................................................................. 133
Commands frm the Host to the Diestro ................................................................................................................. 133
Validation of the sample measurement before sending it to the memory or net .................................................. 133
ANNEX VI – QUALITY CONTROL CHART.............................................................................................................. 134
PARTS, REFERENCE CODES AND WARRANTY ................................................................................................... 135
WARRANTY .................................................................................................................................................. 136
LIST OF FIGURES
Fig. 1 Power supply and ground connection ................................................................................................... 13
Fig. 2 Pack's tray ............................................................................................................................................. 14
Fig. 3 Placing the Pack .................................................................................................................................... 14
Fig. 4 Connecting the Pack .............................................................................................................................. 14
Fig. 5 Pack ....................................................................................................................................................... 14
Fig. 6 Pack connection tubing kit ..................................................................................................................... 15
Fig. 7 Connected Pack .................................................................................................................................... 15
Fig. 8 Clamping button. .................................................................................................................................... 16
Fig. 9 Front opening - Step 1 ........................................................................................................................... 16
Fig. 10 Front opening - Step 2 ......................................................................................................................... 16
Fig. 13 Peristaltic pump ................................................................................................................................... 17
Fig. 14 Opening the Fill Port Cleaner - Step 1 ................................................................................................. 17
Fig. 15 Opening the Fill Port Cleaner - Step 2 ................................................................................................. 17
Fig. 16 Placing the Fill Port Cleaner - Step 1 .................................................................................................. 18
Fig. 17 Placing the Fill Port Cleaner - Step 2 .................................................................................................. 18
Fig. 18 The analyzer with the Fill Port in standby ............................................................................................ 20
Fig. 19 Fill Port in position for Tube ................................................................................................................. 20
Fig. 20 Fill Port in position for Capillary ........................................................................................................... 20
Fig. 21 Capillary adapter .................................................................................................................................. 21
Fig. 22 Taking sample with a capillary adapter ............................................................................................... 21
Fig. 23 ISE Calibrating Pack and its connection tubing kit .............................................................................. 22
Fig. 24 uChip.................................................................................................................................................... 24
Fig. 25 Closing the waste cap.......................................................................................................................... 26
Fig. 26 Installed Pack ...................................................................................................................................... 26
Fig. 27 Sample filling from a capillar ................................................................................................................ 28
Fig. 28 Sample filling from a tube .................................................................................................................... 28
Fig. 29 Printed electrolyte report...................................................................................................................... 32
Fig. 30 Printed urine report .............................................................................................................................. 37
Fig. 31 Printed calibration report...................................................................................................................... 42
Fig. 32 Drop ..................................................................................................................................................... 58
Fig. 33 Printed results of the quality control .................................................................................................... 65
Fig. 34 Example of laboratory's data in a ticket ............................................................................................... 76
Fig. 35 Front panel lock ................................................................................................................................... 85
Fig. 36 Fill Port Cleaner ................................................................................................................................... 86
Fig. 37 Analyzer connection diagram .............................................................................................................. 90
Fig. 38 Electrode train ...................................................................................................................................... 98
Fig. 39 Opening the electrode protector and taking out the electrode lock ..................................................... 99
Fig. 40 Taking out the defective electrode ....................................................................................................... 99
Fig. 41 Roll-holder opening............................................................................................................................ 103
Fig. 42 Paper roll replacement....................................................................................................................... 103
Fig. 43 Roll-holder closed .............................................................................................................................. 103
Fig. 44 Retractable Fill Port ........................................................................................................................... 105
Fig. 45 Fill Port ............................................................................................................................................... 106
Fig. 46 Pinch tube connection ....................................................................................................................... 106
Fig. 47 Front view .......................................................................................................................................... 109
Fig. 48 Side view ........................................................................................................................................... 109
Fig. 49 Front view with the front panel opened .............................................................................................. 110
Fig. 50 Rear view ........................................................................................................................................... 110
Fig. 51 Rear panel detail ................................................................................................................................ 111
Fig. 52 Electrode chamber............................................................................................................................. 111
Fig. 53 Example of patient ID in a ticket ........................................................................................................ 125
Fig. 54 Printed electrolyte report with values out of normal range ................................................................ 130
6
1 - INTRODUCTION
The Diestro analyzer is an IVD Medical Device manufactured with state-of-the-art
technology, accurate, reliable and designed to be simple in use as well as in maintenance.
Intended Use
The Diestro 103AP Electrolyte analyzer is an In Vitro Medical Device that allows the
measurement of electrolytes in whole blood, serum, plasma and urine samples.
It is capable to measure up to 5 electrolytes simultaneously: sodium, potassium,
chloride, calcium and lithium.
The health professionals utilize the obtained data for diagnosis purposes.
All the setup electrolytes can be measured simultaneously.

Every model of the Diestro 103 AP Ion Analyzer is expandable in ions to be measured,
until the maximum setup is reached.
Manufactured by JS Medicina Electrónica

S.R.L.
Bolivia 462 (B1603CFJ) - Villa Martelli
Provincia de Buenos Aires Obelis s.a
República Argentina 53 Boulevard Général Wahis
Tel/Fax.: (54 11) 4709-7707 1030 Brussels, BELGIUM
Email: info@jsweb.com.ar Tel: +(32) 2. 732.59.54
Web: www.jsweb.com.ar Fax: +(32) 2.732.60.03
Technical Direction: Marcelo Miranda E-Mail : mail@obelis.net
National Registration Nº13104
Provincial Registration Nº15964
JS Medicina Electrónica, Diestro and their images, are registered trademarks of JS Medicina
Electrónica S.R.L
The contents of this manual and the hardware are protected under intellectual property laws and
international treaties. File No. 323588.
It is prohibited to reproduce all or part of this manual, the hardware or the menus of the Analyzer by any
means without the written permission of the owner of JS Medicina Electronica SRL.
All Rights Reserved.

Patent pending.
The manufacturer reserves the right to modify the contents of the manual or equipment specifications
without notice.
The manufacturer is not liable for losses or damages directly or indirectly to users or third parties arising
from the use of this analyzer or the interpretation of the results.
JS Medicina Electrónica® manufacture under ISO 9001/ISO 13485 standards.
JS Medicina Electrónica® manufacture under GMP standards according to the Regulations of ANMAT
(National Administration of Drugs, Food and Medical Technology of the Argentine Republic –
MERCOSUR-).
GMP COMPLIANCE MERCOSUR RESOLUTION Nº31/97

ANMAT REGULATION Nº 194/99
CERTIFICATE Nº 7251/06-2
MEDICAL DEVICE AUTORIZATION PM-1108-1
Model and Industrial design Register Number 75440
2 – SAFETY INSTRUCTIONS
1. IMPORTANT SAFETY INSTRUCTIONS
DANGER – Misuse of electrical equipment can cause electrocution, burns, FIRE
and other HAZARDS.
Basic safety precautions should always be taken, including all those listed below.
READ THIS BEFORE USING THE EQUIPMENT

Check that the voltage setting matches the supply voltage.
Connection to Main Supply: Plug the equipment into a supply outlet which has an
earth connection.
Do not place the equipment in liquid, nor put it where it could fall into liquid. If the
equipment becomes wet, unplug it before touch it.
Use the equipment only for the purpose described in the instructions for use.
Do not use accessories which are not supplied or recommended by the
manufacturer.
Do not use the equipment if it is not working properly, or if it has suffered any
Examples:
o Damage to the flexible supply cord or its plug;
o Damage caused by dropping the equipment;
o Damage caused by dropping the equipment into water or splashing water
on it;
o Any type of error message or alarm on the equipment, leak of fluids or
damaged tubings;
o Any kind of anomaly.
Do not let the equipment or its flexible cord come into contact with surfaces which
are too hot to touch.
Do not place anything on top of the equipment.
Do not drop or put anything into any opening in the equipment, or into any hose
or coupling.
Do not use the equipment out of doors.
The power socket where connects the computer power supply must be
accessible at all times to allow the power on and shutdown in any situation.
Always use gloves.
KEEP THESE INSTRUCTIONS ACCESSIBLE
The user manual includes instructions and guidelines to observe during the start-up,
operation and maintenance of the Analyzer.
Therefore, the operator or any person that manipulate the analyzer Diestro 103AP
should read carefully the manual before start using it. This manual should always be near
of the Analyzer. The buyer of the analyzer is responsible to instruct and do read the
manual to each new operator.
8
2. Symbols
Several safety instructions are given in each chapter of the manual and on the analyzer to
highlight aspects relating to a safe operation.
Note: Identify references to information in other sections of the manual.
Press on the touchscreen
Attention: Risk of DANGER. Before using read instructions in the user Manual or related
documentation
Biological RISK. There are parts of the Analyzer, accessories or consumables that may
cause biological damage. Be careful.
USE GLOVES WHENEVER you WORK WITH THE Analyzer,
THEIR PARTS AND SAMPLES ARE POTENTIALLY DANGEROUS.
Lot Number Serial Number
Reference / catalog number In Vitro Device
European authorized representative Read the Manual befote use
Indoors use only
Not discard the product as household waste. Failure to observe these instructions may have
harmful effects. The owner of the product has a responsibility to dispose of it in a location
designated for the recycling of electrical and electronic equipment. This action and subsequent
recycling of discarded material will contribute to the conservation of natural resources and
protecting the environment and its inhabitants. To determine what the correct location for the
recycling of discarded products, consult local authorities, with its collection of waste or recyclable material
services or the establishment in which you obtained the product.
Manufacturer information Manufacture date
Socket polarity
Ground connection
Temperature limits
Install before this date. Expiration date

If the component was not installed,
from this date begins the time of
warranty.
The user or the distributor must notify Box orientation
to the factory the installation date, if not
the guarantee is not valid
Warranty:
Quantity of months of
warranty
Fragile
European Conformity Do not stack more than the

indicated number of boxes
-For more information about the analyzer press the Info button at anytime at any time.
Info button
Print
information
 Go down
Select
-Press Esc to return to the Main Menu.
10
3 - INSTALLATION
1. Unpacking
Carefully unpack and verify that the following items are inside the box:
. REF EQ 07XX Analyzer Diestro 103AP V4.
. REF IN 0100 ISE Calibrating Pack.
. REF IN 0305 Pack connection tubing kit.
. REF IN 0300 ISE Urine Diluent.
. REF IN 0400 ISE Cleaning Solution.
. REF IN 0600 Na+ conditioner.
. REF IN 0050 Fill Port Cleaner.
. REF IN 0750 Diestro Trilevel.
. REF IN 0700 Diestro Control.
. REF RE 0809 CD Manual.
. REF RE 0815 Quick Start guide.
. REF RE 0902 Power Supply 15V 2.5A.
. REF RE 0100 Peristaltic Pump tubing.
. REF RE 0200 Capillary for sampling.
. REF RE 0400 Capillary adapters.
. REF RE 1000 Ground wire.
. REF RE 1005 Pack’s Tray.
See section “Diagrams” to find parts and accessories of the Analyzer. Page 137
See section “Technical Specifications” to find detailed information. Page 141
2. Installation requirements
2.1. Voltage Power

100 - 240 V 50 / 60 Hz
Power voltage and the power socket must comply with local electrical regulations.
There must be a connection to ground available to connect the ground wire of the
Analyzer. The voltage should be free of noise and fluctuations. If it is necessary install a
voltage stabilizer.
See section “Power Supply specifications”. Page 141
2.2. Environmental conditions of installation

Verify the environmental operation conditions detailed in the section “Technical
specifications”
See section “Technical Specifications” to find detailed information. Page 141
2.3. Installation site

The Analyzer must be installed on a horizontal, clean and solid surface, without vibration,
allowing the technician the necessary place to operate it without any obstacles in the front
and the sides.
Dimensions
Height: 270mm
Width: 164mm
Depth: 465mm
Weight: 5,4 Kg
The power socket for the equipment power supply must have easy access to the
connection and disconnection of the Analyzer in any condition.
See section “Power Supply specifications” to find detailed information. Page 141
3. Connection
Before installation see the section “Diagrams” Page 137 to identify the parts and
accessories for your Analyzer.
Use cables and provided accessories with your equipment. If necessary to replace one, use
spare parts provided or recommended by the manufacturer. Se section “Parts, reference
and codes” Page 83
3.1 Connect the ground wire to the Equipment ground terminal and then to the
ground connection. In the Laboratory that connection must be certificated by qualified
personnel. (Fig. 1)
3.2 Connect the power supply plug to the jack in the Analyzer. (Fig. 1)
Do not connect the power supply to the power socket yet.
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uChip connection
USB connection
RS232 connection
External Barcode reader

connection
Power supply connection
Ground terminal
Fig. 1 Power supply and ground connection
3.3 If the Analyzer is connected to a PC or external serial printer RS232, connect the cable
now. Use a Null-modem cable for the serial connection.
See section “Cables” to find detailed information. Page 108
3.4 Screw the Pack’s Tray to the back of the Analyzer. Use the provided Allen key.
3.5 Place the ISE Calibrating Pack on the Pack’s Tray. ( Fig. ).
Clamping
screws
1) 2)
Fig. 2 Pack’s tray Fig. 3 Placing the Pack
3)
Fig. 4 Connecting the Pack
Fig. 5 Pack
3.6 Unscrew the caps, break the aluminum security seals and insert the special connection
caps from de Analyzer. Keep the caps to cover the bottles of the Pack at the moment of
discarding.
14
3.7 Connect the microchip adapter cable to the analyzer and the pack.
Be careful to match the color encoding and the texts on the Analyzer and Pack.
Fig. 6 Pack connection tubing kit
ISE Cleaning
solution
Caps
Analyzer couplings
Connected uChip
Fig. 7 Connected Pack
3.9 Open the front panel by making a quarter on the clamping button. Lean the front
panel forwards.
Clamping
button
Fig. 8 Clamping button
1) 2)
Fig. 9 Front opening - Step 1 Fig. 10 Front opening - Step 2
3) 4)
Fig. 11 Front opening - Step 3 Fig. 12 Front opening - Step 4
3.10 Connect the Peristaltic Pump tubing.
16
Remove one of the peristaltic tubing fittings and wrap around the peristaltic support pump
head with the pipe, to make contact with the roller head and insert the coupling in the free
support.
Waste disposal tubing
Peristaltic Pump Tubing Couplers
Bracket
Peristaltic Pump Tubing
Peristaltic Pump Head
Fig. 13 Peristaltic Pump
See section “Peristaltic Pump Tubing replacement” to find detailed information. Page 104
3.11 Take the new Diestro Fill Port Cleaner, open the flask sealed and removed the
security seal.
Fig. 14 Opening Fill Port Cleaner - Step 1 Fig. 15 Opening Fill Port Cleaner - Step 2
3.12 Carefully lift the Fill Port capillary to take a horizontal position, present the Diestro
Fill Port Cleaner in front of the position guides and slide it gently until it stops against
the inner wall of the Diestro analyzer 103AP.
Make sure the Fill Port Cleaner is in the correct position, with the label "Front / Front"
facing the operator.
Fig. 16 Placing Fill Port Cleaner - Step 1 Fig. 17 Placing Fill Port Cleaner - Step 2
See section “Installation / Replacement of the Diestro Fill Port Cleaner” Page 86
3.13 Close the front panel.

