LABORATORY CRITICAL VALUES

 

TEST LAB SECTION CRITICAL VALUES

AFB Smear

Micro

Positive

Acetaminophen 
 		 Chem  > 30 µg/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 µg/dL
Adults:  >20 µg/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 µg/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/µl 
2)  >50% PMNs
3) Microorganisms
4) Malignant cells
Cell Count and Differential,
CSF		 Heme 1)WBC count > 10 cells/µl
2)Microorganisms
3) Malignant cells
Cell Count and Differential,  Peritoneal Fluid Heme 1)WBC > 500/µl
2) >50% PMNs
2)Microorganisms
3)Malignant cells
Cell Count and Differential, Pleural Fluid  Heme 1) >1000 WBC/µl
2) >50% PMNs
3) Organisms
4) Malignant cells
Cell Count and Differential,
Synovial
 		 Heme 1)Uric Acid and calcium
    pyrophosphate crystals
2) >1000 WBC/µl
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 µg/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 µg/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 µg/mL
Phenytoin (Dilantin)
 		 Chem  >29.9 µg/mL
 
Phenytoin (Dilantin), Free Chem ≥3.0 µg/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/µl

Pediatric:

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

Day 7  - 2 years
low = <20 K/µl     
high = >1000 K/µl  
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/µl
RPR
Peds Lab Reactive

All reactive RPR’s  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 µg/dL

Infants D0 to M6: > 15 µg/dL

Tobramycin Chem >12 µg/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 µg/mL
Vancomycin
 		 Chem >40 µg/mL 
WBC Count
 		 Heme

Adult:
< 1.5* > 30 K/µL

Pediatric: 0 – 2 years 
low = ≤ 3K/µL   
High = ≥ 50K/µL

*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.