Critical Value Reporting

Certain tests have critical values. These are results that may pose an immediate threat to the patient or, in the case of infectious disease, to those around the patient.

When a critical value is confirmed, the result is called to the patient's nurse (inpatient) or a nurse (physician) at the physician's office (outpatient). Laboratory policy further requires that nurse or physician taking the report repeat the results for verification. Documentation of verbal notification and verification read-back is made by computer comment entry in the LIS. Documentation must specify the identity (full name and credentials of person receiving and reading back the result, date and time of call and initials of the technologist who made the call. Documentation in the computer ensures the printed patient test report indicate when and to whom the report was called.

Test Name Lower Limit Upper Limit Units
Core Lab - - -
Hematocrit <20> >65 %
Hematocrit  (neonate 0-28 days) <20.1> >64.9 %
Hemoglobin <7.5> >20.0 gm/dL
Hemoglobin  (Preop) <10.0> gm/dL
WBC <1> >25 K/ µL
WBC (neonate 0-28 days) <2.1> >99.9 K/ µL
Platelet <50> >800 K/ µL
Platelet (Pre-Op) <100> K/ µL
Platelet (neonate 0-28 days) <51> >749 K/ µL
Fibrinogen <100> mg/dL
Prothrombin Time  (Pre-Op) >13.5 sec
Prothrombin Time >45.0 sec
INR >5
Fibrin Split Products >40 µg/mL
Partial Thromboplastin Time (Pre-Op) >39.1 sec
Partial Thromboplastin Time >100 sec
Ammonia (neonate 0-28 days) >99 µmol/L
Amylase >599 mg/dL
Bilirubin (adult) >15.0 mg/dL
Bilirubin (neonate 0-15 days) >10.0 mg/dL
Calcium <7.0> >13.5 mg/dL
Calcium (neonate 0-28 days) <6.1> >11.9 mg/dL
Chloride >149 mmol/L
Creatinine (non-dialysis) >9.9 mg/dL
Creatinine (neonate 0-28 days) >1.9 mg/dL
CKMB (1st elevation) >5.6 ng/mL
Glucose <40> >450 mg/dL
Glucose  (neonate 0-28 days) <46> >249 mg/dL
Ionized Calcium (neonate 0-28 days) <0.9> mmol/L
Lactate (Lactic Acid, venous or arterial) >4.0 mmol/L
Lactate (neonate 0-28 days) >9.9 mmol/L
Magnesium  (Non-Obstetrical) <1.3> >5.0 mg/dL
Magnesium (neonate 0-28 days) <1.1> >2.9 mg/dL
Phosphorus <1.5> mg/dL
Potassium <3.0> >6.0 mmol/L
Potassium (neonate 0-28 days) <3.1> >6.4 mmol/L
Sodium <125> >155 mmol/L
Sodium (neonate 0-28 days) <126> >149 mmol/L
Total protein >12.9 gm/dL
Triglycerides (neonate 0-28 days) >299 mg/dL
Troponin (1st elevation) >0.7 ng/mL
Blood pH <7.30> >7.55
Blood pH (neonate 0-28 days) <7.21> >7.54
pO2 <55> >60 mm Hg
pCO2 <20> >60 mm Hg
pCO2 (neonate 0-28 days) <21> >69 mm Hg
Base Excess -15 mmol/L
Toxic Drug Levels 
Acetaminophen >200.0 ug/dL
Alcohol >400.0 mg/dL
Cyclosporin >700 ng/mL
Gentamycin >3.0 (Trough) >12.0 (peak) µg/mL
Tobramycin >3.0 (Trough) >12.0 (peak) µg/mL
Vancomycin >20.0 (trough) µg/mL
Digoxin >2.5 ng/mL
Carbamazepine >15.0 µg/mL
Lithium >1.2 mmol/L
Phenobarbital >59.0 µg/mL
Dilantin >25.0 µg/mL
Salicylate >30.0 mg/dL
Theophylline >20.0 µg/mL
Valproic Acid >150.0 µg/mL
Microbiology
Blood Culture Positive
Blood Parasite Film Positive
CSF Gram Stain Positive
CSF Culture Positive
CSF Cryptococcal Antigen Positive
CSF Bacterial Antigen Positive
TB Smear Or Culture Positive

Body Cavity Or Tissue Culture
(Not To Include Urine Or Sputum)

Positive
Blood Bank 
Type And Crossmatch Physician To Be Notified If Blood Not Available
Urinalysis
Clinitest Pos. if <1yr old="">
Cystine Or Sulfa Crystals Present