3.14 Connect the power supply to the power socket. The Analyzer is turned on and
automatically performs a purge and calibration.
See section “Calibration” y “Purge” Pages 39 and 58 respectivly.
When the calibration ends, the following display is shown:
3.15 Verify the date and time of the Analyzer. It can be changed by the operator following
the steps detailed in the “Clock” section
See section “Clock” Page 60
Touch Screen calibration

18
If it’s needed to perform a touch screen calibration due to a bad functioning of it, follow the
next sequence:
-Unplug the power source.
-Wait a few seconds. Plug again the power source. Inmediately press the touch screen.
-The next screens will show up. You shall press with a finger or a not sharp plastic element
the points indicated by the arrows.
-Afterwards, the main menu will appear and the touch screen calibration will be over.
4. Retractable Fill Port
Fig. 18 The Analyzer with the Fill Port in Standby
Fig. 19 Fill Port in position for Tube Fig. 20 Fill Port in position for Capillary
See section “Retractable Fill Port” Page 96
20
4.1 Capillary Adapters
Take major safety precautions regarding Bio safety. The samples, capillary and adapter are
potentially infectious. Handle with gloves.
Clean the Fill Port with a gauze wet in Cleaning Solution ISE REF IN 0400 after removing
the sample.
It is specially made for adapt the analyzer fill port to a capillary. It is easy to use:
4.1.1 In the Main Menu, move the handle to the Capillary position.
4.1.2 Connect to an extreme of the capillary.
4.1.3 Take the end of the fill port and connect the other extreme of the adapter to the
fill port and press fill.
4.1.4 When it is ready, remove the capillary and the adapter. Discharge them.
1) 2)
Fig. 21 Capillary adapter Fig. 22 Taking sample with a capillary adapter
Clean the Fill Port with a gauze wet in Cleaning Solution ISE REF IN 0400 after removing
the sample.
4 - CALIBRATING SOLUTION PACK (PACK)

1. Pack REF IN 0100
Fig. 23 ISE Calibrating Pack and its connection tubing Kit.
REF IN 0100
For the model without tubings (REF RE 0100) there is a Pack connection tubing Kit
(REF IN 0305), that consists of 3 caps, green, orange and red, with their corresponding
couplings and tubings to connect the analyzer to the pack. This kit is not for single use, it is
reused and remains connected to the analyzer. (It is a part of the Analyzer)
Two types and Identification of Packs

There are different types of Packs according to the country and region where the
Analyzer has been purchased.
The type of Pack your Analyzer requires can be identified in the following screen of the
Analyzer:
JS Medicina Electrónica recomends to replace simultaneously the Fill port Cleaner with the
ISE Calibrating Pack.
22
The type of Pack your Analyzer requires can be identified in the following screen of the
Analyzer: If the type of Pack is not the appropriate, the Analyzer shows an error message:
“Invalid Pack”.
See section “Error Messages” Page 77
2. Pack of Calibrating Solutions Microchip (uChip)
Fig. 24 uChip
The uChip provides the Analyzer information about volumes of the calibrating
Solutions, calibration values, batch number and date of expiry of the Pack.
3. Calibrating Solutions Pack Validity

Verify the Expiry Date of the Pack to be connected.
If the Pack is expired, the analyzer will show and print the message “Expired Pack”,
however this will allow the operator to use the analyzer, being the exclusive responsibility
of the operator if he uses it or discards it.
The equipment can still work under an expired date.

The Operator is the only responsible for its use under those conditions.
4. Calibrating Solutions Consumption

The Analyzer does not measure the volume of the solutions as real volume, but
electronically deducts “doses”.
When the Pack is exhausted, the Analyzer shows the “Exhausted PACK” message, and
the equipment will stop working with such Pack.
When the Pack is exhausted, discard it and install a new one.
The exhausted Pack contains potentially dangerous waste disposals, handle with gloves.
Do not open. See section “Discard of consumables” Page 87
Take care not to contaminate the caps, the green and orange tubings and their respective
socket, they will be used for the next Pack.
In the exhausted pack, put the green, orange and red caps that came with the Pack to their
5. Pack bottles before discarding to avoid losses.
Performance
The Pack performance depends on the way of use and maintenance of the Analyzer.
24
Due to this, we recommend as long as it is possible:

* Measure the samples in batch, instead of doing so at random: this will save calibrating
solutions and improve the repeatability in measuring.
* Perform the maintenance within the reach and frequency recommended by the
manufacturer.
See section “Maintenance” Page 82
The Pack has been designed in such a way that the Pack solutions are always sufficient
for the doses calculated by the Analyzer under different amount of ions installed in the
Analyzer. In this manner, surplus solutions may remain in the Pack without being used
even if the “Exhausted PACK” message is shown.
It is recommended not to open the Pack.
The consumption of Standard A and Standard B will never be similar. Therefore, there will be
always proportional surplus of one more than the other.
The Analyzer will show the “Exhausted PACK” message when one of the solutions is
exhausted.
6. Replacement of the Pack REF IN 0100
JS Medicina Electrónica recomends to replace simultaneously the Fill port Cleaner with the
ISE Calibrating Pack.
To replace the Pack, follow the sequence:

6.1 Disconnect the Power Supply from the Voltage Line.
6.2 Disconnect the uChip adapter cable from the analyzer and unscrew the couplings of
the green, orange and Red caps. Note that the content of the pipes are purged into the
pack.
Be careful with the Red cap of the analyzer, it may contain potentially infectious waste,
always wear gloves, do not spatter.
The Exhausted PACK contains waste disposals potentially dangerous. Discard the Pack
according to the section ”Discard of the consumables” Page 87
Take care to not contaminate green and orange caps and their respective tubing, they will
be used for the next pack In the exhausted Pack, put the green, orange and Red caps
which brought the Pack, to their respective flasks before discard it, to prevent leaks.
Fig. 25Closing the waste cap

6.3 Replace the Pack of Calibrating Solutions (PACK) on the Pack’s Tray for the new one.
6.4 Connect the uChip adapter cable to the new Pack uChip.
6.5 Unscrew the caps of the new pack of calibrating solutions, break the security seals.
Keep the caps removed to cover the flask of the Pack at the time of discarding it.
6.6 Unscrew the caps of the tubing kit of the exhausted pack and screw it in the new one
in compliance with the corresponding colors.
6.7 Screw the couplings of the tubing kit to the analyzer, be careful to match the
corresponding colors and texts
Fig. 26 Installed Pack
26
6.8 Reconnect the Power Supply to the Voltage Line. The analyzer turns on and
automatically performs Purge and Calibration.
+
See section “Calibration” y “Purge”. Pages 37 and 58 respectively.
Once the Calibrating process is over, the Analyzer display shows the following screen
and is ready to measure:
5 - SERUM/ PLASMA/ WHOLE BLOOD MEASURING

1. General Comments
Ensure the correct working of your Analyzer keeping it maintained and performing a Quality
Control. Refer to the “Maintenance” Page 83 and “Quality Control” Page 62 sections.
The sample should be free from fibrin or clots.

It is recommended to centrifuge the sample and measure serum.
Do not intersperse with Urine samples.
2. Sample Filling
Before measuring, clean well the fill port with cleaning solution ISE REF IN 0400 and then
rinse with distilled water.
The sample can be filled from a tube, syringe, or from a capillary (with an adapter).
Fig. 28 Sample Filling from a Tube

Fig. 27 Sample Filling from a Capillary
When you fill from a Capillary, insert the capillary with the adapter into the needle. (Fig. )
From a tube or Syringe the filling is without adapter. (Fig. )
28
3. Measuring
Pressing Esc. at any time the measurement will be aborted
- From the root menu, press Meas. (If the analyzer is on the principal screen skip the first
two steps)
- In the Measure Menu press Meas.
- The measuring is started from the principal screen:
In case 10 minutes have passed without use, the analyzer will need a Rinse befote
measurement.
- For samples from tube or syringe start measurement by moving the handle to its tube
position (45º). For samples from a capillary move the handle to its capillary position
(horizontal).
- Put the sample and press Fill.
Be careful with the Biological Risk. The samples, capillaries and adapters are potentially
infectious. Handle with gloves.
The Operator may fill the sample manually in case that is a non detected sample (a low
conductivity sample), pressing Sens. See section “Non detected samples” Page 71
If you have small amount of sample, the analyzer makes a beep to indicate that has
charge the minimum and necessary amount of sample to measure, from this warning
the user can remove the sample to reduce the amount that the equipment consumes
The Operator may enter information from the Sample by pressing Info. See section “Sample
Data enter” Page 32
- During the Filling the Analyzer shows the following screen:
- Once the filling is over, the Analyzer will give out a beep sound and will show the
following screen:
- Remove the sample.
- Move the handle to its standby position.

If you do not move the handle to its standby position the analyzer will not continue with the
measurement.
30
- The analyzer automatically positions the Sample in the Measuring Chamber and
performs its measurement.
- Subsequently, the Analyzer fills and places the Std. A for washing and one point
calibration.
If the analyzer can not fills with Std. A, it will show a Not filled error and the measurement is
not performed. See section “Error Messages” Page 77.
- When the measuring is complete, the Analyzer shows the results in the screen:
If the result of Sodium is lower than expected, perform a Sodium Conditioner Wash.
See section “Sodium Conditioner” Page 55.
4. Printed Electrolyte Report
Fig. 29 Printed Electrolyte Report
Refer to the section “Reference Values” for further details about normal and critical ranks
suggested of the electrolytes in serum. Page 107
Refer to the section “Annex I – Clinical Significance of Serum/Plasma/Blood Electrolytes
Page 114
The Measuring Results is saved in memory and can be recovered as well as printed.
The analyzer can save the last 1000 measurements.
See section “Results Storage”. Page 69
5. Sample Data enter (Optional)
The user can enter sample information (Patient Nº) with the sequence:
- Pressing info you have access to the information screen about the sample to be
processed.
32
- The sample number is incremental and non editable. It is placed by the analyzer.
<==> Cover Patient No. figures

 Increases
 Decreases
- Once the Patient Nº is entered, press “Esc” to continue the measuring sequence.
Refer to the step 3.5 of this same section. Page 28.
6 – URINE MEASUREMENT
1. General Comments
Control. Refer to the “Maintenance” Page 83 and “Quality Control” Page 62 sections.
Always dilute Urine Samples. The prefixed dilution is 1 part of Urine

diluent (1:05).
The Analyzer only measures Na, K and Cl in Urine Samples.
2. Sample Filling
Before measuring, clean well the fill port with cleaning solution ISE REF IN 0400 and then
rinse with distilled water.
The Urine sample is always filled from a tube, always DILUTED with ISE Urine Diluent
REF IN 0300 provided with the Analyzer.
3. Measuring
Pressing Esc. at any time the measurement will be aborted
- The measuring can be started from the principal screen pressing Urine:
- The analyzer will ask the dilution.
 Increases parts of the diluting

 Decreases parts of the diluting
<==> Enters selected parts of the dilution
34
- Press Esc and then move the handle to its Tube position.
In case 10 minutes have passed without use, the analyzer will need a Rinse before
measurement.
- Immerse the fill port in the sample and press fill. (Fig. 16)
Be careful with the Biological Risk. The samples, capillaries and adapters are potentially
infectious. Handle with gloves.
The Operator may fill the sample manually in case that is a non detected sample (a low
conductivity sample), pressing Sens. See section “Non detected samples” Page 69.
If you have small amount of sample, the analyzer makes a beep to indicate that has
charge the minimum and necessary amount of sample to measure, from this warning
the user can remove the sample to reduce the amount that the equipment consumes
The Operator may enter information from the Sample by pressing Info. See section “Sample
Data enter” Page 30.
- During the Filling the Analyzer shows the following screen:
- Once the filling is over, the Analyzer will give out a beep sound and will show the
following screen:
- Remove the Sample
Clean the Fill Port with a wet gauze in cleaning solution ISE REF IN 0400 after removing
the sample.
- Move the handle to its standby position to start the measurement.
If you do not move the handle to its standby position the analyzer will not continue with the
measurement.
- The analyzer automatically positions the Sample in the Measuring Chamber and
performs its measurement.
- Subsequently, the Analyzer fills and places the Std A for washing and one point
calibration.
If the analyzer can not fills with Std. A, it will show a Not filled error and the measurement is
not be performed. See section “Error Messages”. Page 77.
- When the measuring is complete, the Analyzer shows the results in the screen
(“O” = Urine)
If the result of Sodium is lower than expected, perform a Sodium Conditioner Wash.
See section “Sodium Conditioner”. Page 55.
36
4. Printed Urine Report
Fig. 30 Printed Urine Report
See section “Reference Values” for further details about normal and critical ranks suggested
of the electrolytes in serum. Page 107
See section “Electrode Slope Range”. Page 113
The result is stored in the memory and can be recovered as well as printed. The
analyzer can store the last 1000 measures.
See section “Result Storage”. Page 69
5. Sample Data Enter (Optional)

The user can enter sample information (Patient Nº) with the sequence:
- Pressing info you have access to the information screen about the sample to be
processed.
- The sample number is incremental and non editable. It is placed by the analyzer.
<==> Cover Patient No. figures

 Increases
 Decreases
- Once the Patient Nº is entered, press “MEAS” to continue the measuring sequence.
Refer to 5.3. "Measuring". Page 29
38
7 - CALIBRATION
1. General Comments
The Analyzer performs two types of Calibration.

