zzzPrisma Health Laboratories Critical Values

	PROCEDURE:	Less Than/Equal To:	Greater Than/Equal To:
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1
2
3	Associated Policy:	.	Revised: 4/9/2025
4	Laboratory General Policy	.
5
6	RESPONSIBLE POSITIONS:	.
7	1. Laboratory Workforce	.
8	2. Prisma Health Providers	.
9
10	CLINICAL LABORATORIES:	.
11	Prisma Health Baptist Columbia Hospital Laboratory Taylor at Marion Street Columbia, SC 29220	Prisma Health Baptist Parkridge Hospital Laboratory 400 Palmetto Health Parkway Columbia, SC 29212	Prisma Health Richland Hospital Central Laboratory 14 Richland Medical Park Drive Columbia, SC 29203
12	Prisma Health Richland Hospital Rapid Laboratory 5 Richland Medical Park Drive Columbia, SC 29203	Prisma Health Tuomey Hospital Laboratory 129 North Washington Street Sumter, SC 29150
13	Prisma Health Baptist Easley Hospital Laboratory 200 Fleetwood Drive Easley, SC 29640	Prisma Health Greenville Memorial Hospital Laboratory 701 Grove Road Greenville, SC 29605	Prisma Health Greer Memorial Hospital Laboratory 830 S Buncombe Road Greer, SC 29650
14	Prisma Health Hillcrest Hospital Laboratory 729 SE Main Street Simpsonville, SC 29681	Prisma Health Laurens County Hospital Laboratory 22725 US-76 Clinton, SC 29325	Prisma Health North Greenville Hospital Laboratory 807 N Main Street Travelers Rest, SC 29690
15	Prisma Health Oconee Memorial Hospital Laboratory 298 Memorial Drive Seneca, SC 29672	Prisma Health Patewood Hospital Laboratory 175 Patewood Drive Greenville, SC 29615
16
17	PROCEDURE:	Less Than/Equal To:	Greater Than/Equal To:
18	Blood Bank
19	Positive Antibody Screen on a patient who has a stat crossmatch ordered
20	Post-transfusion Direct Antiglobulin Test (DAT) when the pre-transfusion DAT was negative.
21	Crossmatch incompatible with no compatible blood available or discovery of a crossmatch incompatibility on a unit which was signed out of the Blood Bank prior to completion of the crossmatch.
22	Discovery of a discrepancy involving the ABO or Rh type of a unit of blood or patient after a unit of blood has already been signed out of the Blood Bank
23
24	Chemistry and Immunoassay
25	Amnisure		Upstate: Positive
26
27	Ammonia
28	NICU/Newborn Inpatient Locations:		80 umol/L
29	All Others:
30	0 - 18 Years:		110 umol/L
31
32	Beta-Hydroxybutyric Acid		1.6 mmol/L
33
34	Bilirubin, Direct
35	NICU Inpatient Locations:		3.0 mg/dL
36	All Others:
37	0 - 14 Days:		3.0 mg/dL
38	>/= 15 Days:		9.0 mg/dL
39
40	Bilirubin, Total:
41	Newborn/NICU Inpatient Locations: 0 - 23 Hours:		6.0 mg/dL
42	Newborn/NICU Inpatient Locations: >/= 1 Day:		15.0 mg/dL
43	All Others:
44	0 - 23 Hours:		6.0 mg/dL
45	1 - 2 Days:		15.0 mg/dL
46	3 - 29 Days:		18.0 mg/dL
47	>/= 1 Months:		15.1 mg/dL
48
49	Blood Urea Nitrogen (BUN)
50	NICU Inpatient Locations:		50 mg/dL
51	Newborn Inpatient Locations:		40 mg/dL
52
53	Calcium, Total
54	NICU/Newborn Inpatient Locations:	7.0 mg/dL	12.0 mg/dL
55	All others:	6.0 mg/dL	13.0 mg/dL
56
57	Calcium, Ionized	0.76 mmol/L	1.53 mmol/L
58
59	Calcium, Ionized Pre-Filter	0.76 mmol/L	1.53 mmol/L
60
61	Calcium, Ionized Post-Filter		1.53 mmol/L
62
63	CO2
64	NICU/Newborn Inpatient Locations:	14 mmol/L	40 mmol/L
65	All Others:
66	< 1 Month:	10 mmol/L
67	>/= 1 Month:	10 mmol/L	40 mmol/L
68
69	Creatinine
70	NICU/Newborn Inpatient Locations:		1.70 mg/dL
71	All Others:
