PH Labs Critical Value Summary

	PROCEDURE:	Less Than/Equal To:	Greater Than/Equal To:
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1	Valid 02/27/21
2	Associated Policy:	.
3	Laboratory General Policy	.
4
5	RESPONSIBLE POSITIONS:	.
6	1. Laboratory Workforce	.
7	2. Prisma Health Providers	.
8
9	LABORATORY ADDRESSES:	.
10	Prisma Health Baptist Easley Hospital Laboratory 200 Fleetwood Drive Easley, SC 29640	Prisma Health Baptist Columbia Hospital Laboratory Taylor at Marion Street Columbia, SC 29220
11	Prisma Health Baptist Parkridge Hospital Laboratory 400 Palmetto Health Parkway Columbia, SC 29212	Prisma Health Greenville Memorial Hospital Laboratory 701 Grove Road Greenville, SC 29605
12	Prisma Health Greer Memorial Hospital Laboratory 830 S Buncombe Road Greer, SC 29650	Prisma Health Hillcrest Hospital Laboratory 729 SE Main Street Simpsonville, SC 29681
13	Kershaw Health Medical Center Laboratory Haile and Roberts Street Camden, SC 2902	Prisma Health Laurens County Hospital Laboratory 22725 US-76 Clinton, SC 29325
14	Prisma Health North Greenville Hospital Laboratory 807 N Main Street Travelers Rest, SC 29690	Prisma Health Oconee Memorial Hospital Laboratory 298 Memorial Drive Seneca, SC 29672
15	Prisma Health Patewood Hospital Laboratory 175 Patewood Drive Greenville, SC 29615	Prisma Health Richland Hospital Central Laboratory 14 Richland Medical Park Drive Columbia, SC 29203
16	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
17
18	PROCEDURE:	Less Than/Equal To:	Greater Than/Equal To:
19	Chemistry and Immunoassay
20	Amnisure		Upstate: Positive
21
22	Ammonia
23	NICU/Newborn:		80 umol/L
24	0 - 18 Years:		110 umol/L
25
26	Beta-Hydroxybutyric Acid		1.6 mmol/L
27
28	Bilirubin, Direct
29	NICU:		3.0 mg/dL
30	0 - 14 Days:		3.0 mg/dL
31	>/= 15 Days:		9.0 mg/dL
32
33	Bilirubin, Indirect		12.0 mg/dL
34
35	Bilirubin, Total:
36	Newborn/NICU: 0 - 23 Hours:		6.0 mg/dL
37	Newborn/NICU: >/= 1 Day:		15.0 mg/dL
38	All Others:
39	0 - 23 Hours:		6.0 mg/dL
40	1 - 2 Days:		15.0 mg/dL
41	3 - 29 Days:		18.0 mg/dL
42	>/= 1 Months:		15.1 mg/dL
43
44	Blood Urea Nitrogen (BUN)
45	NICU:		50 mg/dL
46	Newborn:		40 mg/dL
47
48	Calcium, Total
49	NICU/Newborn:	7.0 mg/dL	12.0 mg/dL
50	All others:	6.0 mg/dL	13.0 mg/dL
51
52	Calcium, Ionized	0.76 mmol/L	1.53 mmol/L
53
54	CO2
55	NICU/Newborn:	14 mmol/L	40 mmol/L
56	< 1 Month:	10 mmol/L
57	>/= 1 Month:	10 mmol/L	40 mmol/L
58
59	Creatinine
60	NICU/Newborn:		1.70 mg/dL
61	0 - 19 Years:		4.00 mg/dL
62
63	Glucose, Serum (Does NOT include Glucometer)
64	NICU:	50 mg/dL	150 mg/dL
65	Newborn:	39 mg/dL	150 mg/dL
66	0 - 59 Days:	39 mg/dL	201 mg/dL
67	>/= 60 Days	53 mg/dL	450 mg/dL
68
69	Glucose, Whole Blood - Glucometer:	53 mg/dL
70
71	Glucose, CSF	25 mg/dL	450 mg/dL
72
73	HCG, Urine	GHS Only: Positive
74
75	Lactic Acid		2.3 mmol/L
76
77	Magnesium
78	NICU:	1.0 mg/dL	6.0 mg/dL
79	Newborn:	1.0 mg/dL	3.6 mg/dL
80	0 - 17 Years:	1.0 mg/dL	5.1 mg/dL
81	>/= 18 Years:	1.0 mg/dL	6.0 mg/dL
82
83	Osmolality, Serum	250 mOsm/kgH2O	330 mOsm/kgH2O
84
85	Phosphorus:
86	NICU:	2.5 mg/dL
87	Newborn:	3.5 mg/dL
88	All Others:	1.2 mg/dL
89
90	Potassium:
91	NICU:	2.5 mmol/L	6.6 mmol/L
92	Newborn:	3.5 mmol/L	6.1 mmol/L
93	All Others:	2.8 mmol/L	6.5 mmol/L
94
95	Procalcitonin		2.00 ng/mL
96
97	Sodium:
98	NICU/Newborn:	130 mmol/L	150 mmol/L
99	0 - 30 Days:	125 mmol/L	150 mmol/L
100	31 Days - 12 years:	125 mmol/L	160 mmol/L
101	>/=13 Years:	120 mmol/L	160 mmol/L
102
103	Troponin		Midlands: 0.30 ng/mL Upstate: 0.04 ng/mL
104
105	Uric Acid & Uric Acid, Rasburicase		12.1 mg/dL
106
107	Chemistry Therapeutic Drugs
108	Acetaminophen		151 ug/mL
109
110	Alcohol		300 mg/dL
111
112	Amikacin, Random		35.0 ug/mL
113
114	Amikacin, Peak		60.1 ug/mL
115
116	Amikacin, Trough		10.0 ug/mL
117
118	Carbamazepine (Tegretol)		15.1 ug/mL
119
120	Cyclosporine		500 ng/mL
121
122	Dilantin, Total		30.0 ug/mL
123
124	Dilantin, Free		4.1 ug/mL
125
126	Digoxin		2.1 ng/mL
127
128	Gentamicin Random		10.1 ug/mL
129
