======Procedure for CKMB(creatine kinase-MB) examination======
  *Learn operation of [[Erba XL-640]] and [[Erbachem]]. 
  *Select equipment
    *Use Erba XL-640 as preferred equipment.
    *If Erba XL-640 is malfunctioning, stop the examination and follow [[procedure for responding to Erba XL-640 failure]]
  *Read following documents

|**references**|{{CKMB_kit_literature.pdf|CKMB Kit literature of RANDOX}}|
|**references**|{{:nchsls:c:biochemistry:document:ckmb_spinreact_kit_literature.pdf|CKMB Kit literature of SPINREACT}}|           
| |**Note:** When a new lot is opened, verify kit literature with the uploaded version.|
| |[[lis_upload_dokuwiki_media|Upload]] newer version when required and make necessary changes in procedure and process|

|**environmental and safety controls**|{{CK-MB.pdf|MSDS of CK-MB Kits}}| 

 
  *Document and revise [[common laboratory informations related to the examinations]].
  *Depending on the selected equipment follow appropriate procedure described below.

======Erba XL-640======

|[[Centrifugation]]|
|[[Preparing aliquot]]|
|[[nchsls:c:biochemistry:document:how_to_perform_examination_in_erba_xl-640|Procedure for examination in Erba XL-640]]|
======Erbachem======
**Note:** Following instruction is useful only if operator is familiar with [[Erbachem]]
^Parameter^Value^
^Sample volume(ul)|50|
^Reagent volume(ul)|500|
^Filter|340 nm|
^Temperature|37'C|
^Aspitation Volume(ul)|300|
^Type of reaction|Rate A|
^Decimal place|0|
^Incubation time|600 seconds|
^Reading time|300 seconds|
^Factor|{{:nchsls:c:biochemistry:document:ckmb_principle_and_calculation_of_factor.ods|3537}}|


^Calibration, Result calculation, Quality control and sample examination in Erbachem^

^[[nchsls:c:biochemistry:document:internal_quality_control|Internal Quality Control]]^
^[[how_to_do_external_quality_control_on_erba_xl-640|EQA]]^

  -[[Print examination wise worklist]] for CKMB
  -Add 2.5 ml buffer(R1a) to one bottle of R1b. Mix by gentle swirling. 
    -Use within 3 days. 
    -Keep at 2-8 'C when not in use.
  -Run control provided in the kit as shown in **sample procedure**. Run control with each 2.5 ml reconstitution.
  -Evaluate QC results. If QC results are acceptable proceed for sample examination.
  -**Sample procedure**
  -Select "Run test" -> CKM in Erbachem menu.
  -When instrument asks "Aspirate water", aspirate water.
  -When instrument asks "Aspirate sample".
  -Take 500 microliter reagent in ependroff cup 			
  -Add 50 microliter sample to it. Mix.
  -Aspirate reaction mixture.
  -Wait till reading is available.
  -Enter result in worklist sheet.
  -[[lis_calibration_entry|Enter Calibration in LIS]]
  -[[list_qc_entry_manual|Enter QC results manually in LIS]]
  -[[list_result_entry_manual|Enter sample results manually in LIS]]. Store the result sheet in a file for at least 2 days for use in event of LIS failures and rechecking results for NCs.
  -**instructions for determining quantitative results when a result is not within the measurement interval:** Dilution of sample with DI water is done in same way as done by Erba XL-640 automatically.