One point Calibration
Two-point Calibration
Control. Refer to “Quality Control” Page 62 and “Maintenance” Page 83.
2. One point Calibration
It is performed automatically by the Analyzer during the measurement of a Sample.

Not accessible by the Operator.
When a measurement fill with Std. A and stabilizes in performing a one point
Calibration.
3. Two-point Calibration
3.1 Automatic Calibration

It is performed when the Analyzer is switched on, or according to the calibration frequency
preset in the equipment.
We recommend the calibration frequency to be of 8 hours.
3.2 On Demand Calibration
3.2.1 It can be performed on the Operator’s demand through the sequence starting
from the principal screen pressing menu:
In case 10 minutes have passed without use, the analyzer will need a Rinse. It is
recommended make it before the calibration, but it is not necessary.
3.2.2 In the Root Menu press Cal.
3.2.3 Press Cal2 to start the two-point calibration
When the two-point calibration starts, the Analyzer fills and stabilizes twice for each
calibration solution automatically. Start with Std B then continues with Std. A.
If the analyzer can not fills with any of both Std. it will show a Not Filled error and the
Calibration is aborted.
4. Calibration Result
4.1 When the Calibration process is complete, the analyzer reports the results through the
screen, showing each electrode with its slopes and status:
40
4.2 Pressing the “Ca.” key, you have 4.3 Pressing the “Na..” key, you can
access to the remaining electrodes. see again the three first electrodes.
The “Calibrated” caption indicates that the electrode is ready for measuring.
See section "Technical Specifications" Page 135 to see the allowed Gain Ranges.
If the result of Sodium is lower or higher than expected, perform a Sodium Conditioner
Wash. See section “Sodium Contitioner”. Page 55.
4.4 In case one of the electrodes did not calibrate, the analyzer will show it in the report.
The “Not CALIB” caption indicates that the electrode is not ready for measuring. In this case
the electrolyte will not be measured.
Refer to section “Error Messages” Page 77.
The results of the last Calibration are saved in the memory analyzer and can be seen by
the user at any time
5. Printed Calibration Report
Fig. 31 Printed Calibration Report
6. Saved results
6.1 The results of the last calibration can be seen by the operator with the following
sequence, starting in the principal screen:
42
6.2 Enter in the Calibration menu.
6.3 Select Hist. to see the last calibration.
6.4 The results are showed in the display.
7. Calibration Options
All the calibration option starts in the calibration menu.
- To access this menu, in the principal screen press menu
- And then Cal
- This is the calibration menu
7.1 Electrolyte Enabling/ Disabling

The present electrodes in the Analyzer can be enabled or disabled.
Disabling an electrode implies it will not take part in the subsequent measurements.
7.1.1 To enable or disable electrolytes, in the calibration menu, press Opt.
7.1.2 Press Ion
44
7.1.3 Press Enab.
7.1.4 In this screen you can enable or disable all the electrolytes
<==> Change Yes/No in selected Electrolyte

 Select Electrolyte
Yes Enabled Electrolyte
No Disabled Electrolyte
7.2 Units Modification
Only applicable to Calcium electrolyte.
1 mmol/l = 2 meq/l = 4 mgr%
7.3.1 To modify the Calcium Unit, press opt.
7.2.2 Press Ion
7.2.3 Press Unit
7.2.4 Choose the unit
<==> Select chosen unit

 Runs available units
7.3 Delta Correction Setting

Delta Correction allows you to correct the results obtained by the Analyzer, in such a way
that they can be matched or leveled with those given out by either other measuring
equipments, Internal or External Quality Controls, or desired Standards.
Before using Deltas, verify the appropriate working order of your Analyzer, performing a
Quality Control since a problem may be hiding. Never apply Deltas if the equipment is not
precise, in other words, if it does not repeat a sample correctly.
See section “Maintenance” Page 82 y “Quality Control” Page 60.
46
7.3.1 The sequence for the Modification of Delta values is as follows in the calibration
menu, press Opt.
7.3.2 In the calibration Options press Delta
7.3.3 Now you can change the delta value. Each electrode has a delta for each type of
sample
Initially you can select the electrode and type of sample

 Select electrode and type of sample.
<==> Pressing you can edit the delta value corresponding to the selected electrode
pressing again you can select another electrode
 Increases Delta value
 Decreases Delta value
The Delta value still remains with the changed Pack.

Verify the need to maintain Delta values with the Pack change.
7.3.4 Pressing Esc. You return to the calibration option menu.
7.4 Delta Correction Ranges
The Analyzer allows you to use the following ranks according to the type of sample.
Serum Range Resolution Urin Range Resoluti
Na -12.7 a 12.7 0.1 e on
K -1.28 a 1.27 0.01 NaU -51.2 a 50.8 0.4
Cl -12.8 a 12.7 0.1 KU -9.92 a 9.92 0.08
Ca -1.28 a 1.27 0.01 ClU -51.2 a 50.8 0.4
Li -1.28 a 1.27 0.01
In case of using Deltas with extreme values, make sure the pattern and use is the
appropriate and/ or the equipment is working properly.
8. Electrode History
General Comments:
This menu contains all the data related to the installed electrodes, such as:
-Serial number.
-Manufacturing date.
-Date until which can be in stock without being installed.
-Date on which it was installed.
-Type of electrode.
Amounts of:
-Times that the analyzer was turned on.
-Calibrations.
-Serum measurements.
-Urine measurements.
-Rinses.
-Washes.
-Sodium washes.
This way is possible to verify how the electrodes are being used.
48
8.1 To access this menu press Cal from the Root Menu.
8.2 Then Opt and Ion.
8.3 Finally Elect
8.4 This is the Electrode History menu:
8.5 To access the history of an electrode, press the desired electrode. For example K:
8.6 This is the K history.
Page 1 Page 2
Page 3
-To change between pages “”.

-To print the electrode history press “” two times, until the same button turns into “Print”.
Press print and the information will be printed.
-To go back to the Electrode History menu press Esc.
9. Installed Pack History

General Comments:
This menu contains all the data related to the installed pack, such as:
-Pack’s type.
-Std A and Std B remaining percentage.
-Pack’s installation date.
Amounts of:
-Times that the analyzer was turned on.
-Purges.
-Calibrations.
-Std A y B Wets.
-Samples in Batch mode.
-Samples in random mode.
-Washes.
-Std A Wets.
-Not empty errors.
-Not filled” errors.
This way is possible to verify how the Pack is being used.
50
9.1 Press Cal from the Root Menu.
9.2 Press Pack Hist.
9.3 This is the History of Installed Pack menu.
Page 1 Page 2
Page 3
 Change between pages.

-To print the Pack History press “” two times, until the same button turns into “Print”.
Press print and the information will be printed.
10. Standby Function

After 10 minutes of inactivity, the Analyzer enters in a standby mode and shows the
following screen:
While the Analyzer is in this mode the automatic operations of calibration and washes are
canceled.
In this mode two operations are executed:
-Wet A&B: It is performed when it would have made a two-point calibration.
-Wet A: It is performed between each Wet A&B.
In this way the performance of the Pack is improved, without losing the benefit of
maintaining of electrodes, valves and tubing.
We recommend to keep the Analyzer on 24/7 the 365 days of the year.
Screen Saver
While the Analyzer is in standby mode, if the operator touches the screen and instead of
executing the action in the reasignable key (left) presses menu and navigates through the
menus, alter 5 minutes of inactivity, the Analyzer goes automatically to the standby screen.
52
8 – RINSE AND CLEANING

1. General Comments
While the analyzer measure or calibrate, it will need to rinse the electrodes. The rinse
renews the Std. A in the electrodes preventing the mixing of different substances Turing
the different process, also clean the flowing circuit removing bubbles, clots, dirt, or other
substance that can change the result of the measurement or calibration.
2. Automatic Rinse
It is performed automatically between Std. B and Std. A during a calibration or between a

sample and Std. A in measurement. Also when the analyzer is ten minutes without use.
3. On Demand Rinse
3.1 It can be performed on the Operator’s demand through the sequence starting from the
principal screen pressing menu:
3.2 Press Meas. to enter measurement menu
3.3 Press Rinse to enter Rinse Menu
3.4 Press Rinse to start
3.5 When the rinse start the analyzer will charge and wash with Std. A .
3.6 When the process is complete, the analyzer will show the rinse screen:
4. Automatic Clean
4.1 The analyzer will need a Clean every 24Hs. When this time from the last clean were
passed the analyzer will show. Dose in a tube clean solution and then press clean.
54
4.2 Move the handle to its Tube position, put the Cleaning Solution and press Fill.
4.3 When ready will make a beep, show a screen that says remove. Remove the tube and
move the handle to its standby position.
4.4 The Analyzer will continue the clean.
4.5 When the clean finishes will need a 2 point calibration. Will show it in the screen, after
1 minute will start the calibration automatically.
4.6 When the calibration is complete, the Analyzer will be Reddy to measure.
5. On Demand Clean
5.4 Press Cln and move the handle to its tube position to start.
56
5.5 Put the Cleaning Solution and press Fill.
5.6 When ready will make a beep, show a screen that says remove. Remove the tube and
move the handle to its standby position.
5.7 The analyzer will continue with the clean.
6. Sodium Conditioner
Pass the sodium conditioner when the electrode has lower values, higher or instability in
the measurement.
JS Medicina Electrónica recomends to replace simultaneously the Fill Port cleaner with
®
the Pack Diestro .
6.1 Dose Sodium Conditioner in a tube.

6.2 Start a clean until step 5.4, see section 5 in this chapter
6.3 In step 5.5 put the tube with sodium conditioner.
6.4 Continue the clean from step 5.6 right to the end.
See section “On Demand Clean” Page 51.
7. Clean of Capillary for sampling

It consists of a receding of Std A to clean the remains of serum, urine or blood in the
capillary sampling.
It must be configured a value that allows the Std A reach the end of the Capillary for
sampling as seen in the following image.
Over time, the Peristaltic Pump performance changes, so this value should be corrected.
If not, it is possible that the liquid does not reach the end increasing the risk of
obstructions.
This wash does not replace the outside cleaning of the capillary.
Drop
Fig. 32 Drop
The access to the new wash settings is detailed in the following steps:
7.1 Enter the menu, then Serv and Conf.
58
7.2 Press Needl.
7.3 By increasing the amount of steps, the sample will recede more, so if a large number
is configured it is possible that during the wash the needle drops, decreasing the life of the
Fill Port cleaner. The suggested value is 700 but it should be corroborated on your
Analyzer.
Press the value to edit.

<==> When you are in the edition mode, press to change one digit to another and to
enter the value.
  Edit the selected digit, increase or decrease.
7.5 Pressing Esc twice you can return to the main menu.
9 - PURGE
1. General Comments
During this process the tubing of the Pack and the analyzer are filled with both
calibrating solutions.
2. Automatic Purge
This is performed automatically when a new Pack is installed in the analyzer, or when
installing a Pack with remaining volume previously used in another equipment.
The display shows the sequence:
If Esc. Is pressed the purge is aborted.

When the process is complete, a Calibration starts automatically.
See section “Calibration”. Page 37
If for any reason, the tubings of the Pack in use get disconnected, it is essential to perform a
Purge manually via the keyboard. Refer to “On Demand Purge”. Otherwise, it comes to
calibration and/or washing errors.
3. On Demand Purge (Manual)

60
3.4 Press Purge to start purge
3.5 When the purge start the display shows the sequence:
10 – QUALITY CONTROL
1. General Comments
The Diestro analyzer has the ability to perform statistical calculations to assist the operator
in the quality control of your equipment. The QC ampoules usually come in 3 levels low,
medium (usually the normal value) and high.
Do not use calibrating solutions as controls.

