CRITICAL VALUES



OUTREACH LIFE THREATENING CRITICAL VALUESDMC University Laboratories will call clients when test results are significantly abnormal (critical). All “Life-threatening critical values” will be called to the physician as soon as possible within 30 minutes after they are released from the testing department. They will be called 24 hours a day regardless of physician preference.All clients of DMC University Laboratories are sent notifications and updates of the critical call lists automatically anytime a change is made.TESTUNITINPATIENTS AND HOSPITAL CLINIC PATIENTSOUTREACHSame as Inpatients & Hospital Clinic patients except where noted belowADULTPEDIATRIC(4 wks - 18 yrs)NEONATAL(0 - 4wks)LowHighLowHighLowHighLowHighTOXICOLOGYAcetaminophen +mcg/mL>50>50>40Acetone (GC)mg/dL>20>20>20Alcohol (Ethanol)+mg/dL>300>200Carbamazepine*mcg/mL>20>15>12>15Carbamazepine, Free*mcg/mL>4>4Digoxinng/mL>2.5>2.5>2.0Isopropanolmg/dL>30>30>30Lead+mcg/mL>44>44>44Lithium?mmol/L>2.0>2.0>1.5Phenobarbital, Total*mcg/mL>45>45>45Phenytoin*mcg/mL>30>30>20Phenytoin Freemcg/mL>4>4>3Salicylate+mg/dL>25>25>20Theophylline*mcg/mL>25>25>20>30Valproic Acid*mcg/mL>100>100>100Valproic Acid, Free*mcg/mL>15>15>15DO NOT CALLCHEMISTRYArterial/pH<7.2>7.6<7.2>7.6<7.2>7.6Venous pH<7.10>7.59Arterial pCO2mmHg207020702070Arterial pO2mmHg<40<40<40Bilirubin, Totalmg/dL>15.00>15.00>12.00BUNmg/dL≥80Calciummg/dL<7>12<8>12<8>12Follow Life Threatening Critical Call Process<6Calcium, Ionizedmmol/L<0.9>1.5<0.9>1.5<0.9>1.5Carboxyhemoglobin Sat%>20%>20%>20%Creatinine mg/dL≥4Ethylene glycolmg/dL>20Glucosemg/dL<50>500<50>300<35>200>350Follow Life Threatening Critical Call Process≤40≥600Lactic Acidmmol/L>2.0>2.0>2.0Magnesiummg/dL<1.0>4.5<1.0>4.0<1.0>6.0≥6Methemoglobin Sat%>4.9>4.0>4.0MethanolMg/dL>20Potassiummmol/L<3.0>6.0<3.0>6.0<3.0>7.0>6.5Sodiummmol/L<120>160<125>160<125>160Troponin Ing/mL≥0.20≥0.20≥0.20HEMATOLOGYHemoglobing/dl<7.0>20.0<7.0>20.0<8.0>22.0Follow Life Threatening Critical Call Process≤7Hematocrit%<18.0>60<18.0>60<24>65PlateletsuL<50,000>1,000,000<50,000>1,000,000<50,000>1,000,000WBCmm<1.5For Karmanos <1.0>30.0<1.5>30.0<1.5>30.0PTINNsecs≥35.0≥35.0≥35.0Fibrinogenmg/dL<100>800<100>800<100>800SEROLOGYHBAG (L&D PTS ONLY)positive or borderlinepositive or borderlineINPATIENTS AND HOSPITAL CLINIC PATIENTSOUTREACHSame as Inpatients & Hospital Clinic patients except where noted belowHEMATOLOGYPositive smear for intracellular organismFirst occurrence of blasts on peripheral blood smearMICROBIOLOGYPositive smear or culture from blood or other normally sterile body site such as fluid/tissue (ie. CSF, pleural fluid, amniotic fluid, CAPD, Cornea)*First Positive smear or culture for acid fast bacilliFirst positive AFB smear or culture from blood, even if there has been a previous positive specimen from another body siteCultures & PCR positive for Neisseria gonorrhoeae & Chlamydia (CHM only for patients < 14 years old)Cultures positive for VibrioFirst positive urine antigen, or culture for LegionellaPositive smear for PneumocystisPositive culture for B.anthracisPositive cryptococcal antigen (blood, CSF)First positive smear for malaria or other blood-borne parasiteMOLECULAR MICROBIOLOGYPositive CMV PCRPositive VZV PCRPositive HSV PCR (CHM only for patients < 6 months old)Positive Enterovirus PCR ................
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