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Critical Tests and Critical Values

Critical tests are those tests which are always called when resulted, regardless of the value of the result. These include Rapid PTH (TAT 60 minutes), Frozen Section (TAT 20 minutes), and L/S ratio on Amniotic Fluid (TAT 6 hours).

Critical value limits have been established for the following tests:

 

              Chemistry

 

 

Critical Low

Critical High

Reporting Unit

Albumin

1.4

6

gm/dL

Amylase

 

400

IU/L

Calcium

6.9

12.1

mg/dL

Carbon Dioxide (CO2)

10

50

mmol/L

Chloride

80

120

mmol/L

CPK

 

500

IU/L

CKMB

 

5.0

ng/mL

Creatinine

 

10

mg/dL

Glucose

50

400

mg/dL

Lactic Acid

 

5.0

mmol/L

Magnesium

1.0

4.0

mg/dL

Neonatal Bilirubin

 

12.0

mg/dL

Osmolality (Serum)

265

320

mOsm/kgH2O

Osmolality (Urine)

100

800

mOsm/kgH2O

Potassium

2.9

6.5

mmol/L

Pseudocholinesterase

7.0

19

U/ml

Sodium

124

155

mmol/L

Total Bilirubin (adult)

 

10.0

mg/dL

Total Protein

3.0

12.0

gm/dL

Troponin-I

 

1.5

ng/mL

TSH <4 days

1.0

20.0

mU/L

          4 days-2yrs

 

10.0

mU/L

        >2 days

 

30.0

mU/L

Urea Nitrogen

 

100

mg/dL

Phosphorus

1.0

7.0

mg/dL

 

 

 

    Therapeutic 

Drugs

 

 

Critical Low

Critical High

Reporting Unit

Acetaminophen

 

200

ug/mL

Amikacin Peak

 

26

ug/mL

Amikacin Trough

 

11

ug/mL

Carbamazepine (Tegretol)

 

14

ug/mL

Digoxin

 

2.0

ng/mL

Ethosuximide

 

150

mg/L

Lidocaine

 

5.1

mg/mL

Lithium

 

2.0

mmol/L

Phenobarbital

 

60

ug/mL

Phenytoin (Dilantin)

 

30

ug/mL

Proc+NAPA

 

30

ug/mL

Primidone

 

12.1

ug/mL

Salicylate

 

30

mg/L

Theophylline

 

20.1

ug/mL

Valproic Acid (Depakene)

 

150

ug/mL

Gentamicin Peak

 

11

ug/mL

Gentamicin Trough

 

3

ug/mL

Tobramycin Peak

 

11

ug/mL

Tobramycin Trough

 

3

ug/mL

Vancomycin Peak

 

50

ug/ml

Vancomycin Trough

 

40

ug/ml

 

 

 

 

 

 

 

 

 

         Hematology/Coagulation

 

 

Critical Low

Critical High

Reporting Unit

Hemoglobin

6.0

 

g/dL

WBC

1.0

25.0

mm3

WBC's, Blasts

 

2.0

%

Activated PTT

 

> 160.0

sec

Fibrinogen

100

 

mg/dL

Platelets

30

1,000

mm3

INR

 

> 5.0

 

Prothrombin

 

> 55.0

sec

 

         Microbiology

 

 

 

 

 

 

1. Positive result of gram stain on blood culture, CSF or body cavity fluids (includes pleural, peritoneal, pericardial and joint fluid

 

 

 

 

2. Positive India ink or Cryptococcal antigen test

 

 

 

 

 

 

3.Positive meningitis panel

 

 

 

 

 

 

 

4. Positive Beta Streptococcus on OB patients and from nursery

 

 

 

 

 

5. Positive AFB smear or culture

 

 

 

 

 

 

 

6. Presence of blood parasites (malaria)

 

 

 

 

 

 

7. MRSA and VRE

 

 

 

 

 

 

 

8. Any potential agent of bioterrorism

 

 

 

 

 

9. Positive  Clostridium difficile toxin

 

 

 

 

 

 

 

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