Do not use calibrating solutions or flame photometer controls.
Use controls for ISE direct.
Contact the manufacturer, distributor or authorized technical service to be sure which
controls the most appropriated are and how interpreting the results obtained.
Take major safety precautions regarding Bio safety. Handle with gloves.
Greater amount of control samples measures, more accurate is the analysis. The analyzer
allows the operator to store up to 22 samples of each level in its internal memory.
The analyzer calculates statistics with 5 samples by level or more (up to 22); with fewer
samples won't calculate statistical results although it will store the results.
If the operator wants to corroborate the specifications of the analyzer must perform 22
measurements and have the equipment in optimum conditions of maintenance.
Statistical calculations are: average value, standard deviation and coefficient of variability.
2. Quality Control procedure

From the root menu press QC
You can choose the level to evaluate, press QC1 if you want to measure the level 1,
QC2 for level 2 and for level 3, QC3 do not interleave levels, make all measurements of
one level and then another and the remaining then. The example we will explain in the
manual is for level 2, for other levels is exactly the same, entering by the corresponding
option.
62
Press Meas, to make the control of level 2
Pressing Clear, you must confirm and the memory with previous results will be deleted.
3. Results of the Quality Control
If you press Mem, you can view the memory of the chosen level with the results for each
electrolyte.
“Yes” means that the sample enters statistics, if you press Yes/No change the status of
included or not included in statistics.
“No” is for a sample that was loaded with bubbles or for some reason the operator wants
to put it out of statistics.
The equipment sets in “No” the 2 first samples, because it is understood that they are
conditioning samples. The operator is free to put them into “Yes” when he wants, as well
as placing in “No” to any other.
With arrows memory can be explored; the number between the arrows is the number of
sample within the 22 possible that is watched at this moment.
To view the statistics press Stat.
There is one screen by each electrolyte.

The arrows changes the electrolyte; N is the number of samples that exists in memory and
are marked “Yes”
If you press Print, a ticket with all including measurements and statistical values will be
printed (see next page).
64
Fig. 33 Printed results of the quality control
To exit the Quality Control menu press Esc.
If you press ESC, a confirmation is asked, because if you are within a measurement
process, exits and returns to enter, clears the memory of results and starts a new cycle of
measurements, this is so to not mix controls carried out in different hours or days.
4. Delta Corrections
In some cases during a Quality Control, some difference may arise in the results obtained
by the Analyzer regarding the ones given out in the result chart of the chosen
Control. This situation can be solved using Delta Correction.
The Analyzer comes out of the factory with a Delta= 0.00 for every ion and types of
sample, which can be modified by the operator all the time.
Delta Correction can be applied independently for each ion and according to the type of
sample (Serum or Urine).
The value of Delta Correction (Delta) depends on the desired measuring result.
Example: If the average result outlined by your Analyzer for Na is 140, and your
Control indicates
Na = 144, you can level your Analyzer to the Control placing a Delta= 4.
If your Control indicates
Na = 137, place a Delta = - 3.
5. Definitions
Precision is the ability to obtain the same result upon repeated measurement of a
specimen. It is verified by the Standard deviation and coefficient of variation.
Accuracy or recovery is the ability to recover the correct amount of analyte (the assigned
value) present in the specimen. It is verified comparing the average value obtained with
the assigned value provided by the QC´s manufacturer.
Imprecise equipment cannot be accurate.
66
11 - CLOCK
1. Definition
The analyzer is able to memorize the time and date even thought the analyzer is power off
for a long time.
2. Clock Adjust
2.1 To adjust the clock, first enter in the menu:
2.2 In the Root Menu press Serv and then Conf.
2.3 Press Clock
2.4 Now you are able to change the time and date of the analyzer.
<==> Select year, month, day, hour and minute

 Increases selected value
 Decreases selected value
2.5 Pressing Esc. you return to the configure menu
68
12 – RESULT STORAGE
1. General Comments
Allow the operator to have access to previous measurement results, ordered by sample’s
number. The analyzer can save the last 1000 measurement.
2. Measurement Result
2.1 Start pressing menu
2.2 Press Meas.
2.3 Press Mem. to enter the result storage
2.4 Select sample number and press Result to see the measurement result.
<==> Not use

 Increases sample number
 Decreases sample number
Res See the result
2.5 The selected result is displayed in the screen.
2.6 Pressing Info go back to select sample number

Pressing print the analyzer will print and send to serial port the result
Pressing Esc. came out from the result storage and go to the principal screen
Pressing Info Pressing Esc.
70
13 – NON DETECTED SAMPLES

1. General Comments
It may occur that a sample (Serum, Whole Blood or Urine) with low conductivity is not
detected or the sample volume is not enough to measure all the configured ions and gives
out an error in your Analyzer (Not Filled Error).
If the Operator is sure about having filled the Sample properly, the Sample Sensor can be
disabled, to perform a measurement without the risk of losing it.
Disabling the Sample Sensor implies both a visual and manual positioning of the
Sample on the part the operator.
2. Disabling the Sample Sensor
2.1 In front of a “Not filled” error your Analyzer shows:
If you press Rinse, the analyzer will wash and you loose the sample, the analyzer after the
rinse will be ready for measuring again.
If Esc. is pressed the sample can be measured
2.2 Open the front panel to be able to position correctly the sample into the electrode
chamber.
2.3 When press Esc. the analyzer goes to Root Menu, press Meas.
2.4 Press Meas again
2.5 Select what the type of sample and move the handle to its Tube position.
2.6 Press Sens. to charge the sample manually.
2.7 In this moment, while is pressed, the sample moves forward filling the chamber.
While is pressed, the sample move backwards emptying the chamber.
If the sample was filled before entering this option (because a not filled error occurs) you
only have to keep press until the sample fills completely the electrode chamber.
2.8 When the chamber is filled, move the handle to its standby position to start measuring.
2.9 Will Start the measurement and continue normally
The user is the only responsible of how the sample is positioned. Position it from the reference
electrode covering the more electrodes you can according to the sample volume you have. But
remember that the reference electrode must always be in touch with the sample. Be carefull with the
electrodes that do not touch the sample, those results will be wrong. Is the operator's responsibility not
to bear in mind those electrodes results.
72
14 – CONFIGURATION OF PRINTER, SERIAL OUT, LANGUAGE

AND LABORATORY’S DATA
1. General Comments
Allows configuring the available outs in the Analyzer: Printer, Serial Out and choose the
language.
The Serial Out (RS232) allows connecting the Analyzer to a printer, or any other type of
Interface (for example a PC or data network).
2. Printer, serial out and language configuration

2.1 To configure enter the menu pressing Menu
2.2 In the root menu press Serv. and then Conf.
2.3 Press out
2.4 In this screen you can enable or disable the printer, serial out, change the language
and the laboratory’s data.
When pressed Print for example an asterisk will appear, which means that is enabled.
If pressed Print again the asterisk will disappear meaning that the printer is disabled.
The language can be changed by pressing the language button, switching between the
available languages.
74
To enable or disable the Bip press Bip.
To modify the Display Time press Disp Time.
When editing:
<==> Next character.
  Increase or decrease value.
To change the Laboratory data press Lab.
When editing:
<==> Switch to the next character
  Choose the character.
Fig. 34 Example of laboratory’s data in a ticket
76
2.5 Pressing Esc. goes to the Root Menu or if the serial out is enabled will appear the
options for the serial out
Serial Out: No Serial Out: Yes
Press Esc and this screen will appear where

<CR>+<LF>: Is an option that needs some
the Baud and “Xon-Xoff” can be configured
printers or interfaces. If the data is printed or
showed in the same line, this option must be
enabled.
Baud: Is the speed of data transfer of serial
out
Xon – Xoff: Is an option of the serial
communication protocol.
The serial communication is: (8N1)
8 bits of data
1 bit Stop Press Esc when finish to return to
None parity the Root Menu.
15 – ERROR MESSAGES
1. List of errors
Check the following chart for a list of errors
Error Description Possible cause Effect Action

Analyzer the error
Analyzer the error
Not CALIB The Ion cannot be character after the phrase:
Not calibrated character after the
measured. ”Not Calib” or proceed as in
electrode phrase: ”Not Calib”.
Not Filled Error.
Does not Bubbles in the liquid In Calibration: The

stabilize circuit. Ion cannot be
the measuring of Electrode failure. measured.
/ Standards in the
Calibration or the
Failure in the
Measuring In Measuring: The In Measuring try with other
Sample in the Canal. outcome is not samples.
measurement. Destabilizing Sample. reliable. Repeat calibrations
Check obstructions in
In Calibration: tubing and electrodes.
Bubbles in the liquid The Ion cannot be Check valve or peristaltic
circuit. measured. tubing.
ADC out of rank. Electrode failure. Change Electrode or
? Failure in the In Measuring: contact Technical Service.
measuring canal. The outcome is not Possible electronic failure.
reliable. In the case of the sodium
electrode pass sodium
Bubbles in the liquid conditioners.
circuit.
The Ion cannot be
Low or High Electrode failure.
measured.
S Slope. Failure in the
measuring canal.
Check the correct

The slope of the connection of the tubing
! Calibration line is Varied or contaminated The Ions cannot be sections of the Pack. Purge
inversed. Calibration Standards. measured. and calibrate.
Replace for a new Pack.
Insufficient Sample.
Sample with coagula
and fibrins.
Check sample.
The Sample Operator’s error. The operation in
Not Filled Check filling process.
Could not be Tubing and/ or process is not
Obstructions in tubing,
filled. Electrode circuit complete.
sampling, peristaltic and
obstructed.
electrodes.
Defective Peristaltic
Check valves.
Tubing.
Replace electrode or
contact technical service.
The measuring Tubing or Electrode
The operation in
No Empty chamber cannot circuit obstructed.
process is not
be emptied. Defective Peristaltic
complete.
Tubing.
Does not calibrate

Does not Pack uChip not (*) Connect an uChip.
Missing Does not measure.
recognize the connected. (*) Reboot the Analyzer.
Pack Does not wash.
uChip. Contact technical service.
78
Error Description Possible cause Effect Action

Print “Expired
Out of date Pack or
Pack” on screen (*) Check Clock
Pack The Pack has incorrect time on the
and printer during Place a new Pack.
Expired expired. clock.
calibration Contact technical service
The Pack is Does not Calibrate.

Pack Pack is electronically Does not measure. (*) Place a new Pack.
Empty exhausted. exhausted. Does not wash. Contact technical service.
Internal Error Hardware or software Does not Calibrate. Contact technical service
01 error. Does not measure.
Hardware or software Does not Calibrate. Contact technical service
02 Internal Error
error.. Does not measure.
The balance
during
1 point
calibration
C differs from the
last
2 points
calibration. External interference
Repeat measurement or
during measurement.
The balance calibration
Bubbles in the circuit of
Turing 1 point Check obstructions in
liquids. Failure of the
L calibration differs
electrode. Failure in The result is not
tubing and electrodes.
from the last 1 Check Valve or Peristaltic
the measurement valid.
point calibration. Tubing.
channel.
Change Electrode
Sharp Bad ground
Investigate possible
differences connection.
interference from other
during the Noisy power line.
Q measurement
equipments or devices.
Contact Technical Service.
process.
Sharp
differences
during the
U stabilization of
the sample.
Low
measurements of Low measurements
Sodium electrode is dirty Pass sodium conditioner
sodium of sodium
The errors are displayed on the principal screen with an exclamation sign as shown in
the picture:
Pressing the exclamation mark the errors can be seen.
(*) 1 minute should pass between the equipment is switched on and switched off. Otherwise
a Pack Error can be generated.
2. Internal errors 01 or 02
Some types of internal errors can be fixed with an alphanumerical code. This consists of
entering a code from the keyboard, (16 alphanumeric digit combination 0, 1, 2, 3, 4,
5, 6, 7, 8, 9, A, B, C, D, E, F) supplied by the Manufacturer from a code generated by the
Analyzer.
Not all internal errors can be fixed with this method.
2.1 If the analyzer show the error 01 or 02
2.2 Generate the code in your analyzer following the sequence:

Enter Menu by pressing Menu key
2.3 Enter the Configuration menu
80
2.4 Press Enab. to enter the code
2.5 This is the code generated because the error
2.6 Contact the Manufacturer and report the generated code.
2.7 From that point, the manufacturer will provide you a new code that you must enter in
the analyzer from keyboard pressing Mod.:
2.8 Edit each Character
 Increment value selected

 Decrement value selected
<==> Go to next value
2.9 Once the code is entered, press Ent.
82
16 – MAINTENANCE
The Analyzer has been designed to require an easy and minimum maintenance.
1. Daily maintenance
1.1 Analyzer decontamination
1.1.1 Keep the worktop and the surface of the Analyzer in hygienic conditions.
1.1.2 Clean all the surfaces with a soft cloth wet in 1:10 Sodium Hypochlorite Solution.
1.1.3 Decontaminate the Fill Port with a ISE Cleaning Solution REF IN 0400
1.2 Clean
To protect the Analyzer from possible contamination and from blockage and obstructions
perform a Clean daily.
It is recommended to make the clean at the end of the working day for remove possible
waste in the fluid circuit.
If the Clean is not performed 24 hours after any measuring, the Analyzer will not permit to
continue working until the Clean is complete.
See section “Rinse and Cleaning”. Page 51.
2. Weekly maintenance
2.1 Sodium Conditioner

Once a week perform a clean with sodium conditioner
See section “Sodium Conditioner”. Page 55.
2.2 Internal clean of the analyzer

Clean the area that says "keep clean" and any splashing of biological substances with a
cloth soaked in a dilution 1: 10 sodium hypochlorite.
3. Other Maintenance and Spare Part or Component Replacement
Purchase only original spare parts
The set frequencies are only preventative and indicative. Such frequencies can be
modified depending on the amount of processed samples or according to need.
Precaution. Potentially dangerous elements. Discard them according to the regulations currently in
force in your country for the treatment of Pathological Waste. Use gloves in the replacement.
In the following chart you will find instructions for components, suggested frequencies and
authorized service to perform such replacements:
Spare Part / Suggested Authorized

Reference
Component Frequency Service
Trained Operator
Peristaltic Pump Every three
Technical Service Page 104
tubing months
Manufacturer
Trained Operator
Electrodes According to need Technical Service Page 98
Manufacturer
Trained Operator
Capillary for
Every six months Technical Service Page 105
sampling
Manufacturer
Standard and
Technical Service
Pinch Valve Every one year Page 90
Manufacturer
Tubing
Technical Service
Battery According to need Page 106
Manufacturer
Trained Operator
Fill Port According to need Technical Service Page 105
Manufacturer
Simultaneously
Trained Operator
with the
Fill Port Cleaner Technical Service Page 86
calibrating
Manufacturer
solution Pack
Trained Operator
Distributor
Gel baterry Every 5 years Page 106
Technical Service
Manufacturer
4. Open the front panel

4.1 Loose the clamping button with a screwdriver or a coin. Make a quarter turn. (Fig. 9)
4.2 Open the front panel leaning it forward. (Fig. 12)
84
5. Close the front panel

5.2 Adjust the clamping button. (Fig. 9)
Clamping button
Fig. 9 Front opening – Step 1 Fig. 12 Front opening – Step 4
Fig. 35 Front panel lock
6. Installation / Replacement of the Diestro Fill Port Cleaner

(wear gloves) REF IN 0050
Fig. 36 Fill Port cleaner
Wear gloves at any time.
The life of The Fill Port Cleaner is calculated for 800 samples for an estimated consumption of 100
samples day or 3 months for a consumption of 10 samples day.
JS Medicina Electrónica suggests replace the Fill Port Cleaner simultaneously with the
Pack Diestro.
Note that if a rinse is made without the Fill port Cleaner it will drip on the area below the
sample.
Note that if whole blood is passed then the time in which the Fill Port Cleaner is effective
may be decreased by having landslides or fibrin clots in the dressing cleaner.
6.1 When the analyzer is off, remove the front.

