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 Value

 

Low

High

 

Glucose

< 50 mg/dL

>900 mg/dL

350-900 mg/dL

Potassium

< 2.8 mEq/L

>6.5 mEq/L

 

Sodium

< 125 mEq/L

>159 mEq/L

125-128 mEq

Total CO2

< 12 mEq/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

>2.6-5 mg/dL

BUN

 

>80 mg/dL

40-80 mg/dL

Phosphorus

< 1.0 mg/dL

>8.0 mg/dL

1.0-1.5 mg/dL

CK

 

>4,000 U/L

 

Troponin

 

>1.0 ng/mL

 

Hemoglobin

< 5.0 gm/dL

>21.0 gm/dL

(NICU: <5 gm/dL or >25 gm/dL)

 

5-7 gm/dL

PTT

 

>75 sec

 

INR

 

>4.0

 

WBC

<0.200x103/mm3

unless previous value was critical

 

0.200 - 2.0x103/mm3

unless previous value was significant

ANC

<500 unless previous value was critical

 

 

Platelets

<10 x 103/mm3

>1000 x 103/mm3

10-50 x 103/mm3

Fibrinogen

<45 mg/dL

 

<100 mg/dL

Blasts on Blood Smear

 

 

Present unless previous value was significant

Phenobarital

 

>50 ug/mL

 

Phenytoin

 

>30 ug/mL

 

Salicylate

 

>30 ug/mL

 

Theophylline

 

>20 ug/mL

 

Digoxin

 

>2.5 ng/mL

 

Vancomycin

 

   >25 ug/mL

20-25 ug/mL

Blood culture

 

Positive

 

CSF Gram Stains or Culture

 

Positive (call direct caregiver)

 

Lead

 

 

>40 ug/mL

Pregnancy Test

 

 

Positive

PCR for Pertussis

 

 

Positive

PCR for Enterovirus

 

 

Positive

PCR for HSV

 

 

Positive

Acid-Fast Bacilli

 

 

Positive

Chlamydia trachomatis

 

 

Positive (<30 DO)

Herpes Simplex virus

 

 

Positive (undiagnosed Pt.)

HIV

 

 

Positive

N. gonorrhoeae

 

 

Positive

Stool Pathogens

 

 

Positive

Malaria

 

 

Positive

 

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