Heartland Health Laboratories, Inc.

CRITICAL VALUES

 

Critical limits define the boundaries of the low and high life threatening values for laboratory test results. Urgent clinician notification of critical results is a responsibility of the laboratory technologist performing the testing. Test values that coincide with the alert values listed below should be verified and called immediately to the patient's facility so that the nursing staff may notify the physician as soon as possible.

 

ANALYTE REFERENCE                      RANGE                                                ALERT VALUE LIMIT

Hematology

WBC                                                     4.5-10.5 x10(3)/MM3                            <2.0 x 10(3)/MM3

                                                                                                                            >37.0 x 10(3)/MM3

Hemoglobin                                           M 14.0-18.0 g/dl                                   <7.6 g/dl

                                                               F 12.0-16.0 g/dl                                    <7.6 g/dl

Platelet                                                 140 - 400 x1000/MM3                           <40,000/MM3

 

Chemistry

Sodium                                                 136 – 145 mmol/L                                 <120mmol/L OR >160mmol/L

Potassium                                             3.5 - 5.1 mmol/L                                   <3.0mmol/L OR >6.0mmol/L

Chloride                                                98 – 107 mmol/L                                  <80mmol/L OR >125mmol/L   

CO2                                                      21 – 31 mmol/L                                    <15mmol/L OR >40 mmol/L

Glucose                                                70 – 105 mg/dl                                     <40 mg/dl OR >400 mg/dl

Calcium                                                8.2 - 10.0 mg/dl                                    <7.5 mg/dl OR >12.5mg/dl

Phosphorus                                          2.0 – 5.0 mg/dl                                      <1.5 mg/dl OR >7.0 mg/dl

BUN                                                     7.0 - 25 mg/dl                                        >100 mg/dl

Creatinine                                             0.6 - 1.3 mg/dl                                       >5.0 mg/dl

Uric Acid                                               3.3 – 8.7 mg/dl                                      >13.0 mg/dl

Total Bilirubin                                       0.1 - 1.2 mg/dl                                       >15.0 mg/dl

Magnesium                                          1.8 – 2.4 meq/L                                     <1.0 meq/L OR >4.9 meq/L

Amylase                                                29 – 103 U/L                                         >400 U/L

BNP                                                      0 – 125 pg/ml     0-75 yrs old                >25,000 pg/ml

                                                              0 – 450 pg/ml     76 yrs - & over    

Ammonia                                              29 –90 ug/dl                                          >150 ug/dl

 

Toxicology

Carbamazepine                                   4.0 - 10.0 ug/ml                                      >15.0 ug/ml

Digoxin                                                0.9 - 2.0 ng/ml                                        >2.5 ng/ml

Gentamycin                                         Peak: 4.0 - 8.0 ug/ml                              >13.0 ug/ml

                                                             Trough: 0.5 - 2.0 ug/ml                           >2.5 uq/ml

Lithium                                                0.5 - 1.2 meq/l                                         >2.0 meq/l

Phenytoin                                           10.0 - 20.0 ug/ml                                     <5.0 or >25.0 ug/ml

Phenobarbital                                     15.0 - 40.0 ug/ml                                     >50.0 ug/ml

Theophylline                                      10.0 - 20.0 ug/ml                                      >25.0 ug/ml

Valproic Acid                                      50.0 - 100.0 ug/ml                                    >200.0 ug/ml

Vancomycin                                        Peak: 18.0 - 26.0 ug/ml                           >35.0 ug/ml

                                                            Trough: 5.0 - 15.0 ug/ml                          >22.5 ug/ml

Coagulation

INR                                                     2.0 - 3.0                                                   >4.5

APTT                                                 24.0 – 30.0 seconds                                >60 seconds

Microbiology

Blood Culture                                     NO GROWTH IN SPECIMEN                 ANY GROWTH IN SPECIMEN

Any Culture                                        NEGATIVE FOR MRSA                           ISOLATION OF MRSA

Any Culture                                        NEGATIVE FOR VRE                              ISOLATION OF VRE

 

Reference:

Clinical Laboratory Reference, 2015 – 2016

Updated 1/2016