6.2 Carefully lift the Retractable fill port to take horizontal position, remove The Fill Port
Cleaner used and discarded according to applicable regulations related to potentially
infectious biological waste.
6.3 Clean the needle with a disposable cloth or towel moistened with Diestro intensive
wash solution.
The needle and the used Diestro Fill Port Cleaner may contain potentially infectious
waste: be cautious, wear gloves and avoid splashing.
Discard the cloth or towel and the used Diestro Fill Port Cleaner in accordance with the
clarifications in “Discard of Consumables”. Page 89.
86
6.4 Remove the security seal of the new cleaning module as shown in figure
Fig. 13 Opening the Fill Port cleaner – Step 1 Fig. 14 Opening the Fill Port cleaner – Step 1
6.5 Present the new Diestro Fill Port Cleaner in front of the guide position, make sure it is
in the correct position and gently slide it on till hit the central wall of the analyzer.
Make sure the Fill Port Cleaner is in the correct position, with the label "Front / Front"
facing the operator.
Fig. 16 Placing the Fill Port cleaner – Step 1 Fig. 17 Placing the Fill Port cleaner – Step 2
6.6 Enter the retractable fill port into the analyzer.

6.7 Place the front of the analyzer in its position and continue using the analyzer normally
7. Transportation of the analyzer
Perform, clean and if necessary decontaminate all the surfaces of the Analyzer.
Prevent damage to the power cord during transport or storage of the analyzer. In case of
damage change it with a new one.
7.1 Transportation within the laboratory

If the transportation does not imply significant movements will be sufficient to verify that
the clamping buttons of the Pack’s Tray are tight and transport it carefully, without tilt or
hitting the Analyzer.
7.2 If transportation involves large movements, but it will be reinstalled within a day,
proceed as follows:
1. Disconnect the caps of Std. A, Std. B and waste

2. Turn off the Analyzer
3. Close tight the bottles of the Pack.
4. Do not tilt the Analyzer.
5. If necessary, pack for transport. Use the original box of the Analyzer with the
accessories to prevent hits and movements. If this box is not available, use a similar one.
6. Follow the installation procedures.
7.3 If the analyzer will not be installed in more than two days.
1. Disconnect the caps of Std. A and Std. B.
2. Empty the equipment’s tubing.
a. In the Valve menu, open the A valve, then in manual movements menu, press
CW until the waste tubing is emptied.
b. Repeat the operation with the B valve open.
c. Repeat the operation with the M valve open
See section “Service”. Page 90
3. Connect a tubing to the couplings of Standard A and B of the analyzer and immerse in
distilled water, then proceed as in step 2 to wash all the circuit.
4. Repeat step 2 without the tubings immersed in water.
5. Disconnect the waste container.
6. Turn off the analyzer.
7. Close tight the bottles of the Pack. (Model of PACK without tubings REF IN 0100)
8. Do not tilt the Analyzer.
9. If necessary, pack for transport. Use the original box of the Analyzer with the
accessories to prevent hits and movements. If this box is not available, use a similar one.
10. Follow the installation procedures.
88
8. Discard of consumables
To discard the consumables should proceed as usual in your laboratory according the
local rules or ask to the environmental authorities.
As orientation we recommend:
 Close tight the Pack bottles and consider as pathological waste.
 Close tight the Std. A and B bottles and consider as pathological waste.
 The spare parts used with biological samples and not decontaminated are
pathological waste.
9. Final discarding of the Analyzer

For the final discard of the Analyzer ask to the environmental authorities.
As an orientation we suggest:
Sort:
 Potentially infectious waste, as samples from patients, Pack, and all those parts
that had contact with biological samples and were not properly disinfected (tubings,
electrodes, capillary for sample, etc)
 Special waste, as liquid consumables and items used in the Cleaning, without
having infectious potential.
 The rest, which is the Analyzer itself, properly disinfected.
With each of these groups identified, contact to the corresponding company/s authorized
by the Ministry of the environment of its jurisdiction to discarding them properly.
17 – SERVICE
1. General Comments
This is a feature of the software of the Analyzer which allows the Technician, the Operator
trained by the Manufacturer, or the Authorized Dealer to check and assess the fluid flow
and the state of the electrodes.
The fluid flow in your Analyzer is shown in the following diagram:
Fig. 37 Analyzer connection diagram

2. Access to the Service Menu
2.1 The Operator can access the Test Menu, following the sequence. First press Menu
2.2 Press Serv and then Test for entering Test Menu (Service Menu)
90
2.3 This is the Service Menu.
3. Revision and Assessment of the state of Electrodes

The presence of a Sample or Solution in the Measuring Chamber causes that each
electrode generates an electrical voltage (mV) in its corresponding canal.
The voltage produced by the Std A and Std B in the Measuring Chamber allows the
operator to assess:
 Electrode Stability: Tension without significant variations implies stable electrodes.
 Electrode Slope: Difference between the voltages produced by the Std. A and B.
Thus, in some cases it may be useful to determine which voltage generates a given
Sample in the Measuring Chamber.
The positioning of either the Calibrating Solutions or the Sample in the measuring
chamber can be performed manually as well as automatically.
3.1. Manual Positioning
3.1.1. Before the positioning is by hand, it is necessary to open the corresponding valves.
To do this press mV
3.1.2 Press Valv.
3.1.3 By pressing any of these options, the corresponding valve opens.
A: Open / Close Std. A valve.

B: Open / Close Std. B valve.
M: Open / Close Sample valve.
3.1.4 Open valve is indicated with *
For Example: Pressing a, opens Std. A Valve
3.1.5 Press Esc. to continue to Movements
If you want to charge air, open Valve M and don’t put any sample.
Is not recommended to open more than one valve at each time because can enter air in the
piping system. If necessary, after all tests purge the analyzer
Do not keep the valves open for a long time.
92
3.1.6 Now press Man.
3.1.7 In this screen you can move fluid, see the conductivity and the tension measured by
the electrodes
: The peristaltic turn in clockwise direction. Charge the electrode chamber with
Std. A, Std. B, sample or Air. Make that the solution that leave the electrode chamber go to
waste. (Direction right)
: The peristaltic turn in counterclockwise direction. Discharge the electrode chamber

with Std. A, Std. B, sample and Air. Make that the solution that leave the electrode
chamber go to the valve opened. (Direction left).
When is moving the peristaltic and 5 second after the peristaltic pump stops
rotating will show the value being measured by the sample detector with the existing liquid
in the measuring chamber, also appear a symbol that represent the measuring chamber
status:
Chamber Empty
Chamber Filled
3.1.8 Position the Solution or sample chosen pressing continuously. The indicator of
the Measuring Chamber state turns from empty ( ) into filled ( ) when the
positioning of the Std A is complete. Once the “Filled” message is visible, stop clicking on
the button.
In case it was necessary to move back the Solution in the Measuring Chamber, you MUST
ENABLE THE VALVE corresponding to the sample. See step 3.1.1 to 3.1.5
Subsequently, you can press until the Solution is properly located in the Measuring
Chamber.
Five seconds after the Peristaltic Pump stops rotating, the display shows the voltages
generated by the chosen Calibrating Solution or entered Sample. Allow then to stabilize
during 30 seconds so that no significant variations are perceived.
Voltages generated by the calibrating solution or the entered sample.
Bear in mind only the voltages corresponding to the enabled electrolytes in the analyzer.
3.1.9 Press Esc. and go back to Service Menu. All open valves will be closed.
3.2. Automatic Positioning

The Std. A or Std. B or Sample automatic filling is performed by the following sequence:
3.2.1 Press mV
3.2.2 Press Auto
94
3.2.3 In this screen you can fill Std. A, Std. B or Sample
Press Std. A to charge a dose of Standard A.

Press Std. B to charge a dose of Standard B.
Move the handle to its Tube position to charge Sample.
The display shows the voltages generated by the chosen Calibrating Solutions or entered
Sample.
Allow them to stabilize during 30 seconds so that no significant variations are perceived.
Tension generated by the calibration solution or simple charged.
Bear in mind only the voltages corresponding to the enabled electrolytes in the analyzer.
3.3. Interpretation of the Results obtained

The results obtained for the Std A and Std B, allow you to work out the gain of each
electrode.
See section “Reference Values” Page 107
4. Threshold Option
The “Threshold Option” allows you to modify the threshold conductivity from which your
Analyzer detects Std A, Std B, Serum or Urine.
To be handled only by trained Technicians. It will affect the liquid filling operation in case it
is altered improperly.
4. The access to this feature is displayed below, in the service menu press Thrsh.
4.2 Edit Threshold values
  Select value to edit (Std. A, Std. B, Serum and Urine)

<==> Press once to edit value
  Increase / Decrease value
<==> Pressing once go back to select value to edit (Std. A, Std. B, Serum and Urine)
4.3 Pressing Esc. go back to service menu
5. Retractable Fill Port
See section “Retractable Fill Port” Page 19
To be handled only by trained Technicians. It will affect the liquid filling operation in case it is
altered improperly.
96
5.1 The access to this feature is displayed below, in the service menu press Needle
5.2 In this menu you can set the needle wash and Sample BIP (alert sound that
indicates the minimum amount of sample needed for the analyzer to measure
correctly). When the analyzer cleans makes the liquid recede so it can wash the
inside of the needle and drips onto the Fill Port Cleaner cleaning the remains of
Sampling serum and fillings.
By increasing the number of steps, the liquid recede more and increases the drip.
Note: A high cleaning value will reduce the performance of the Fill Port Cleaner.
<==> Press once to edit the value / pass by each digit

<==> Edit the number: Press to cycle through each digit, once you pass the last
  Edit the selected digit
5.5 To go back to the Configuration Menu press Esc.
18 – ELECTRODE REPLACEMENT
1. Replacement
Purchase original spare parts from the manufacturer.
To replace an electrode, perform the following sequence:
1.1 Disconnect the power supply of the analyzer from the Voltage Line.
1.2 Open the front panel of the Analyzer and loose the holding screw in the top right of
the electrode lock and open the electrode protector in order to have access to the
electrodes.
1.3 Take out the electrode lock by loosing the holding screw in its back part.
1.4 Disconnect the electrode cable to be replaced. If necessary, also disconnect this
cable from the remaining electrodes located on the right of the one to be replaced.
The angular cable is placed by force in each of the pins.
1.5 Loosen the terminal/s of all electrodes in order to move the electrodes which are
1.6 Remove the defective electrode.
1.7 Place the new electrode with the same couplers and relate it to the remaining ones.
1.8 Put again the electrode lock.
1.9 Connect the electrode cables again to the corresponding pins.
1.10 Put again the electrode protector and close the front panel.
1.11 Switch on the equipment and check that it performs the Washing and Calibration
properly.
Fig. 38 Electrode train
98
Fig. 39 Opening the electrode protector and taking out the electrode lock.
Fig. 40 Taking out the defective electrode
19 – ELECTROLYTE EXPANSION
1. General Comments
One of the features of your Analyzer is to be an ion expandable device, i.e. it admits
adding ions until it reaches the maximum configuration: Na, K, Cl Ca and Li.
The inclusion of new electrodes, called Expansion, can be performed remotely and
consists of the following steps:
2. Installation in the Analyzer of the Electrode/s and accessories that make up the
expansion.
This can be performed by the Operator, following the guidelines supplied by the
Manufacturer with the new electrode.
2.1 Expansion enabling in the software
This consists of entering a code from the keyboard, (16 alphanumeric digit combination 0,
1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F) supplied by the Manufacturer from a first code
generated by the Analyzer.
2.1.1 Generate a Code in your Analyzer following the sequence:
Enter Menu by pressing Menu key
2.1.2 Enter the Configuration menu
2.1.3 Press Enab. to enter the code
100
2.1.4 Pressing Gen. and then Ready to generate a new code
2.2 Contact the Manufacturer and report the generated code
2.2.1 From that point, the Manufacturer will provide you a new Code that you must enter in
the Analyzer from keyboard pressing Mod. key:
2.2.2 Edit each character
 Increment value selected

 Decrement value selected
<==> Go to the next value
2.2.3 Once the code is entered, press Ent.

