LifeBridge Health - Department of Pathology Clinical Pathology Critical Values

Values outside these ranges are considered critical and will be called to the attention of a caregiver.

Test Name	Age	Range	Units
ACETAMINOPHEN	120 yrs	>150	MCG/ML
AMIKACIN	120 yrs	>30.0	MCG/ML
APTT(SHB)	120 yrs	>100	SEC
(NWHC)		>200	SEC
BILIRUBIN, TOTAL	30 days	>12.0	MG/DL
	120 yrs	>5.0	MG/DL
BLOOD GAS PROFILE
PH, ARTERIAL	120 yrs	<7.20 or >7.55	UNITS
PCO2, ARTERIAL	120 yrs	<20 or >50	MMHG
P02	120 yrs	<50	MMHG
CALCIUM, TOTAL	120yrs	<6.0 or >12.0	MG/DL
CARBOXYHEMOGLOBIN	120 yrs	>25.0	%
CBC, CELL COUNT
WBC	120 yrs	<3.0 or >30.0	K/MM3
HCT	120 yrs	<20.0 or >90%	%
HGB	120 yrs	<7.0	GM/DL
PLATELET	120 yrs	>999	K/MM3
C02
(CARBON DIOXIDE)	120 yrs	<10 or >40.	MMOL/L
CREATININE	120 yrs	>10.0	MG/DL
DIGOXIN	120yrs	>2.00	NG/ML
DILANTIN	120yrs	>30.0	MCG/ML
ELECTROLYES PANEL
SODIUM	120 yrs	<120. or >155.	MMOL/L
POTASSIUM	30 days	<2.5 or >8.0	MMOL/L
	120 yrs	<3.0 or >6.0	MMOL/L
CO2	120 yrs	<10. or >40.	MMOL/L
FIBRINOGEN	120 yrs	<100.0 or >801	MG/DL
GENTAMICIN	120 yrs	>12.0	MCG/ML
GLUCOSE	120 yrs	<50 or >400	MG/DL
LACTATE
(LACTIC ACID)	120 yrs	>4.9	MMOL/L
LIDOCAINE	120 yrs	>7.0	MCG/ML
LITHIUM	120 yrs	>1.50	MEQ/L
MAGNESIUM	120 yrs	<1.0 or >4.0	MG/DL
PHENOBARBITAL	120 yrs	>50.0	MCG/ML
PLATELET COUNT	120 yrs	<20.0 or >999	K/MM3
POTASSIUM	30 days	<2.5 or >8.0	MMOL/L
	120 yrs	<3.0 or >6.0	MMOL/L
PROCAINAMIDE	120 yrs	>12.0	MCG/ML
PROTIME(PT)	120 yrs	>38.0	SEC
(INR)		>4.0
QUINIDINE	120 yrs	>5.0	MCG/ML
SALICYLATE	120 yrs	>30.0	MG/DL
SODIUM	120 yrs	<120. or >155.	MMOL/L
BLOOD LEAD	120 yrs	>45	MCG
BLOOD UREA NITROGEN	120 yrs	>100.	MCG/DL
TEGRETOL	120 yrs	>15.0	MCG/ML
THEOPHULLINE	120 yrs	>20.0	MCG/ML
TOBRAMYCIN	120 yrs	>8.0	MCG/ML
VALPROIC ACID	120 yrs	>100	MCG/ML
VANCOMYCIN	120 yrs	>40.0	MCG/ML

List of Panic Values in Microbiology
Organisms �any body site
Acid fast bacilli Aeromonas AFB � both positive smears and cultures  Campylobacter Clostridium perfringens Escherichia coli o107 or hemmoragic Malaria Mycobacterium species (Mtb, Mai, etc) Neisseria (pathogenic, from non-genital site) Plesiomonas Salmonella Shigella Vibrio		Note: Notify the lab supervisor immediately upon receipt of any of the following requests to be ruled out: Bacillus anthracis Blastomyces dermatitidis Brucella spp Coccidioides immitis Francisella tularensis Histoplasma capulatum Paracoccidioides brasiliensis Pseudomonas pseudomallei Smallpox Yersinia pestis Any agent of bioterrorism
Body sites� organism isolation or stain indicative of infection
Blood, Plasma, and Bone marrow
(1)		Stain positive (first blood bottle of the set, then again for the second bottle if the gram stain is different)
(2)		Isolation of Beta hemolytic streptococcigroup A or B, Haemophilus, listeria, Neisseria meningitidis, or Streptococcus pneumoniae (second call for the culture)
CSF � any growth or positive stain
Eye � aqueous or vitreous humor� any growth or positive stain
Fluids � normally sterile fluids including, but not limited to: Paracentesis, Pleural, Peritoneal, Peritoneal dialysis, Pericardial, Joint (synovial) � any growth or positive stain
Placenta and Amniotic fluid: growth of beta hemolytic streptococci group A or B, Haemophilus, listeria, Neisseria meningitidis, or Streptococcus pneumoniae
Tissues � deep visceral tissue including, but not limited to: lymph node, lung biopsy, liver biopsy� any growth or positive stain
Positive tests
Antigen detection -- Positive CSF or Serum Cryptococcal antigen detection  Influenza Legionella urinary antigen  Streptococcus pneumoniae urinary antigen Pneumocystis Rotavirus RSV GC Chlamydia		Positive Send-out Microbiology tests Legionella Ova and parasite Special request tests Viral culture (non-genital, non-mouth lesion) Viral d�FA
Urinalysis*
Blood (heme) positive chemical strip in the absence of microscopic hematuria or mild hematuria may indicate marked myoglobinuria or intravascular hemolysis.
Microscopic presence of oval fat bodies, many casts (>16/lpf for granular,> 64/lpf for hyaline casts), any red cell casts, any leukocyte casts, and any pigmented casts.
Microscopic presence of yeast with pseudohyphae or any parasite (Schistosoma, Trichomonas without a positive wetprep, etc.)
*Any analytes assayed must fall within set parameters in order for the results to be valid.  The validity of the results vary with the individual assays and the methodology used.  For each analyte, a critical range has been established.  When the results obtained fall into the established critical range, the critical values obtained must be repeated immediately if sample volume permits.  If repeat results are discrepant, then investigate the problem.