PH Labs Critical Value Summary
PROCEDURE:Less Than/Equal To:Greater Than/Equal To:
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Valid 02/27/21
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Associated Policy:
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Laboratory General Policy
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RESPONSIBLE POSITIONS:
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1. Laboratory Workforce
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2. Prisma Health Providers
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LABORATORY ADDRESSES:
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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
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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
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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
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Kershaw Health Medical Center Laboratory
Haile and Roberts Street
Camden, SC 2902
Prisma Health Laurens County Hospital Laboratory
22725 US-76
Clinton, SC 29325
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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
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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
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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
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PROCEDURE:
Less Than/Equal To:Greater Than/Equal To:
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-Chemistry and Immunoassay
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Amnisure
Upstate: Positive
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-Ammonia
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NICU/Newborn:
80 umol/L
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0 - 18 Years:
110 umol/L
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Beta-Hydroxybutyric Acid
1.6 mmol/L
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-Bilirubin, Direct
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NICU:
3.0 mg/dL
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0 - 14 Days:
3.0 mg/dL
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>/= 15 Days:
9.0 mg/dL
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Bilirubin, Indirect
12.0 mg/dL
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-Bilirubin, Total:
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Newborn/NICU: 0 - 23 Hours:
6.0 mg/dL
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Newborn/NICU: >/= 1 Day:
15.0 mg/dL
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-All Others:
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0 - 23 Hours:
6.0 mg/dL
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1 - 2 Days:
15.0 mg/dL
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3 - 29 Days:
18.0 mg/dL
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>/= 1 Months:
15.1 mg/dL
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-Blood Urea Nitrogen (BUN)
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NICU:
50 mg/dL
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Newborn:
40 mg/dL
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-Calcium, Total
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NICU/Newborn:
7.0 mg/dL12.0 mg/dL
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All others:
6.0 mg/dL13.0 mg/dL
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Calcium, Ionized
0.76 mmol/L1.53 mmol/L
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-CO2
55
NICU/Newborn:
14 mmol/L40 mmol/L
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< 1 Month:
10 mmol/L
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>/= 1 Month:
10 mmol/L40 mmol/L
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-Creatinine
60
NICU/Newborn:
1.70 mg/dL
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0 - 19 Years:
4.00 mg/dL
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-Glucose, Serum (Does NOT include Glucometer)
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NICU:
50 mg/dL150 mg/dL
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Newborn:
39 mg/dL150 mg/dL
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0 - 59 Days:
39 mg/dL201 mg/dL
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>/= 60 Days
53 mg/dL450 mg/dL
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Glucose, Whole Blood - Glucometer:
53 mg/dL
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Glucose, CSF
25 mg/dL450 mg/dL
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HCG, Urine
GHS Only: Positive
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Lactic Acid
2.3 mmol/L
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-Magnesium
78
NICU:
1.0 mg/dL6.0 mg/dL
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Newborn:
1.0 mg/dL3.6 mg/dL
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0 - 17 Years:
1.0 mg/dL5.1 mg/dL
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>/= 18 Years:
1.0 mg/dL6.0 mg/dL
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Osmolality, Serum
250 mOsm/kgH2O330 mOsm/kgH2O
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-Phosphorus:
86
NICU:
2.5 mg/dL
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Newborn:
3.5 mg/dL
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All Others:
1.2 mg/dL
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-Potassium:
91
NICU:
2.5 mmol/L6.6 mmol/L
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Newborn:
3.5 mmol/L6.1 mmol/L
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All Others:
2.8 mmol/L6.5 mmol/L
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Procalcitonin
2.00 ng/mL
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-Sodium:
98
NICU/Newborn:
130 mmol/L150 mmol/L
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0 - 30 Days:
125 mmol/L150 mmol/L
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31 Days - 12 years:
125 mmol/L160 mmol/L
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>/=13 Years:
120 mmol/L160 mmol/L
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Troponin
Midlands: 0.30 ng/mL
Upstate: 0.04 ng/mL
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Uric Acid &
Uric Acid, Rasburicase
12.1 mg/dL
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-Chemistry Therapeutic Drugs
108
Acetaminophen
151 ug/mL
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Alcohol
300 mg/dL
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Amikacin, Random
35.0 ug/mL
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Amikacin, Peak
60.1 ug/mL
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Amikacin, Trough
10.0 ug/mL
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Carbamazepine (Tegretol)
15.1 ug/mL