2.3 Enabling the new electrode
2.3.1 When the sequence is complete, it is necessary to enable by keyboard the new
electrode added, this step verify that the code was entered correctly
The enabled ions are showed with an asterisk.
If the ion is not enabled it is showed without the asterisk. Press the desired ion to enable it.
2.3.2 Subsequently, perform a Calibration.
102
20 - REPLACING THE PRINT PAPER

To replace the roll of thermal paper, perform the following sequence:
1. Open the lid of the roll-holder, by making a gently force from the rabbet outwards.
Fig. 41 Roll-holder opening

2. Replace the roll and pull out the end of the paper as shown in the picture.
Fig. 42 Paper roll replacement.

3. Close the lid of the roll-holder.
Fig. 43 Roll-holder closed

21 - PERISTALTIC PUMP TUBING REPLACEMENT

1. Open the front panel of the Analyzer in order to have access to the Peristaltic Pump
Tubing.
2. Remove the couplers of the Peristaltic Pump Tubing from the bracket.
Waste Disposal Tubing
Peristaltic Pump Couplers
Bracket
Peristaltic Pump Tubing
Peristaltic Pump Head
Fig. 13 Peristaltic Pump
3. Disconnect the waste disposal tubing from both couplers.
4. Connect the waste disposal tubing to the replacing peristaltic pump tubing couplers.
5. Place one of the couplers of the peristaltic pump tubing in the bracket. Wrap the
peristaltic pump head with the tubing, so as it makes contact with the head roller and insert
the free coupler into the bracket.
6. Close the front panel.
104
22 – CAPILLARY FOR SAMPLING REPLACEMENT
Pinch tube
Teflon support
Support screw.
Steel axle
Stainless steel capillary
Capillary for
sampling
Fig. 44 Retractable Fill Port

Parts
REF RE 0200 Capillary for sampling
REF RE 0202 Fill Port: Stainless steel capillary + Capillary for sampling
1. Capillary for Sampling replacement

1.1 Open the front panel to access the capillary for sampling (Fig. ).
1.2 Remove the capillary for sampling that surrounds the stainless steel capillary.
1.3 Place the new capillary for sampling and leave it in the same position.
2. Fill Port replacement

2.1 Dismounting the Fill Port
2.1.1 Open the front panel.
2.1.2 Take out the Pinch tube from the capillary stainless steel.
2.1.3 Loosen the screw and take out the Fill Port.

2.2 Mounting the Fill Port

2.2.1 Insert the steel capillary inside the plastic capillary leaving 1.5 cm. in the lower
side. (Fig. 45).
2.2.2 Now insert the assembly into the slot of the Teflon support and secure it with the
screw.
2.2.3 Check that the stainless steel capillary is lined and does not clash with the edges of
the front panel.
2.2.4 Connect the Pinch tube coming from the sample valve to the steel capillary.
(Fig.46)
Fig. 45 Fill Port Fig. 46 Pinch tube connection
23 – REPLACEMENT OF THE BACKUP BATTERY

1.- Disconnect the power supply.
2.- Disconnect the Pack from the analyzer (See section 3)
3.- Tilt the analyzer to one of its sides.
4.- Unscrew the two battery holders from the bottom of the analyzer with the provided
Allen key.
5.- Open the front panel. (See section 3)
6.- Take out the Fill Port Cleaner.
7.- Move the handle to a horizontal position and take out with care the two holders.
8.- Disconnect the two battery cables.
9.- Replace the battery for the new one (see technical specifications, section 28)
10.- Perform steps 1 to 9 backwards.
Cautions:
-Once the battery is replaced. Connect the power supply and charge the battery for 8
hours.
This means that during this period of time the operator cannot perform any measurements
with the analyzer.
-Before starting to perform measurements, perform a two-point calibration. (See section 7)
-This is a maintenance free, sealed lead battery.
-Follow the instructions printed on the battery for its disposal.
106
24 – REFERENCE VALUES
1. Electrolyte Range
Laboratory must establish its own criterion to determine the normal ranges and critical
values of the electrolytes.
The following chart is provided as a guideline:
Low critical High critical

Normal range Normal range for
ION UNIT value for value for
for SERUM URINES 24 HOURS
SERUM SERUM
Sodium mmol / L 120 135 - 148 158 75 – 200
Potassium mmol / L 2.8 3.7 - 5.3 6.2 40 – 80
Chloride mmol / L 75 98 - 109 156 140 – 250
Calcium mgr./ % 3 4 - 5.6 6.4 Not applicable
Lithium mmol / L 0.5 – 1.0 >2.0 Toxic Not applicable
The Normal Values for Urine Samples are relative, since they depend to a great extent on
the diet and treatment the patient is subjected to.
In the chart, Reference Values for Urine Samples of 24 hours are indicated in mmoles.
To obtain the value in mMoles/24 hours, it must be multiplied by the 24 hour Urine volume
from such patient, expressed in liters.
2. Electrode Span (mV)
Electrode Na K Cl Ca Li
Span (mV) 4.0-7.0 12.0-19.0 3.0-7.0 3.0-7.0 8-13
These values are only for reference. They depend on the electrode performance, time from
the installation, correct working of the analyzer and the Pack.

25 - CABLES
Connection cable between Diestro 103AP Analyzer and a PC
DB9 female connector DB9 female connector

Pin Out (Analyzer) Pin Out (PC)
1 1
2 3
3 2
4 6
5 5
6 4
7 8
8 7
9 9
108
26 - DIAGRAMS
Printer
Touchpad
Pack
Display
Clamping button
Fill Port
Pack’s Tray
External barcote
Fig. 47 Front View
reader (Opcional)

USB
connector
uChip connector
RS232
connector
External
barcode reader
connector
Power supply
connector
Ground
Borne
Fig. 51 Rear panel detail
Electrode
wire
Electrode
assembly
Electrode
lock
Fig. 52 Electrode chamber
110
27 – TECHNICAL SPECIFICATIONS
1. Size and Weight
Height: 270mm
Width: 164mm
Depth: 465mm
Weight: 5,4 Kg.
Weight with the optional battery: 7,4 Kg.
Pack’s weight: 1,4kg
Power supply weight: 215g
ISE Urine Diluent weight: 165g
ISE Cleaning Solution weight: 120g
1.2 Seize and Weight of the box

Height: 410mm
Width: 465mm
Depth: 270mm
Weight: 6,7 Kg (Box with the Analyzer, 1 Pack, power supply, Urine Diluent, Cleaning
Solution and accessories)
Weight with the optional battery: 8,7 Kg. (Box with the Analyzer, battery, 1 Pack, power
supply, Urine Diluent, Cleaning Solution and accessories)
2. Environmental Conditions of Operation

Ambient temperature: between 15º - 30º C (59º - 86º F).
Humidity: Below 80% and non- condensed humidity.
Avoid direct exposure to sun light.
3. Environmental conditions of storage and transport

Environment temperature between 5º - 35º C (41º - 95º F)
Humidity: Below 80% and non- condensed humidity.
Avoid direct exposure to sun light.
4. Line Voltage Required

100 - 240 V 50 / 60 Hz
5. Power Supply Specifications (included)

Input voltage: 100 - 240 V 50 / 60 Hz, 0.5A
Output voltage: 15V 2.5A 37,5W
6. Samples/ Hour
Up to 60 Samples/Hour
7. Maximum Sample Volume

250 uL.
8. Minimum Sample Volume

From 50 uL on for 2 Electrolytes.

9. Range and measuring performance
SODIUM POTASSIUM CHLORIDE CALCIUM LITHIUM

Detection Range
40 - 220 1 - 30 20 - 250 0.2 - 5 0.2 - 5
Serum [mmol/L]
Detection Range Does not Does not
20 - 300 2 - 150 20 - 300
Urine [mmol/L] apply apply
Display
0,01 0,01
Resolution 0,1 0,01 0,1
[mmol/L]
Serum S.D.<
C.V<= 1% C.V<= 1% S.D.< 0,05
Reproducibility C.V<= 1% 0,06
140/160 90/125 1/1,5
within run 4/8 mmol/L 1/1,5
mmol/L mmol/L mmol/L
N = 20 mmol/L
Urine
Reproducibility Does not Does not
C.V.<=10% C.V<=5% C.V<=5%
within run apply apply
N = 20
10. Electrodes
Maintenance-free Ion Selective Electrodes.
11. Electrode slope range

ELECTRODE SODIUM POTASSIUM CHLORIDE CALCIUM LITHIUM
Range 25-90 30-80 20-80 10-40 15-80
12. Battery
Lithium Cell 3V CR2032
13. External barcode reader specifications

PS2 connector to external keyboard and RS-232.
Readable formats: UPC/EAN/JAN, UPC-A & UPC-E, EAN-8 & EAN-13, JAN-8 & JAN-
13, ISBN/ISSN, Code 39, Codabar, Code 128 & EAN 128 and Code 93 among others.
14. Gel battery:

12V 5Ah 21W/Cell/1.67V/15Min
112
ANNEX I - CLINICAL SIGNIFICANCE OF

SERUM/PLASMA/BLOOD ELECTROLYTES
Potassium Concentration: cK+
1. Definition
cK+ (P) is the potassium concentration (K+) in plasma, whereas cK+ (aP) is the equivalent
for arterial blood. In the Ion Analyzer it is shown as K.
2. cK+ indicates
Our body has a total quantity of 3000 - 4000 mmol of potassium of which the major part is
intracellular. The plasma (and the extra cellular fluid) only contains about 4.0 mmol/L,
totaling 50 mmol (the extra cellular fluid is about 12 L.). However, a given plasma
concentration may be found with any body potassium level. Although extra cellular
potassium only accounts for 1-2% of the total potassium, it is of great importance, since
one of its main functions is to mediate the regulation of the entire potassium balance in the
organism. A normal potassium is essential to regulate cardiac function. Values outside the
range of 2.5-7.0, are lethal.
3. Reference Ranges
cK+ (aP) Reference Ranges (adult): 3.7- 5.3 mmol/L.
4. Clinical Interpretation
4.1 Low cK+ values can be caused by:

* Potassium movement from extracellular to intracellular space: Respiratory or metabolic
Alkalosis, increase of plasmatic insulin, forced Diuresis, (treatment with diuretics),
Hypercalcemia, and Diabetes Mellitus.
* Less potassium intake: Low-potassium diet, Alcoholism, Anorexia Nervosa.
* Increase in gastrointestinal waste: Diarrhea, Vomits, Fistula, Gastrointestinal
Catheter Drainage, Malabsorption, Abuse of laxatives and enemas.
* Increase in urinary waste: Primary and Secondary Hyperaldosteronism, Adrenal
Hyperplasia, Bartter Syndrome, Oral anticonceptives, Adrenogenital Syndrome, Kidney
diseases (Renal tubular acidosis, Fanconi Syndrome, Diuretics, Thiazides, Henle’s loop
diuretics like Furosemide, Carbonic like Acetazolamide).
* Magnesium Depletion.
4.2 High cK+ levels can be caused by:

* Pseudohyperkalemia, Hemolysis, Leukocytosis.
* Movement from intracellular to extracellular space: Acidosis, Serious
Traumatisms, Tissular Hypoxia, Insulin Deficiency, Digitalis Overdoses.
* High potassium intake: High-potassium diet, Potassium Oral supplements,
Intravenous Potassium administration, large of Penicillin Potassium, old blood
Transfusion.
* Diminished Potassium excretion: Renal Failure, Hyperaldosteronism (Adrenal
Failure), Diuretics which block potassium tubular distal secretion, (Triamtirene,
Amiloride, Spironolactone), Primary defects in Renal Tubular Potassium Secretion
* Endogenous Metabolic Acidosis, (Lactate, Ketones in sepsis).

