Critical Values

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The definition of a “critical value”, according to the American Society of Clinical Pathologists (ASCP) is “a pathological state at such variance with normal as to be immediately life-threatening unless something is done promptly and for which some corrective action must be taken.”  The laboratory is required by law to call critical values to the patient’s caregiver and document the call. 

Critical values for this laboratory

Test

Critical Values

Significant Values

Critical Tests

 

    Low      

    High

 

 

 

Glucose

 

<50 mg/dL

 

>900 mg/dL

           

350-900 mg/dL

 

Frozen Sections

Potassium

<2.8 mEq/L

>6.5 mEq/L

 

All Corrected Results

Sodium

<128 mEq/L

>160 mEq/L

 

 

Total CO2

<10mEq/L

 

 

 

Bilirubin, Total

 

>25 mg/dL

unless previous value was critical

                18-25 mg/dL;

unless previous value was significant

 

Calcium

<6.5 mg/dL

>13.0 mg/dL

 

 

Creatinine

 

>5 mg/dL

           

 

BUN

Phosphorus

CK

Troponin

 

>80 mg/dL

>9.0 mg/dL

>4,000 U/L

> 1.0 ng/mL

            40-80 mg/dL

 

 

Hemoglobin

 

<5.0 gm/dL

 

>21.0 g/dL; >25 g/dL NICU

           

5 – 7 g/dL

 

PTT

 

>75 sec

 

 

INR

 

>4

 

 

WBC

<0.200 K/mm3 unless previous value was critical

 

0.200 - 2.0 K/mm3

unless previous value was significant

 

Platelets

<10 K/mm3

 

            10  -  50 K/mm3

 

Fibrinogen

Blasts on Blood Smear

<45 mg/dL

 

 

            Present

unless previous value was significant

 

 

Phenobarbital

 

 

> 50 μg/mL

 

 

Phenytoin

 

> 30 μg/mL

 

 

Salicylate

 

> 30 mg/dL

 

 

Theophylline

Digoxin

 

> 20 μg/mL

>2.5 ng/mL

 

 

 

 

Blood Culture

 

 

Positive

 

 

CSF Gram Stains or Culture

 

Positive {Call to Direct Caregiver AND Dr. Kleiner (Neurosurgery)}

 

 

Leads

 

 

            > 40 mg/dL

 

Pregnancy Test

 

 

          Positive

 

PCR for Pertussis

 

 

          Positive

 

PCR for Enterovirus

 

 

          Positive

 

PCR for HSV

Acid-Fast Bacilli

Chlamydia trachomatis

Herpes Simplex virus

HIV

 

 

          Positive

          Positive

          Positive

          Positive (<30 DO)

          Positive (undiagnosed Pt)

 

N. gonorrhoeae

Stool Pathogens

Malaria

 

 

          Positive

          Positive

          Positive

 

 

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