YNHH Laboratory Manual - Critical Values
 

YNHH Laboratory Manual

[ Table of Contents ]
Critical Values

If the lab person calling panic values cannot reach anyone or if the lab feels the person reached does not understand the significance of panic data, the clinical pathology resident will be contacted. It will then be the resident's responsibility to pursue the doctor and discuss the results.

Blood Bank YNHHChemistry YNHHHematology YNHHMicrobiology YNHHVirology YNHHMed Onc Treatment Center/Lab Med at Long WharfSMC Laboratory * if delta is > 2.0 mg/dL higher than previous value, treat as critical ** no repeat required prior to call
Test/Analyte Value
Urgent need for transfusion and compatible blood Blood not available in an appropriate time
Life Threatening Transfusion Reactions Labeling errors, hematuria, or positive gram stain
Stem cells Positive culture
Calcium <= 6.5 mg/dL
>= 13.0 mg/dL (first time only)
Cortisol <= 3 ug/dL
CO2, Total <= 12 mmol/L
>= 45 mmol/L
Sodium <= 120 mmol/L
>= 160 mmol/L
Potassium <= 2.8 mmol/L
>= 6.0 mmol/L
Glucose <= 50 mg/dL
>= 450 mg/dL
Magnesium <= 1.0 mg/dL
>= 5.0 mg/dL
Phosphate <= 1.2 mg/dL
Ionized Calcium <= 3.0 mg/dL
>= 6.5 mg/dL (first time only)
White blood cells (WBC) < 1.5 K/ul or >50.0 K/ul
Hematocrit (HCT) <22.0%
>60.0% (except in newborns, which could be slightly higher)
Platelets (PLT) <50.0 K/ul or >1000.0 K/ul
Granulocytes <500 (or 10% if WBC normal)
International normalized PT ratio (INR) >4.0
Partial thromboplastin time (PTT) >60.0 seconds
PTT on heparin >100 seconds
BACTERIA Present in any sterile fluid
MALIGNANT CELLS Present in any sterile fluid
URINE Ketonuria and Glycosuria (3+/4+)
Blood Cultures Positive Gram Stain
Priority Specimens Positive Gram Stain or Culture Result
Rapid Tests (Strep Gp A, Strep Gp B) Positive Result
Group A Strep in Pediatric Patients Positive Growth
Cryptococcal Antigen/India Ink Positive Result
Hyphae in Sinus Smears Positive Finding
Shiga Toxin (children under 10 only) Positive Finding
AFB Smears Positive Finding
Growth of M. tuberculosis/MTD test Positive Finding
Suspected Agents of Bioterrorism Any Positive or Suspected Positive Finding
HSV PCR Positive CSF or Brain Biopsy
HSV (PCR, Cx or DFA) Positive Findings in Neonates
Calcium <= 6.5 mg/dL
>= 13.0 mg/dL
Creatinine >= 5.0 mg/dL*(Outpatient only)
CO2, Total <= 12 mmol/L
>= 45 mmol/L
Sodium <= 120 mmol/L
>= 160 mmol/L
Potassium <= 2.8 mmol/L
>= 6.0 mmol/L
Glucose <= 50 mg/dL
>= 450 mg/dL
Phosphate <= 1.2 mg/dL
White blood cells (WBC) < 1.5 K/ul or >50.0 K/ul
Hematocrit (HCT) <22.0%
>60.0%
Platelets (PLT) <50.0 K/ul or >1000.0 K/ul
Calcium <= 6.5 mg/dL
>= 13.0 mg/dL (first time only)
Creatinine* >= 5.0 mg/dL(Outpatient only)
CO2, Total <= 12 mmol/L
>= 45 mmol/L
Sodium <= 120 mmol/L
>= 160 mmol/L
Potassium <= 2.8 mmol/L
>= 6.0 mmol/L
Glucose <= 50 mg/dL
>= 450 mg/dL
Magnesium <= 1.0 mg/dL
>= 5.0 mg/dL
White blood cells (WBC) < 2.5 K/ul or >50.0 K/ul
Hematocrit (HCT) <22.0%
>60.0%
Platelets (PLT) <50.0 K/ul or >1000.0 K/ul
Granulocytes <500 (or 10% if WBC normal)
International normalized PT ratio (INR) >4.0
Partial thromboplastin time (PTT) >60.0 seconds
BACTERIA Present in any sterile fluid
URINE Ketonuria and Glycosuria >= 3+
pH** <= 7.20
>= 7.60
pCO2** <= 20 mmHG
>= 60 mmHG
pO2** <= 50 mmHG

Updated: July-2008


Please send comments and questions using the Information Request Form.
© 1998-2009 Department of Laboratory Medicine, Yale Medical School