Making blood smears or films is arguably one of the most time-consuming chores performed in the hematology lab. Unfortunately, it also one of the most necessary. Smears are used to check leukocyte distribution for the presence of abnormal leukocyte cells, determine the leukocyte differential count and study erythrocytes and platelets.

     Until recently, manual slide-making was the only way to go. However, this month Beckman Coulter launches its automated hematology flow cytometer slidemaker to help laboratories achieve faster turnaround on their hematology workloads. Early adopters of the system have found that it improves overall productivity, enhances slide consistency and streamlines the testing process.

Integrated Solution Improves Efficiency
The laboratory at Barberton Citizens Hospital, a 347-bed hospital in Barberton, Ohio, operates 24 hours a day, seven days a week, processing approximately 9,000 hematology tests each month.

     Earlier this year, the lab augmented its two Gen•S systems with slidemaker modules. The resulting automation and flexibility have helped the lab make big strides toward enhanced testing productivity, according to Pat Rogers, hematology supervisor.

ptb01.jpg (15064 bytes) Pat Rogers, hematology supervisor, of Barberton Citizens Hospital at the Gen•S hematology flow cytometer SideMaker

    “Since we acquired the two Gen•S systems, we have experienced improved efficiency due to less sample handling, less maintenance and the automation of follow-up procedures and result validation,” Rogers said.

    Many of the competing systems the lab looked at didn’t have the flexibility and range of options available on the Gen•S. She was also looking for a system that allowed the lab to improve its processes on the fly, something that was not easy to find.

Slide and Sample Flow
The Gen•S SM SlideMaker automatically prepares a blood smear based on user-defined criteria in the Gen•S workstation. The operator loads at least one slide cassette containing clean slides into the slide ejector module. A mechanism pushes the cassette to the front of the module, and pushes slides out individually. Grippers hold the slide on the smear truck that carries the slide to the shuttle.

    Next, the Gen•S system aspirates the first sample from the specimen tube for analysis; a second 250-mL sample for the SlideMaker is aspirated from the vent side of the needle.

A regulated vacuum pulls the sample into one of two coiled sample reservoirs. An air bubble is inserted into the middle of the sample before it goes into the sample reservoir where the system moves the sample back and forth to keep it mixed. The aspiration lines are rinsed and dried before the Gen•S finishes its count cycle.

    Depending on user-defined criteria, the sample smear process either starts immediately or is held until a sample is flagged based on its CBC or Diff results. The slide on the shuttle moves to the label printer and receives a label with user-defined sample information sent from the Gen•S system.

     The smear truck holds a second, clean slide at approximately a 45-degree angle and drags its edge over the slide with the sample to spread the blood sample. Then the second slide moves back over the first slide to make a wedge smear. Pusher bars eject the slide onto the conveyor belt of a dryer module and the second slide transfers to the shuttle to be used for the next sample.

     Warm air dries the smear as the conveyor belt moves the slide through the dryer module. Once dry, the conveyor belt transfers the slide to a platform, called a platen. There, grippers hold the slide as the platen rotates to a vertical position. Slides are then lowered and placed in the basket directly below. From there the basket of slides can be inspected to ensure that each slide meets the laboratory’s characteristics prior to staining.

     The only operator-required actions are loading sample cassettes on the Gen•S system and retrieving prepared blood smears. Complete blood counts and smear preparation are simplified through workstation features that include:

  • Automated, integrated CBC, differential, reticulocyte and smear preparation from a single, whole blood aspiration
  • Automatic adjustment for sample viscosity to assure consistent slide quality
  • User-definable, customizable smear criteria facilitates reflex slide preparation for only those samples requiring review
  • Fewer clerical errors through complete, clear labeling, stain resistant labels and optional bar coding
  • High throughput smear preparation concurrent with Gen•S output

     Among the benefits of this automated process are no exposure to blood samples, no manual decision making on whether a smear is to be made and more time for an operator to review abnormal results and smears.

     Rogers calls the on-board tutorial for the Gen•S, “self-paced, entertaining and flexible. The system can be taught a little bit at a time or all at once. Its customized decision rules allow even a newly trained person to validate abnormal results quickly and with confidence.

      Experienced users can access the on-board operator’s guide as a troubleshooting manual. “It’s available to you with a few mouse clicks, and it eliminates having to look for a book in a bookcase, flipping through pages and storing a lot of outdated manuals.”

     “One of the best things about the SlideMakers is flexibility — the options that they provide and the fact that we can continually make adjustments even after they are installed and running in a particular way,” Rogers said. “If we decide to update procedures to improve efficiency, it’s not hard to do at all. We can do it on the fly — simply and easily.”

For additional information on Beckman Coulter’s Geno•S system, visit their web site at www.beckmancoulter.com .