72	0 - 19 Years:		4.00 mg/dL
73
74	Glucose (Does NOT include Glucometer)
75	NICU Inpatient Locations:	50 mg/dL	150 mg/dL
76	Newborn Inpatient Locations:	39 mg/dL	150 mg/dL
77	All Others:
78	0 - 59 Days:	39 mg/dL	201 mg/dL
79	>/= 60 Days	53 mg/dL	450 mg/dL
80
81	Glucose, Glucometer
82	NICU Inpatient Locations:	50 mg/dL	150 mg/dL
83	Newborn Inpatient Locations:	39 mg/dL	150 mg/dL
84	All Others:
85	>/= 1 Year:	53 mg/dL
86
87	Glucose, CSF	25 mg/dL	450 mg/dL
88
89	HCG, Urine	GHS Only: Positive
90
91	Lactic Acid		2.3 mmol/L
92
93	Magnesium
94	NICU Inpatient Locations:	1.0 mg/dL	6.0 mg/dL
95	Newborn Inpatient Locations:	1.0 mg/dL	3.6 mg/dL
96	All Others:
97	0 - 17 Years:	1.0 mg/dL	5.1 mg/dL
98	>/= 18 Years:	1.0 mg/dL	6.0 mg/dL
99
100	Osmolality, Serum	250 mOsm/kgH2O	330 mOsm/kgH2O
101
102	Phosphorus:
103	NICU Inpatient Locations:	2.5 mg/dL
104	Newborn Inpatient Locations:	3.5 mg/dL
105	All Others:	1.2 mg/dL
106
107	Potassium:
108	NICU Inpatient Locations:	2.5 mmol/L	6.6 mmol/L
109	Newborn Inpatient Locations:	3.5 mmol/L	6.1 mmol/L
110	All Others:	2.8 mmol/L	6.5 mmol/L
111
112	Procalcitonin		2.00 ng/mL
113
114	Sodium:
115	NICU/Newborn Inpatient Locations:	130 mmol/L	150 mmol/L
116	All Others:
117	0 - 30 Days:	125 mmol/L	150 mmol/L
118	31 Days - 12 years:	125 mmol/L	160 mmol/L
119	>/=13 Years:	120 mmol/L	160 mmol/L
120
121	TCO2 (Point of Care):
122	NICU/Newborn Inpatient Locations:	14 mmol/L	40 mmol/L
123	All Others:
124	< 1 Month:	10 mmol/L
125	>/= 1 Month:	10 mmol/L	40 mmol/L
126
127	Troponin I		Midlands: 0.30 ng/mL Upstate: 0.04 ng/mL
128
129	Troponin T		>/= 6 Months: 52 ng/L
130
131	Troponin I (Point of Care):		iSTAT: 0.09 ng/mL
132
133	Uric Acid & Uric Acid, Rasburicase		12.1 mg/dL
134
135	Chemistry Therapeutic Drugs
136	Acetaminophen		151 ug/mL
137
138	Alcohol/Ethanol		300 mg/dL
139
140	Amikacin, Random		35.0 ug/mL
141
142	Amikacin, Peak		60.1 ug/mL
143
144	Amikacin, Trough		10.0 ug/mL
145
146	Carbamazepine (Tegretol)		15.1 ug/mL
147
148	Cyclosporine		500 ng/mL
149
150	Dilantin, Total		30.0 ug/mL
151
152	Dilantin, Free		4.1 ug/mL
153
154	Digoxin		2.1 ng/mL
155
156	Gentamicin Random		10.1 ug/mL
157
158	Gentamicin Peak		15.0 ug/mL
159
160	Gentamicin Trough		2.0 ug/mL
161
162	Lithium		1.6 mmol/L
163
164	Methotrexate
165	Methotrexate levels portend potential toxicity when in excess of:
166	At 24 Hours		50.01 umol/L
167	At 48 Hours		10.01 umol/L
168	At 72 Hours		0.51 umol/L
169
170	Phenobarbital		41 ug/mL
171
172	Salicylate		41 mg/dL
173
174	Sirolimus		15.1 ng/mL
175
176	Tacrolimus		20.1 ng/mL
177
178	Theophylline		25.0 ug/mL
179
180	Tobramycin, Random		10.1 ug/mL
181
182	Tobramycin, Peak		15.0 ug/mL
183
184	Tobramycin, Peak CF		40.0 ug/mL
185
186	Tobramycin, Trough		2.0 ug/mL
187
188	Valproic Acid, Total		150 ug/mL
189
190	Valproic Acid, Free		31.0 ug/mL
191
192	Vancomycin, Random		60.0 ug/mL
193
194	Vancomycin Peak		60.0 ug/mL
195
196	Vancomycin, Trough		25.0 ug/mL
197
198	Coagulation
199	Antithrombin III	50%
200
201	Fibrinogen	100 mg/dL
202
203	INR		5.0
204
205	PTT		128 seconds
206
207	Flow Cytometry
208	Fetal Hgb Flow Marker		0.30%
209
210	Hematology
211	POC Hematocrit:
212	NICU/Newborn Inpatient Locations:	Upstate POC Only: 7.5%
213
214	Hemoglobin
215	NICU/Newborn Inpatient Locations:	7.5 g/dL	n/a
216	All Others:
217	< 1 Month:	9.6 g/dL	20.0 g/dL
218	>/= 1 Month:	6.5 g/dL	20.0 g/dL
219	.