5. General Comments
High cK+ levels can be caused by Hemolysis. This is because red blood cells present a
higher concentration of this ion regarding serum or plasma, from what there may be
observed an artificially augmented cK+.
It is very common when a traumatic extraction is performed, but it may also occur when
taking a scant sample, (capillary sample). To minimize Hemolysis risks, it is advisable to
separate serum or plasma as soon as possible from the globular Packet, as well as mixing
the sample softly with anticoagulants. When Hemolysis is evident, the values obtained are
very high. For this reason, if the coloration seems to be more reddish than normal in
plasma and serum samples, it is recommended to either repeat the sample or add a
comment on the color next to the ck+ results.
Sodium Concentration: cNa+
1. Definition
cNa+ (P) is the concentration of sodium in plasma. The systematic symbol for arterial blood
is cNa+ (aP). The Analyzer symbol is Na.
2. cNa+ indicates:
The body has a total sodium level of about 60 mmoL/Kg, the majority of which is divided
between the bone and the extra cellular fluid. The plasma level (about 140 mmol/l), is
regulated by the plasma content of sodium, water and intracellular potassium. Therefore,
high-plasma sodium may be due to low-body water – or vice versa. It represents about the
90% of the inorganic cations in plasma, making it responsible for almost half the osmolality
of the plasma.
3. Reference Ranges
cNa+ (aP) Reference Range (adult): 135 -148 mmol/L.
4.1 Low values of cNa+ can be caused by:

* More excessive increase of water load than sodium: Heart failure, renal failure,
Liver disease, Nephrotic syndrome, Increased ADH secretion, excessive water intake,
(Polydipsia).
* More excessive sodium deficit than water: vomits, diarrhea, fistula, intestinal obstruction,
Diuretic treatment, burns, Adrenal failure (Hyperaldosteronism).
* Sodium movement from extracellular to intracellular space: Adrenal failure
(Hyperaldosteronism), Anemic Hemolytic syndrome- shock.
* Pseudo Hypernatremia: Hyperglycemia, Hyperlipidemia, Hyperglobulinemia.
4.2 High values of cNa+ can be caused by:

* More excessive increase of sodium load than water: Excessive sodium intake,
NaCl or NaHCO3 administration, Hypertonics, Primary Hyperaldosteronism.
* More excessive water load deficit than sodium: Excessive sweating (exercise, fever,
warm ambient), burns and certain diarrheas and vomits where there is an increased loss
of water greater than sodium, as well as in Osmotic Diuresis, (Diabetes
Mannitol infusion), Hyperventilation, Diabetes insipidus, (ADH or nephorgenic deficiency),
Decrease in water intake.
* Steroids.
114
5. General comments
Regional edema in the sampling area can cause false decreased values of cNa + .
Chloride Concentration: cCl-
1. Definition
cCl- (P) is the concentration of chloride (Cl-) in plasma. The systematic symbol for arterial
blood is cCl-(aP).The Analyzer symbol is shown as CI.
2. cCI indicates:
The chloride ion is the body’s major anion in the extra cellular fluid. The plasma level is
about 100 mmol/L, representing the largest fraction of inorganic ions. Sodium and chloride
together represent the majority of the osmotically active plasma components.
The kidney plays a major role in the body’s handling of chloride. Chloride accompanies
a large part of the sodium filtered by the glomerulus and is also active in the
chloridebicarbonate exchange.
3. Reference Range
cCl-(aP) reference range (adult): 98-109 mmol/L.
cCl- itself as a single parameter is of minor importance in most settings. However, low
values can cause muscles seizures, apathy and anorexia. High values may cause
Hyperchloremic metabolic acidosis.
5. General Comments
The major importance of cCl- is in relation to calculation of anion gap.
Calcium Concentration: cCa++
1. Definition
cCa++(P) is the concentration of Calcium in plasma. The systematic symbol for arterial
blood is cCa2+(aP). The Analyzer symbol is Ca.
2. cCa++ indicates
Ionized Calcium in plasma is the metabolically active part of total calcium, making up
around 50% of the total calcium. Total calcium in plasma is in part bound to proteins
(mainly albumin) 40%, and the remaining 10% bicarbonate, citrate, phosphate, and lactate
anions. The binding to proteins depends on pH. The ionized calcium is necessary for a
number of enzymatic processes and membrane transport mechanisms.
It thereby plays a key role in blood coagulation, cellular growth, neuro-muscular
transmission, and a series of other functions essential to life.
3. Reference Range
cCa++(aP) reference range (adult): 1.00 -1.40 mmol/L ( 4.0 – 5.6 mgrs%).
4.1 Low values of cCa++ can be caused by:

* Alkalosis.
* Renal Failure.

* Acute circulatory Insufficiency.

* Lack of Vitamin D.
* Hypoparathyroidism.
4.2 High values of cCa++ can be caused by:

* Cancer.
* Thyreotoxicosis.
* Pancreatitis.
* Immobilization
* Hyperparathyroidism.
5. General Comments
There are a number of factors that can affect the cCa++ measured values. To minimize the
mistakes that may be made it is recommended: no more than 30- second estasis applied
to the extremity where the sample is being taken; the patient should remain
sitting for more than 5 minutes before the venipunction; the use of small tubes without
anticoagulant; use tubes with balanced heparin for whole blood or plasma; complete the
tube with sample so as to minimize air drawn into it, and process the sample within one
hour after the sample has been taken.
Whole blood samples taken in tubes with Li or Na heparin, show low cCa++ values
compared to those obtained in the same sample without heparin.This is because heparin
completes and diminishes cCa++. There are commercially balanced heparin which would
diminish this effect. If the amount of heparin added to the tube or syringe may be
diminished, then this mistake would diminish as well, but low levels of anticoagulant
increase the risk of sample coagulation.
Anticoagulated blood with Oxalate or EDTA is not accepted since these compounds are
strong calcium chelators. Venous estasis and an upright position may contribute to elevate
calcium. Estasis produced by keeping tourniquets longer than 1minute may lead to
anaerobic glycolysis with lactic acid production, which diminishes pH and varies the free
Ca++ since the Ca-protein bind is dissociated, showing augmented cCa++ values.
Lithium Concentration: cLi+
1. Definition
cLi+ (P) is the concentration of lithium (Li+) in plasma, while cLi+ (PDB) is the equivalent to
the arterial blood. In Ion Analyzer displays as Li+.
2. cLi+ indicates
Lithium is a metallic monovalent cation that is usually absent in the body. It is used to treat
psychosis manic - depressive. The drug produced significant effects, but may be
significant clinical complications associated with their use. The binding of lithium to plasma
proteins is less than 10% and their average life is 7 to 35 hours. Its elimination is mainly
urinary (95 to 99% of the daily intake, after fixed state).
3. Reference Range
Lithium has a very narrow therapeutic range. The initial doses are between 0.80 and
1.20 mmol / L.
Reference range CLI + (AP) (adult): 0.50 -1.00 mmol / L
5. General Comments
During treatment with lithium and during maintenance (prophylaxis) is important to adjust
the dosage to achieve plasma levels required because the lithium can cause acute toxicity
if their concentration is just above the therapeutic range (about 2.00 mmol
116
/ L, although some patients seem to be more sensitive and have side effects such as
tremors or confusion with even lower doses).

ANNEX II - CLINICAL SIGNIFICANCE OF URINARY

ELECTROLYTES
The urinary ionogram is extremely variable from one individual to another, and from one
day to the other in the same individual. Therefore, it must be compared to plasma
ionogram as well as with the patient’s vital signs.
For example, potassium concentration in a urine sample cannot be given any value if the
patient’s potassium input and the degree of hydratation.
The Electrolytes present in the body as well as those daily intaken with the diet, are
excreted via renal system in urine.
Urine Electrolytes determination provides relevant information about the kidneys
efficiency and other pathological situations.
Determination can be performed in a urine sample collected during 24 hours. The
amount of electrolytes excreted per day is obtained multiplying the measured
concentration (mmol/ L) by the total quantity of urine excreted in a day.
Sodium Chloride Concentration

Chloride concentrations usually present great variations related to salt intake, being able
to reach ciphers oscillating between 5 and 20g / 24 hours.
Decreases chloride concentrations: In all the hypodrotyc syndromes (asistolia, nephrotic

syndrome), where salt is retained in edema fluids, bleeding; in the great infiltrators, in
pneumonia, in exudative processes; in saline dehydration syndrome because of abundant
extrarenal wastes: repeated vomits, diarrhea, intestinal fistula, excessive sweating,
extended burns, in the intestinal obstruction; in the free-salt diet, in insipid diabetes,
advanced renal failure, immediate postoperatory period, by chloride tissue retention.
Increases chloride elimination: in rich-salt diet, during the diuretic effect of saluretics and
other similar preparations; in certain acute nephropathies (tubular necrosis), in the poliuric
phase that follows anuria; in chronic nephropathies (pielonephritis, chronic
glomerulonephritis or polycystic kidney), with the saline incontinence syndrome, in
suprarenal insufficiency of Addison’s disease; hypernatruria; it appears in Schwartz-
Bartter syndrome (excessive ADH secretion).
Determination of urinary sodium is of useful diagnoses in the following clinical situations:
1) A diminished sodium urinary concentration indicates there is an extrarenal sodium

loss, whereas a high sodium concentration indicates a renal salt loss or an adrenal
insufficiency.
2) In the differential diagnoses of an acute renal insufficiency, grouped with other

additional diagnoses elements.
3) In hyponatremia, a reduced sodium urinary concentration indicates sodium retention,

which can be adscribable to a severe volume reduction or to a state of saline retention
observed in cyrrosis, nephrotic syndrome and cardiac congestive insufficiency
Urine Potassium (Potasuria)

118
Elimination of Urine Potassium varies within great limits according to the diet. On a
normal mixed diet, normal potasuria oscilates between 1.5 and 3.5 g/ 24 hours, i.e. it does
not exceed 90 mEq./day.
Hyperpotasuria appears in the following cases: Renal diseases, repeated administering

of Mercurial diuretics, Thiazides or carbonic anhydrase inhibitors, carbenoxolona or
regaliz; in processes in course with proteic hypercatabolism like inhanition or hypotonic
dehydration, diabetic acidosis, Cushing syndrome, and treatments with ACTH, corticoids,
etc; in Primary Hyperaldosteronism (Conn syndrome), or after excessive administering of
DOCA; in Bartter syndrome (secondary
Hyperaldosteronism by hyperreninemia), and in alcalosis of any origin.

Hypopotasuria may be observed in: intense and prolonged diarrheas, important disorders
in intestinal absorption, acute renal insufficiency, prolonged diets deficient in potassium.

ANNEX III - WORKING PRINCIPLE
Measurement Technology
Ion selective electrodes (ISE) measure electrolytes by two different technologies, direct
and indirect, commonly known as Direct ISE and Indirect ISE (ISE = Ion Selective
Electrode).
Direct ISE
 The measurement is performed directly on the whole blood, plasma or serum

sample.
 The use of whole blood does not involve previous sample preparation.
 The direct ISE measures the electrolyte activity in plasma (mmol/Kg H2O), or
“concentration in plasma (mmol/L)”. The electrochemical activity of ions in water turns into
the corresponding concentration by means of a specific ion factor. This is only applicable
to a given concentration rank. The use of this factor ensures that the ISE Direct reflects the
current situation, activity of clinical relevance, regardless of the protein an/or lipid values.
Nevertheless, the result is traditionally called “concentration”. This conversion is based on
recommendations of IFCC
Expert Panel on PH and Blood Gases, in order to avoid the confusion of having two types
of electrolyte results.
 This technology is typically utilized in both Blood Gases Analyzers and Point of
Care Analyzers.
 The result informed is independent of the sample content of solids.
 The results obtained by the ISE Direct system are well correlated when working
with samples with normal content of proteins and lipids. This obviously requires the
elimination of pre-analytical errors.
The automatic Analyzer employs for electrolyte determination the Direct Ion Selective
method which is based on the properties of its transducers or sensors (electrodes) to be
selective to a specific ion in solution.
This is achieved because the membranes of the Ion selective Electrodes develop a
potential measured against a stable reference electrode of constant potential related to the
activity of this particular ion for which they are selective. Such potential is due to the
Nernst equation.
120
 RT 
E  E0    ln ai . (+ for cations and – for anions)
 nF 
 RT 
But ai  fi  ci , then E  E    ln( fi  ci )
0
 nF 
E = Electrical potential measured
Eº = Electrical potencial (constant) that depends on the measure system.
ai = Electrolyte activity.
R = General constant of gases.
T = Temperature
n = Electrolyte Valence.
F = Faraday constant.
ci = Electrolyte concentration.
fi = Electrolyte activity.
Enunciating the equation in terminus of Analyzer functions
E  E 0  P  ln( fi  ci )
P = Slope of the Electrode equation for the working temperature.
This is calculated by the Analyzer measuring the Standard Calibrators A and B and
knowing the concentration of each electrolyte.
Finally the equation to find the Electrolyte concentration is

This is the algorithm for the Analyzer Diestro® 103 AP
122
ANNEX IV – ADVANTAGES OF THE NEW 4.00 SOFTWARE

VERSION
Barcode reader and external keyboard.
1. Connect the keyboard/bar code reader in the connector installed in the back of the
analyzer. (See Fig. 1)
USB
connection
RS232
connection
External barcode
reader and keyboard
connection
Power supply
connection
Ground
connection
Fig. 51 Rear panel detail
2. Entering information in the Measuring process (See section 5.3 and 6.3 in the user
manual)
2.1. When the needle is out and the next figure appears in the screen, press info

2.2. Type the patient ID in the Keyboard and press enter or read the bar code of the
sample with the bar code reader.
Note: The patient ID will appear in the Measurement screen.
The Patient ID can be re-entered repeating the step 1.2.1
2.3 To continue with the normal procedure of measurement press fill and follow the steps
described in the manual
124
Fig. 53 Example of Patient ID in a ticket

Quadratic equation correction for measurements in serum and urine.

Not all the analyzers measure the same way or by the same method, with this correction
equation the Diestro analyzer is capable of emulate the measurement behavior of any
other analyzer.
The method consist in compare the measurements of the diestro analyzer with the
analyzer to emulate and perform a curve with the form:
Y= - B2 x2+ AX + Constant value
B= Quadratic value
A= Lineal value
Constant value = Delta
For more information about the quadratic equation and the way of calculate
this parameters please contact Technical service
Entering Delta correction (Constant value)
Before using Deltas, verify that the analyzer works properly. Never apply Deltas if your
analyzer is not precise, in other words, if it does not repeat the measures correctly.
1. In the Calibration menu, press Opt.
2. In the Calibration Options press Delta.
126
3. Now you can change the delta value. Each electrode has a delta for each type of
sample.
Initially you can select the electrode and type of sample

 Select electrode and type of sample (Serum or Urine)
<==> Pressing you can edit the delta value corresponding to the electrode selected,
pressing again you can select another electrode.
4. Edit the Delta value digit beginning with the sign.
 Digit value increases.

