RUH Bath NHS Foundation Trust – Pathology Department

STANDARD OPERATING PROCEDURE SOP/POCT/49/8

Title: HEMOCUE Hb 201+ Effective date:15.05.2018

COPY
Summary of Significant Changes at this Revision
CR6476 - Update locations

Purpose and Scope Items Required

The HemoCue Hb201+ used in a POCT setting is HemoCue Hb201+

to give an instant measurement of the Haemoglobin Mains adapter
level of the patient. 4x AA batteries
The Hemocue must only be used by appropriately Gloves
trained staff. Waste bin
Lancets
HemoCue 201 microcuvettes

Definitions and Abbreviations Grade / Qualifications

Only to be used by appropriately trained

staff.
Hb= Haemoglobin g/L

Competencies Required
Current Version of: FM/POCT/14

Risk Assessment:
Current Version of: RA/HA/57

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 RUH Bath NHS Foundation Trust – Pathology Department

STANDARD OPERATING PROCEDURE SOP/POCT/49/8

Title: HEMOCUE Hb 201+ Effective date:15.05.2018

Principle of test
The Hemocue 201 is used to determine the total amount of Haemoglobin in whole
blood. The system consists of the analyser and specially designed cuvettes containing
dried reagents. The cuvette serves as a pipette, reaction vessel and a measuring cuvette.
No dilution is required. The haemoglobin measurement takes place in the analyser and is
factory calibrated against the haemiglobincyanide (HiCN) method, the international
reference method.
Sodium deoxycholate haemolyses the erythrocytes and haemoglobin is released. Sodium
nitrite converts haemoglobin to methaemoglobin which, together with sodium azide gives
azidemethaemoglobin. The absorbance is measured at two wavelengths (570 and 880
nm) in order to compensate for turbidity in the sample.

Purpose of the test

Quantitative determination of Haemoglobin in capillary, venous or arterial blood.

Storage of reagents
HemoCue Hb 201 microcuvettes can be stored at room temperature(15-30 degrees
centigrade) They must not be stored in a refrigerator. Check expiry date before use.

Method
The Hemocue must only be used by competently trained staff, who have
successfully completed competence sheet FM/POCT/14.
Competency must be re-assessed every three years.

Start up procedure
• If mains power is available, connect the adapter to the socket in back of analyser.
• If no mains power is available insert 4 x AA batteries in the battery compartment
• Pull cuvette holder out to its loading position.
• Press and hold the left button until the display is activated (all symbols appear on
the display)
• Display shows the version number of the programme after which it shows an hour
glass timer and Hb symbols.
• After 10 seconds the display will show three flashing dashes and the HemoCue
symbol – it is now ready for use.

Set Up QC test
• Internal QC must be run daily or before use.
• Internal QC test – using HemoCue control
• Press both buttons on the HemoCue 201 together
• Display shows a flashing QC symbol
• Select QC test by pressing Left button
• Fill microcuvette with QC solution.
• Insert cuvette in the holder and await result.
• Record QC result on the iQC / maintenance log (FM/POCT/16). Check acceptance
limits, usually within 2SD of mean.

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 RUH Bath NHS Foundation Trust – Pathology Department

STANDARD OPERATING PROCEDURE SOP/POCT/49/8

Title: HEMOCUE Hb 201+ Effective date:15.05.2018

• If QC fails, fill in action on iQC / maintenance log, the analyser must be taken out of
use, until the problem has been resolved.. Samples should be taken for FBC and
sent to laboratory.
• If QC result is acceptable, no further action is required, the machine will
automatically return to patient mode after running QC.

Measuring capillary blood

• Wear nitrile gloves.
• Clean patient finger with disinfectant wipe, generally middle or ring finger is best,
avoid fingers with rings on.
• Prick side of finger with pre-prepared lancet.
• Wipe away first 2 -3 drops of blood
• Re-apply light pressure towards fingertip until another drop of blood appears
• Fill microcuvette in one continuous process. Do not overfill.
• Wipe off any excess on the outside of the microcuvette, do not draw any blood out
of the microcuvette during this process.
• Check that no air bubbles are present in the microcuvette, small bubbles around the
edge can be ignored. – Bubbles in the cuvette will result in a falsely low Hb reading.
• Place microcuvette in the cuvette holder
• Push cuvette holder to reading position.
• During measurement the hour glass symbol is displayed.
• The Haemoglobin value is displayed within 15 to 60 seconds.
The results will be displayed as long as the cuvette is present in the holder.

Record Hb result on a Hemocue record label (FM/POCT/15) along with all other
essential information. Attach label to patient’s notes.

If sample obtained is insufficient or clotted, record this on the label (FM/POCT/15)

and on the iQC chart (FM/POCT/16)

• Remove cuvette and dispose of in clinical waste bin.

• To turn OFF –Hold left button until the display reads OFF and becomes blank.

External Quality control

External quality control samples are to be run every month in line with NEQAS.
Run external QC as a patient sample, filling cuvette with a syringe and needle.
Record results on spread sheet provided.
External QC results are returned monthly and reviewed at the POCT meeting and
Haematology QC meeting held quarterly.
Quality control results need to be retained for the life time of the analyser.

Maintenance
• If analyser has been contaminated with blood, maintenance must be performed.
• Turn analyser off.
• Pull cuvette holder out of the loading position – Use a pointed object to depress the
catch in the upper right corner of cuvette holder.
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 RUH Bath NHS Foundation Trust – Pathology Department

STANDARD OPERATING PROCEDURE SOP/POCT/49/8

Title: HEMOCUE Hb 201+ Effective date:15.05.2018

• Pull out cuvette holder, keeping catch depressed.

• Clean cuvette holder with alcohol or detergent wipe.
• Push HemoCue Cleaner swab in to the opening of the cuvette holder. Insert 5 – 10
times. If swab is still stained, repeat with a new swab.
• Wait 15 minutes before re-using the machine.
• Replace the cuvette holder.
• Record maintenance performed on iQC / maintenance log (FM/POCT/16)

Health and Safety

In addition to the local Health and Safety policy, the following measures must be
taken.

1. Gloves must be worn by all staff performing the finger prick technique.
2. Dispose of gloves in an appropriate clinical waste bin.
3. All sharps must be disposed of in a sharps bin.
4. If the machine is contaminated with blood, wipe with an alcohol base wipe.
5. After use, wipe machine down with an alcohol based wipe before storing
away.

Trouble Shooting
If battery symbol appears in display, the batteries are running low, replace as soon
as possible, the analyser will still give accurate results.
Report any problems to the senior nurse on duty, discontinue using until a Sister is
available.
If for any reason the result obtained is unexpected, (either too high or too low),
always send a venous EDTA sample to the laboratory for a Full blood count.

Copy number Location held

1 PACU
2 Main Theatre
3 PAW Theatre

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