220	WBC
221	NICU/Newborn Inpatient Locations:	3.8 K/uL	30.0 K/uL
222	All others:	2.0 K/uL	50.0 K/uL
223
224	Platelet Count
225	NICU/Newborn Inpatient Locations:	50 K/uL	1000 K/uL
226	All Others:
227	< 2 Months:	50 K/uL	1000 K/uL
228	>/= 2 Months:	20 K/uL	1000 K/uL
229
230	CSF WBC Count
231	0 - 11 Months:		30 mm3
232	>/= 1 Year:		10 mm3
233
234	Immunology
235	Bacterial Antigen Detection, Rapid Test for:
236	Legionella urinary antigen		Positive
237	Streptococcus pneumonia antigen (CSF or Urine)		Positive
238	Cryptococcal Antigen (CSF or Serum)		Positive
239	Malaria Screen (P. falciparum, P. vivax, P. malariae, P. ovale)		Positive
240
241	Heparin Induced Thrombocytopenia IgG		Positive
242	.
243	HIV, Rapid test		Upstate: Positive
244	.
245	Influenzae A & B Antigen Screen		Positive
246	.
247	Respiratory Syncytial Virus (RSV) Antigen		Positive
248
249	Syphilis Testing
250	</= 2 Months:
251	Treponema Antibody		Reactive
252	Rapid Plasma Reagin (RPR)		Reactive
253	VDRL, CSF		Reactive
254
255	Microbiology
256	All of the following are critical calls. Critical values depend on the organism isolated.
257	Smears and/or cultures from:
258	Acid Fast Bacteria (AFB)
259	Blood Cultures
260	CSF
261	Sterile Body fluids
262	Tissue Samples from OR (to include bone and cornea samples)
263
264	Identification of the following:
265	Acid Fast Bacteria (AFB)
266	Bordetella
267	Campylobacter
268	Carbapenemase producing organisms
269	E coli 0157:H7
270	E coli, Shiga toxin-producing (STEC)
271	Haemophilus influenzae (Invasive)
272	Listeria
273	Neisseria gonorrheae
274	Neisseria meningitidis
275	Salmonella
276	Shigella
277	Streptococcus pneumoniae (Invasive)
278	MRSA (Vancomycin Intermediate/ Resistant)
279	VRE, ESBL, Penicillin Resistant Strep Pneumo
280	Multi-drug resistant Gram Negative Rods that are KPC positive
281	Chlamydia/N. gonorrhea DNA
282
283	Microbiology Other
284	Adenovirus Rapid		Detected
285	Blood Culture ID by PCR		Detected
286	Carbapenemase Resistance by PCR		Detected
287	Clostridium difficile Toxin B gene by PCR		Detected
288	GI Panel by PCR		Detected
289	Group B Strep by Rapid PCR		Detected
290	India Ink Prep		Detected
291	M. tuberculosis by PCR		Detected
292	Influenzae A/B by PCR		Detected
293
294	Molecular Pathology
295	Bordetella pertussis DNA		Positive
296	HSV 1 & 2, CSF		Positive
297	Meningitis/Encephalitis (ME) Panel by PCR, CSF		Positive
298	Respiratory Panel by PCR		Positive
299
300	Parasitology
301	Malaria Smears		Positive/Present
302	Pathologic parasites from O&P exam		Positive/Present
303	Cryptosporidium Antigen		Positive/Present
304	Cryptosporidium Stain		Positive/Present
305	Giardia Antigen		Positive/Present
306	Giardia/Cryptosporidia Antigen		Positive/Present
307
308	Reference Lab
309	Other Reference Lab Critical value results as determined by the reference lab will be called by the reference lab to the Prisma Health Richland Central Laboratory. Prisma Health Richland Central Laboratory will then call the panic value result per lab policy.