 Digit value decreases.
5. Pressing Esc. You return to the calibration option menu
Entering quadratic and lineal values
1. In the calibration menu, press Opt.
2. In the Calibration Options press Corr.

3. Now you can change the quadratic factor (Sqr) and the lineal (Lin) value of each ion.
 Select the electrode and type of sample (Serum or Urine)

<==> Pressing you can edit the delta value corresponding to the electrode selected,
pressing again you can select another electrode.
4. Edit the the quadratic factor (Sqr) and the lineal (Lin) value digit by digit beginning with
the sign.

5. Pressing Esc. You return to the calibration option menu
128
Range of normal values for serum and urine measurements.

1. To set or modify the normal values for serum and urine press Menu to enter the menu.
2. In the Root Menu press Serv and then Norm.
3. Edit the values
Serum Urine
 Select the electrode and type of sample (Serum or Urine)

<==> Pressing you can edit the value corresponding to the electrode selected, pressing again you can
select another electrode. Once selected the value, modify it digit by digit and press <==> to confirm
the value.

Fig. 54 Printed Electrolyte Report with values out of Normal Range
Screen measurement time configurable and option to remove beeper.

1. Press Menu to enter the menu.
2. In the Root Menu press Serv and then Conf.
130
3. Press Out.
Press to activate or deactivate the out.
*
“ ” = Out activated
Displ. Time is the time (in seconds) the results of the calibration and
measurements are displayed on the screen
Beeper: Yes (The analyzer will make sound alerts)
No (The analyzer is in silent mode)
Na clean request every 7 days.

The analyzer will need a Na Clean every 7 days. When the time from the last Na clean
were passed the analyzer will show CleanNa. Dose in a tube Na clean solution and then
press cleanNa.
Then continue with the steps in the manual for the case of the Wash.
See section “Rinse and Cleaning” Page 51.
Serial output for net connections (LIS)

In the software version V2.03 modifications were added to the serial output options
(RS232). See section 14 - PRINTER, SERIAL OUT AND LANGUAGE
CONFIGURATION in the user manual.

Serial output configuration:
The “Serial Out” parameter must be changed. It can be found in the Serv->Conf->out
menu.
This parameter includes the following options:
 No: Serial output disabled.
 Ticket: Transmits through the serial output (RS232) calibrations and measurements
performed by the analyzer in the ticket printer format (equal to the printer ticket).
 >Net: Send the measurement data in a string of fields separated by ";" in the
following format:
# Number of sample;& Patient ID; Date Hour; Result of the Na measurement;

Result of the K measurement; Result of the Cl measurement; Result of the Ca
measurement; Result of the Li measurement; CR
Field name Field format Observations

From 1 to 65535 incremental and not editable
Number of sample #XXXXX
by the user.
Up to 20 alphanumeric characters entered by
Patient ID &XXXXXXXXXXXXXXXXXXXX keyboard or bar code reader or keypad built into
the computer.
Between the date and time are two separating
Date and Time AAAA/MM/DD HH:MM:SS
spaces
Result of the Na
Na= XX.X [mmol/l]Error:Z
measurement in serum
Result of the K
K = X.XX[mmol/l]Error:Z
Result of the Cl
Cl=XXX.X [mmol/l]Error:Z
Result of the Ca Z: Measurement Error Flags (^v/?SCLQuU)
Ca= X.XX [mmol/l]Error:Z
Result of the Li
Li= X.XX[mmol/l]Error:Z Calcium units can be [mmol/l] , [mgr %] o [meq/l]
Result of the Na
NaO=XXX.X [mmol/l]Error:Z
measurement in urine
Result of the K
K O= XX.XX [mmol/l]Error:Z
Result of the Cl
ClO=XXX.X [mmol/l]Error:Z
CR (Carry return)
Note: In this mode the calibration data or measurements of quality control will not
be reported by the serial port. Only the measurements will be reported to the net.
Examples of String sent to the Net:
Serum measurement in analyzer with Na-K-Cl-Ca configuration, Number of sample 7,

Patient ID Juan Perez1234, Na measurement with ?CL errors, K Measurement with ?Q errors, Cl
measurement OK, Ca under the normal value error and no Lithium (empty).
All ion units is [mmol/l]
# 7;&JUAN PEREZ1234;2012/10/13 16:10:05;Na= 62.8[mmol/l]Error:?CL;K =

2.60[mmol/l]Error:?Q;Cl=107.8 [mmol/l];Ca= 4.12 [mmol/l]Error:v;;CR
Urine measurement in analyzer with Na-K-Cl-Ca configuration, urine measurement without errors, no
patient ID. All ion units is [mmol/l].
# 8;&;2012/10/13 16:39:57;NaO=251.0 [mmol/l];K O= 21.20 [mmol/l];ClO=251.0 [mmol/l];;;CR
132
Note: In the measurement of urine is added an "O" after the ion measured and
reported only sodium, potassium and chloride, the other fields are empty report.
That is never measured Ca and Li in Urine
Setting baud rate, flow control, carriage return and Line Feed.
Pressing Esc in the serv-> Conf-> Out menu having serial out enabled a screen with the
options will appear:
Baud: (Baud rate) The speed of transfer of the serial output data.
Xon – Xoff: It is a choice of serial communication protocol.
Serial communication is: (8N1)
8 data bits
1 sop bit
No Parity
<CR>+<LF>: Some printers or interfaces need this option. (Appears only when the serial
output is configured as a ticket)
Network delivery of results from memory
In the case the result of a performed measurement must be reported to the network you
can enter in the memory measured results in the meas-> Mem menu and navigate the
measurements using the "v" and "^" to find the searched measurement.
Note: In the search screen you will find the patient ID, sample number, date and time.
Once measurement is found press "Resul" to see the measurement.
Pressing "> Net" measurement data will be sent via RS232.
Commands from the Host to the Diestro
nM? Send to network the last n measurements to Host.

nM! Generate n simulated consecutive measurements (ONLY WORKS IN FACTORY,
NOT AVAILABLE TO THE USER)
Validation of the sample measurement before sending it to the memory

or net.
The analyzer needs to know whether to validate the data before sending it to the network
via serial port and for this you need to modify the parameter "validate" you can find in the
serv-> Conf-> Out menu.
This parameter includes the following options:
 Yes: Each time you finish a measurement operator gives the OK (pressing "> Net")
for data to be sent via RS232 or "ESC" to cancel sending.
 No: Each time you finish a measurement data is sent automatically by RS232.
 With error: Each time you finish the measurement and there is an error in
measuring the operator must give the OK (pressing "> Net") for data to be sent via
RS232 or "ESC" to cancel sending. Data without error is sent automatically to the
net without validation by the operator.

ANNEX VI – QUALITY CONTROL CHART
134
PARTS, REFERENCE CODES AND WARRANTY
REF DESCRIPTION INSTALL BEFORE WARRANTY

EL 0001 Reference Digital Electrode 6 months 6 months
EL 0002 Sodium Digital Electrode 6 months 6 months
EL 0003 Potassium Digital Electrode 6 months 6 months
EL 0004 Chloride Digital Electrode 6 months 6 months
EL 0005 Calcium Digital Electrode 6 months 6 months
EL 0006 Lithium Digital Electrode 6 months 6 months
EL 0007 Sample detector Digital Electrode undefined 12 months
IN 0100 ISE Calibrating Pack Use before expiration date
IN 0300 ISE Urine Diluent Use before expiration date
IN 0400 ISE Cleaning Solution Use before expiration date
IN 0600 Na+ Conditioner Use before expiration date
3 months or
IN 0050 Fill Port Cleaner undefined
800 samples
RE 0100 Peristaltic Pump tubing undefined 3 months
RE 0200 Capillary for sampling (AP) undefined 3 months
RE 0202 Fill Port undefined 3 months
RE 0300 Spare tubing Kit (AP) undefined 3 months
RE 0305 Pack connection tubing Kit undefined 3 months
RE 0400 Capillary adapters undefined 3 months
RE 0501 Pinch Valve undefined 6 months
RE 0808 Spanish Diestro 103AP CD Manual undefined ---
RE 0809 English Diestro 103AP CD Manual undefined ---
RE 0902 Power Supply 15V 2.5A undefined 6 months
RE 1000 Ground Wire undefined ---
RE 1003 Gel Battery 6 months 12 months
Install by Date: Use of the component must commence by that date (maximum) to
guarantee the component warranty period.

WARRANTY
JS MEDICINA ELECTRONICA SRL LIMITED WARRANTY

Coverage. JS Medicina Electrónica SRL guarantees its product (the analyzer Diestro
103AP) to the original purchaser, free of failures of manufacturing and labor for one year,
from the date of its purchase from the company or a distributor or seller duly authorized by
JS. The electrodes of analyzer Diestro 103AP have 6 months of guarantee, in the same
conditions.
This guarantee, in the period of time indicated, covers without any failure of
manufacturing, provided that the failure arose as a result of the correct use of the analyzer,
or its operation according to the manual. In case there is a failure, JS Medicina Electrónica
SRL, at its option, may repair or replace the defective parts, or replace it by another new
one of identical quality, after the return of it. In the event that at the time of the replacement
JS Medicina Electrónica SRL does not have a product of the same type or quality (either
by discontinuity of its production, lack of stock or any other reason) it may be replaced by
another of similar characteristics or even of higher quality. If, after a reasonable period of
time, the unit cannot possible be repaired or replaced, the user will have the right to
receive a refund of the purchase price as the sole compensation.
Exclusions. Warranty deadlines do not include those parts or consumables that wear off
or are consumed or expended because of the operational and normal use of the product.
In these cases, the warranty period will be the indicated in the manual of the operator as
“install by” or “expiration date”.
Reasons for the cancellation of this guarantee, if the product has been subjected to
beatings or accidents of any nature, misuse, excesses or falls from electrical voltage
involving use in abnormal situations, altered improperly or repaired or installed by
personnel not authorized by JS Medicina Electrónica SRL.
The guarantee lacks validity if any amendments or deletions in the guarantee certificate
or purchase invoice are made, or if this last one is missing, or the purchase date has not
been clearly written on it.
Limitation. The guarantee that has been described is exclusive of JS Medicina
Electrónica SRL and makes null and void any other implicit or explicit guarantee, and
consequently any other person, society or association is not authorized to assume on our
behalf any responsibility with respect to our products.
Exemption of liability. In no event shall JS Medicina Electrónica SRL be liable to the

buyer and any person for personal injury or property damage that could cause the use or
malfunction of the analyzer, including its lack of maintenance.
The terms and conditions of this guarantee are exclusively subject to the legislation of the
Republic of Argentina, and to the jurisdiction of the National Justice of the City of Buenos
Aires- RA. These terms and conditions are not subject to any other legislation in any other
jurisdiction.
If the warranty service is required in the Argentine Republic, inform phone-fax 11

4709 7707, or email info@jsweb.com.ar
Outside of the territory of Argentina contact your local

distributor.
136

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ELECTROLYTE ANALYZER

OPERATOR´S AND SERVICE MANUAL

3.1. Manual Positioning ........................................................................................................................ 91

All the setup electrolytes can be measured simultaneously.

Manufactured by JS Medicina Electrónica

All Rights Reserved.

JS Medicina Electrónica® manufacture under ISO 9001/ISO 13485 standards.

GMP COMPLIANCE MERCOSUR RESOLUTION Nº31/97

READ THIS BEFORE USING THE EQUIPMENT

KEEP THESE INSTRUCTIONS ACCESSIBLE

Note: Identify references to information in other sections of the manual.

Press on the touchscreen

Lot Number Serial Number

Reference / catalog number In Vitro Device

European authorized representative Read the Manual befote use

Indoors use only

Manufacturer information Manufacture date

Install before this date. Expiration date

European Conformity Do not stack more than the

-Press Esc to return to the Main Menu.

2.1. Voltage Power

See section “Power Supply specifications”. Page 141

2.2. Environmental conditions of installation

See section “Technical Specifications” to find detailed information. Page 141

2.3. Installation site

Do not connect the power supply to the power socket yet.

External Barcode reader

Power supply connection

Fig. 1 Power supply and ground connection

Fig. 6 Pack connection tubing kit

Fig. 7 Connected Pack

Fig. 8 Clamping button

3.10 Connect the Peristaltic Pump tubing.

Waste disposal tubing

Peristaltic Pump Tubing Couplers

Peristaltic Pump Tubing

Peristaltic Pump Head

Fig. 13 Peristaltic Pump

3.13 Close the front panel.

See section “Calibration” y “Purge” Pages 39 and 58 respectivly.

When the calibration ends, the following display is shown:

See section “Clock” Page 60

Touch Screen calibration

-Unplug the power source.

4. Retractable Fill Port

Fig. 18 The Analyzer with the Fill Port in Standby

See section “Retractable Fill Port” Page 96

4.1 Capillary Adapters

4 - CALIBRATING SOLUTION PACK (PACK)

1. Pack REF IN 0100

Fig. 23 ISE Calibrating Pack and its connection tubing Kit.

Two types and Identification of Packs

See section “Error Messages” Page 77

2. Pack of Calibrating Solutions Microchip (uChip)

3. Calibrating Solutions Pack Validity

The equipment can still work under an expired date.

4. Calibrating Solutions Consumption

Due to this, we recommend as long as it is possible:

See section “Maintenance” Page 82

6. Replacement of the Pack REF IN 0100

To replace the Pack, follow the sequence:

Fig. 25Closing the waste cap

Fig. 26 Installed Pack