LABORATORY CRITICAL VALUES

 

TEST LAB SECTION CRITICAL VALUES

AFB Smear

Micro

Positive

Acetaminophen 
 
Chem  > 30 g/mL
Activated Partial Thromboplastin Time Coag See Partial Thromboplastin Time
Alcohol (Ethanol) Chem >350 mg/dL
Aminophylline {Theophylline}
 
Peds Lab Infants D0 to M6:  >15 g/dL
Adults:  >20 g/dL
Aspergillus Antigen Immuno Positive
Index of ≥0.5
Aspirin (Salicylate), Serum
 
Chem  See Salicylate, Plasma
Blast

Heme

Any new occurrence

BUN (Urea Nitrogen), Neonates Peds Lab > 40 mg/dL
Calcium, Total Serum
 
Chem/
Peds Lab
 
Adult: <7.0 and >12.0 mg/dL

Infant Critical:  <5.9 and
>12.5 mg/dL
Calcium, Ionized 
 
Chem ≤0.75 or ≥1.63 mmol/L
Carbamazepine {Tegretol}
 
Chem >11 g/mL
Carbon Dioxide, CO2,
 
Chem/
Peds Lab
<10 and  >40 mEq/L

Infant Critical:  ≤10 and ≥40
mmol/L

Cell Count and Differential,
Ascites
Heme 1) WBC count >500/l 
2)  >50% PMNs
3) Microorganisms
4) Malignant cells
Cell Count and Differential,
CSF
Heme 1)WBC count > 10 cells/l
2)Microorganisms
3) Malignant cells
Cell Count and Differential,  Peritoneal Fluid Heme 1)WBC > 500/l
2) >50% PMNs
2)Microorganisms
3)Malignant cells
Cell Count and Differential, Pleural Fluid  Heme 1) >1000 WBC/l
2) >50% PMNs
3) Organisms
4) Malignant cells
Cell Count and Differential,
Synovia
l
 
Heme 1)Uric Acid and calcium
    pyrophosphate crystals
2) >1000 WBC/l
3) >50% PMN's
4) Microorganisms.
Chloride, Neonates
 
Peds Lab 90  and  120 mmol/L

Chromosome analysis results

Cytogenetics

Trisomy 13

Trisomy 18

Trisomy 21

Any constitutional X aneuploidy

Acute promyelocytic leukemia (APL)

t(15;17)(q22;q21)

CMV by PCR, Quantitative (Called only on first positive)

Molecular

Positive

C-Reactive Protein (CRPL) Chem ≥ 200 mg/L
(MIC, BONC,7COP)
CSF culture

Micro

Positive

Cryptococcal antigen

Micro

Positive

Depakene (Valproic Acid) 
 
Chem See Valproic Acid
Digoxin 
 
Chem  >2.2 ng/mL
Dilantin, Total (Phenytoin)
 
Chem >29.9 g/mL

Direct Coombs

Blood Bank

Positive

Electrolytes Panel
 
Chem /
Peds Lab

See Individual Tests

Fetal Fibronectin
 
Peds Lab Positive
Fibrinogen [Factor I]
 
Coag <100 and  > N/A
Gentamicin 
 
Chem >10 g/mL 
Glucose, Adult
Random
Chem
 
<50 and >450 mg/dL
Glucose, Neonates
 
Peds Lab D1: <50 and >150 mg/dL

≥D2: <50 and >150 mg/dL

 

Gram stain, CSF or other sterile body fluids (including blood culture) and any specimen collected in the OR

Micro

Positive

Hematocrit Heme Adult Critical: <21 and >55%

Pediatric:

Day 0 2 years

low =  < 24%

Day 0

high =  >65%

Day 1 1 month
high = >70.0%

1 month 2 years
high = > 60%

Hematocrit (Spun) Peds Lab

Newborn Critical:

Term Newborn: <36% and >65%

Preterm: <31% and >59%

Hemoglobin
 
Heme  Adult: <7 and >18 gm/dL

Pediatric:
Day 0 2 years

low = ≤ 8gm/dL

Day 0

high = ≥ 22gm/dL

Day 1 1 month
 
high= ≥ 23.5gm/dL  

1 month 2 years
 
high = ≥ 20gm/dL         

INR

Coag

>4.0

Lactate Dehydrogenase (LD) Chem ≥ 400 IU/L
(MIC, BONC,7COP)
Lithium 
 
Peds Lab  >2.0 mmol/L
Magnesium Chem <1.0 and >9.0 mg/dL
Magnesium, Neonates Peds Lab ≤1.2 and ≥4.0 mg/dL

Malaria smear

Micro

Positive

Myoglobin

Heme

Positive

Partial Thromboplastin Time, Activated Heme <18 sec. or >90 sec. (no heparin)

≥140 sec. (on heparin) 
 

Phenobarbital Chem >40 g/mL
Phenytoin (Dilantin)
 
Chem  >29.9 g/mL
 
Phenytoin (Dilantin), Free Chem ≥3.0 g/mL
Phosphorus, Serum Chem /
Peds Lab

Adult Critical: <1 and >8 mg/dL

Infant Critical:
1.0 and ≥9.0 mg/dL

Plasma Cells

Heme

>20% (BONC)

Platelet Count  
 
Heme Adult: <20 and >1000 K/l

Pediatric:

Day 0 - Day 6 
low =<50 K/l    
high = >1000 K
/l

Day 7  - 2 years
low = <20 K/l     
high = >1000 K
/l  

Potassium, Plasma Chem Adult Critical:
<3.0  and >6.0 mEq/L

Infant Critical:
≤3.0 and ≥6.0 mmol/L
PT
 
Coag See INR
PTT
 
Coag See Partial Thromboplastin Time
RBC {Red Blood Count}
 
Heme < 2.0 and >7.0 m/l
RPR
Peds Lab Reactive

All reactive RPRs  will have a titer performed and will be sent out for confirmation by FTA-Abs
Salicylate, Plasma
 
Chem  >20 mg/mL
Sodium, Serum
 
Chem /
Peds Lab
Adult Critical:
< 120 and >155 mEq/L

Infant Critical:

≤130 and ≥146 mmol/L
Tegretol (Carbamazepine)
 
Chem See Carbamazepine
Theophylline
Peds Lab

>6 months to Adult:  > 20 g/dL

Infants D0 to M6:
> 15 g/dL

Tobramycin Chem >12 g/mL
Troponin Chem ≥0.5 ng/mL
Tylenol (Acetaminophen)
 
Chem  See Acetaminophen
Urinalysis
Heme Reducing substances- any positive in neonate/child

Ketone- any positive in neonate/child
Valproic Acid (Depakene) 
 
Chem >125 g/mL
Vancomycin
 
Chem >40 g/mL 
WBC Count
 
Heme

Adult:
< 1.5* > 30 K/L

Pediatric: 0 2 years 
low = 3K/L   
High = 50K
/L

*The low panic value has been removed from the WBC parameter on all ONC patients at the request of the ONC physicians. 

*Only WBC > 70,000 is called to CTA.