310
311	CANCER INSTITUTE LABORATORIES:
312	Prisma Health Cancer Institute – Easley 109 Fleetwood Dr Suite A Easley, SC 29640	Prisma Health Cancer Institute – Eastside 65 International Dr. Greenville, SC 29615	Prisma Health Cancer Institute – Faris Road 900 W Faris Rd. Greenville, SC 29605
313	Prisma Health Cancer Institute – Greer 340 Medical Pkwy Greer, SC 29650	Prisma Health Cancer Institute – Grove Commons 3 Butternut Dr Suite B Greenville, SC 29605	Prisma Health Cancer Institute – Seneca 131 Lila Doyle Dr Seneca, SC 29672
314	Prisma Health Cancer Institute – Spartanburg 2400 Boiling Springs Rd Spartanburg, SC 29316
315
316	PROCEDURE:	Less Than/Equal To:	Greater Than/Equal To:
317	Chemistry
318	ALT (SGPT)		150 IU/L
319	AST (SGOT		120 IU/L
320	Bilirubin, Total		15 mg/dL
321	Blood Urea Nitrogen (BUN)		50 mg/dL
322	Calcium, Total	6.6 mg/dL	12.0 mg/dL
323	Chloride	75 mmol/L	130 mmol/L
324	CO2	10 mmol/L	40 mmol/L
325	Creatinine		3.5 mg/dL
326	GGT		300 IU/L
327	Glucose, Serum	45 mg/dL	350 mg/dL
328	Lactate Dehydrogenase (LDH)		600 IU/L
329	Magnesium	1.0 mg/dL	4.9 mg/dL
330	Phosphorous	1.0 mg/dL	10.0 mg/dL
331	Potassium (K+)	2.9 mmol/L	6.0 mmol/L
332	Sodium (Na)	125 mmol/L	150 mmol/L
333	Thyroid Stimulating Hormone (TSH)	0.4 uIU/mL	20 uIU/L
334	Uric Acid		12 mg/dL
335
336	Hematology
337	Hemoglobin	8.0 g/dL	18.0 g/dL
338	Platelet	20 K/uL	800 K/uL
339
340	Coagulation
341	INR		5
342
343	Urinalysis
344	Glucose		50, 100, 150, 250, 500, 750, 1000, >500, ≥1000 mg/dL
345	Nitrite		Positive
346	Casts		Any - (Waxy, EPI, WBC, RBC, Fatty, Broad, Coarse, Fine, Cellular, Granular)
347	Hyaline Casts		3/LPF
348	Crystals		Urate, Cysteine, Leucine, Tyrosine
349
350	RESPIRATORY (Blood Gas):
351	Prisma Health Baptist Columbia Respiratory Therapy Taylor at Marion Street Columbia, SC 29220	Prisma Health Baptist Parkridge Respiratory Therapy 400 Palmetto Health Parkway Columbia, SC 29212	Prisma Health Greenville Memorial Respiratory Therapy 701 Grove Road Greenville, SC 29605
352	Prisma Health Richland Respiratory Therapy 5 Richland Medical Park Drive Columbia, SC 29203	Prisma Health Tuomey Hospital Laboratory 129 North Washington Street Sumter, SC 29150
353
354	*Unless otherwise indicated, critical values apply to all ages and genders
355	PROCEDURE:	Less Than/Equal To:	Greater Than/Equal To:
356	Blood Gas
357	Arterial:
358	pH
359	0 - 1 Year:	7.19	7.50
360	1 - 150 Years:	7.24	7.59
361	pCO2
362	0 - 1 Year:	25 mmHg	71 mmHg
363	1 - 150 Years:	20 mmHg	60 mmHg
364	pO2