130	Gentamicin Peak		15.0 ug/mL
131
132	Gentamicin Trough		2.0 ug/mL
133
134	Lithium		1.6 mmol/L
135
136	Methotrexate
137	Methotrexate levels portend potential toxicity when in excess of:
138	At 24 Hours		50.01 umol/L
139	At 48 Hours		10.01 umol/L
140	At 72 Hours		0.51 umol/L
141
142	Phenobarbital		41 ug/mL
143
144	Salicylate		41 mg/dL
145
146	Sirolimus		15.1 ng/mL
147
148	Tacrolimus		20.1 ng/mL
149
150	Theophylline		25.0 ug/mL
151
152	Tobramycin, Random		10.1 ug/mL
153
154	Tobramycin, Peak		15.0 ug/mL
155
156	Tobramycin, Peak CF		40.0 ug/mL
157
158	Tobramycin, Trough		2.0 ug/mL
159
160	Valproic Acid, Total		150 ug/mL
161
162	Valproic Acid, Free		31.0 ug/mL
163
164	Vancomycin, Random		60.0 ug/mL
165
166	Vancomycin Peak		60.0 ug/mL
167
168	Vancomycin, Trough		25.0 ug/mL
169
170	Coagulation
171	Antithrombin III	50%
172
173	Fibrinogen	100 mg/dL
174
175	INR		5.0
176
177	PTT		128 seconds
178
179	Hematology
180	Hemoglobin
181	NICU/Newborn:	7.5 g/dL
182	< 1 Month:	9.6 g/dL	20.1 g/dL
183	>/= 1 Month:	6.5 g/dL	20.1 g/dL
184	.
185	WBC
186	NICU/Newborn:	3.8 K/uL	30.0 K/uL
187	All others:	2.0 K/uL	50.0 K/uL
188
189	Platelet Count
190	NICU/Newborn:	50 K/uL	1000 K/uL
191	< 2 Months:	50 K/uL	1000 K/uL
192	>/= 2 Months:	20 K/uL	1000 K/uL
193
194	CSF WBC Count
195	0 - 11 Months:		30 mm3
196	>/= 1 Year:		10 mm3
197
198	Immunology
199	Bacterial Antigen Detection, Rapid Test for:
200	Legionella urinary antigen		Positive
201	Streptococcus pneumonia antigen (CSF or Urine)		Positive
202	Cryptococcal Antigen (CSF or Serum)		Positive
203	Malaria Screen (P. falciparum, P. vivax, P. malariae, P. ovale)		Positive
204
205	Heparin Induced Platelet Antibody		Positive
206	.
207	HIV, Rapid test		Upstate: Positive
208	.
209	Influenzae A & B Antigen Screen		Positive
210	.
211	Respiratory Syncytial Virus (RSV) Antigen		Positive
212
213	Microbiology
214	All of the following are critical calls. Critical values depend on the organism isolated.
215	Smears and/or cultures from:
216	Acid Fast Bacteria (AFB)
217	Blood Cultures
218	CSF
219	Sterile Body fluids
220	Tissue Samples from OR (to include bone and cornea samples)
221
222	Identification of the following:
223	Acid Fast Bacteria (AFB)
224	Bordetella
225	Campylobacter
226	Carbapenemase producing organisms
227	E coli 0157:H7
228	E coli, Shiga toxin-producing (STEC)
229	Haemophilus influenzae (Invasive)
230	Listeria
231	Neisseria gonorrheae
232	Neisseria meningitidis
233	Salmonella
234	Shigella
235	Streptococcus pneumoniae (Invasive)
236	MRSA (Vancomycin Intermediate/ Resistant)
237	VRE, ESBL, Penicillin Resistant Strep Pneumo
238	Multi-drug resistant Gram Negative Rods that are KPC positive
239	Chlamydia/N. gonorrhea DNA
240
241	Microbiology Other
242	Adenovirus Rapid		Detected
243	Blood Culture ID by PCR		Detected
244	Carbapenemase Resistance by PCR		Detected
245	Clostridium difficile Toxin B gene by PCR		Detected
246	GI Panel by PCR		Detected
247	Group B Strep by Rapid PCR		Detected
248	India Ink Prep		Detected
249	M. tuberculosis by PCR		Detected
250	Influenzae A/B by PCR		Detected
251
252	Molecular Pathology
253	Bordetella pertussis DNA		Positive
254	HSV 1 & 2, CSF		Positive
255	Meningitis/Encephalitis (ME) Panel by PCR, CSF		Positive
256	Respiratory Panel by PCR		Positive
257
258	Flow Cytometry
259	Fetal Hgb Flow Marker		0.30%
260
261	Parasitology
262	Malaria Smears		Positive/Present
263	Pathologic parasites from O&P exam		Positive/Present
264	Cryptosporidium Antigen		Positive/Present
265	Cryptosporidium Stain		Positive/Present
266	Giardia Antigen		Positive/Present
267	Giardia/Cryptosporidia Antigen		Positive/Present
268
269	Blood Bank
270	Antibody Screen on a patient who has a stat crossmatch ordered
271	Post-transfusion Direct Antiglobulin Test (DAT) when the pre-transfusion DAT was negative.
272	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.
273	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
274
275	Reference Lab
276	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.