365	0 - 1 Year:	40 mmHg	140 mmHg
366	1 - 150 Years:	50 mmHg	n/a
367	O2 Saturation
368	0 - 1 Year:	75.4%	n/a
369	1 - 150 Years:	86.4%	n/a
370	OxyHemoglobin
371	0 - 1 Year:	75.4%	n/a
372	1 - 150 Years:	86.4%	n/a
373	CarboxyHemoglobin
374	0 - 1 Year:	n/a	7.9%
375	1 - 150 Years:	n/a	7.9%
376	MetHemoglobin
377	0 - 1 Year:	n/a	5.10%
378	1 - 150 Years:	n/a	5.10%
379
380	Venous:
381	pH
382	0 - 1 Year:	7.19	7.50
383	1 - 150 Years:	7.19	7.55
384	pCO2
385	0 - 1 Year:	25 mmHg	70 mmHg
386	1 - 150 Years:	25 mmHg	70 mmHg
387	pO2
388	0 - 1 Year:	n/a	n/a
389	1 - 150 Years:	n/a	n/a
390	O2 Saturation
391	0 - 1 Year:	60.4%	n/a
392	1 - 150 Years:	60.4%	n/a
393	OxyHemoglobin
394	0 - 1 Year:	60.4%	n/a
395	1 - 150 Years:	60.4%	n/a
396	CarboxyHemoglobin
397	0 - 1 Year:	n/a	7.9%
398	1 - 150 Years:	n/a	7.9%
399	MetHemoglobin
400	0 - 1 Year:	n/a	5.10%
401	1 - 150 Years:	n/a	5.10%
402
403	Capillary:
404	pH
405	0 - 1 Year:	7.19	7.50
406	1 - 150 Years:	7.24	7.61
407	pCO2
408	0 - 1 Year:	25 mmHg	80 mmHg
409	1 - 150 Years:	20 mmHg	80 mmHg
410	pO2
411	0 - 1 Year:	n/a	n/a
412	1 - 150 Years:	n/a	n/a
413	O2 Saturation
414	0 - 1 Year:	n/a	n/a
415	1 - 150 Years:	n/a	n/a
416	OxyHemoglobin
417	0 - 1 Year:	n/a	n/a
418	1 - 150 Years:	n/a	n/a
419	CarboxyHemoglobin
420	0 - 1 Year:	n/a	7.9%
421	1 - 150 Years:	n/a	7.9%
422	MetHemoglobin
423	0 - 1 Year:	n/a	5.10%
424	1 - 150 Years:	n/a	5.10%
425
426	Mixed Venous:
427	pH
428	0 - 1 Year:	7.20	7.56
429	1 - 150 Years:	7.20	7.56
430	pCO2
431	0 - 1 Year:	25 mmHg	70 mmHg
432	1 - 150 Years:	25 mmHg	70 mmHg
433	pO2
434	0 - 1 Year:	25 mmHg	n/a
435	1 - 150 Years:	25 mmHg	n/a
436	O2 Saturation
437	0 - 1 Year:	60.4%	n/a
438	1 - 150 Years:	60.4%	n/a
439	OxyHemoglobin
440	0 - 1 Year:	60.1%	n/a
441	1 - 150 Years:	60.1%	n/a
442	CarboxyHemoglobin
443	0 - 1 Year:	n/a	7.9%
444	1 - 150 Years:	n/a	7.9%
445	MetHemoglobin
446	0 - 1 Year:	n/a	5.10%
447	1 - 150 Years:	n/a	5.10%
448
449	Cord Blood - Arterial
450	pH	7.15	7.50
451	pCO2	n/a	n/a
452	pO2	n/a	n/a
453	HCO3	15.4 mmol/L	n/a
454
455	Cord Blood - Venous
456	pH	7.15	7.50
457	pCO2	n/a	n/a
458	pO2	n/a	n/a
459	HCO3	15.4 mmol/L	n/a
460
461	Sodium
462	NICU/Newborn Inpatient Locations:	130 mmol/L	150 mmol/L
463	All Others:
464	0 - 30 Days:	125 mmol/L	150 mmol/L
465	31 Days - 12 years:	125 mmol/L	160 mmol/L
466	>/=13 Years:	120 mmol/L	160 mmol/L
467
468	Potassium
469	NICU Inpatient Locations:	2.5 mmol/L	6.6 mmol/L
470	Newborn Inpatient Locations:	3.5 mmol/L	6.1 mmol/L
471	All Others:	2.8 mmol/L	6.5 mmol/L
472
473	Lactate	n/a	2.3 mmol/L