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Cyclosporine
500 ng/mL
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Dilantin, Total
30.0 ug/mL
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Dilantin, Free
4.1 ug/mL
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Digoxin
2.1 ng/mL
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Gentamicin Random
10.1 ug/mL
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Gentamicin Peak
15.0 ug/mL
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Gentamicin Trough
2.0 ug/mL
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Lithium
1.6 mmol/L
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-Methotrexate
137
Methotrexate levels portend potential toxicity when in excess of:
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At 24 Hours
50.01 umol/L
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At 48 Hours
10.01 umol/L
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At 72 Hours
0.51 umol/L
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Phenobarbital
41 ug/mL
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Salicylate
41 mg/dL
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Sirolimus
15.1 ng/mL
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Tacrolimus
20.1 ng/mL
149
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Theophylline
25.0 ug/mL
151
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Tobramycin, Random
10.1 ug/mL
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Tobramycin, Peak
15.0 ug/mL
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Tobramycin, Peak CF
40.0 ug/mL
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158
Tobramycin, Trough
2.0 ug/mL
159
160
Valproic Acid, Total
150 ug/mL
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Valproic Acid, Free
31.0 ug/mL
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164
Vancomycin, Random
60.0 ug/mL
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Vancomycin Peak
60.0 ug/mL
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Vancomycin, Trough
25.0 ug/mL
169
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-Coagulation
171
Antithrombin III
50%
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Fibrinogen
100 mg/dL
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INR
5.0
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PTT
128 seconds
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-Hematology
180
-Hemoglobin
181
NICU/Newborn:
7.5 g/dL
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< 1 Month:
9.6 g/dL20.1 g/dL
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>/= 1 Month:
6.5 g/dL20.1 g/dL
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-WBC
186
NICU/Newborn:
3.8 K/uL30.0 K/uL
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All others:
2.0 K/uL50.0 K/uL
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-Platelet Count
190
NICU/Newborn:
50 K/uL1000 K/uL
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< 2 Months:
50 K/uL1000 K/uL
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>/= 2 Months:
20 K/uL1000 K/uL
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-CSF WBC Count
195
0 - 11 Months:
30 mm3
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>/= 1 Year:
10 mm3
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-Immunology
199
-Bacterial Antigen Detection, Rapid Test for:
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Legionella urinary antigen
Positive
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Streptococcus pneumonia antigen (CSF or Urine)
Positive
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Cryptococcal Antigen (CSF or Serum)
Positive
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Malaria Screen (P. falciparum, P. vivax, P. malariae, P. ovale)
Positive
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Heparin Induced Platelet Antibody
Positive
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HIV, Rapid test
Upstate: Positive
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Influenzae A & B Antigen Screen
Positive
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Respiratory Syncytial Virus (RSV) Antigen
Positive
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-Microbiology
214
-All of the following are critical calls. Critical values depend on the organism isolated.
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-Smears and/or cultures from:
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Acid Fast Bacteria (AFB)
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Blood Cultures
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CSF
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Sterile Body fluids
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Tissue Samples from OR (to include bone and cornea samples)
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-Identification of the following:
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Acid Fast Bacteria (AFB)
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Bordetella
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Campylobacter
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Carbapenemase producing organisms
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E coli 0157:H7
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E coli, Shiga toxin-producing (STEC)
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Haemophilus influenzae (Invasive)
230
Listeria
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Neisseria gonorrheae
232
Neisseria meningitidis
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Salmonella
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Shigella
235
Streptococcus pneumoniae (Invasive)
236
MRSA (Vancomycin Intermediate/ Resistant)
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VRE, ESBL, Penicillin Resistant Strep Pneumo
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Multi-drug resistant Gram Negative Rods that are KPC positive
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Chlamydia/N. gonorrhea DNA
240
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-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
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-Molecular Pathology
253
Bordetella pertussis DNA
Positive
254
HSV 1 & 2, CSF
Positive
255
Meningitis/Encephalitis (ME) Panel by PCR, CSF
Positive
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Respiratory Panel by PCR
Positive
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-Flow Cytometry
259
Fetal Hgb Flow Marker
0.30%
260
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-Parasitology
262
Malaria Smears
Positive/Present
263
Pathologic parasites from O&P exam
Positive/Present
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Cryptosporidium Antigen
Positive/Present
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Cryptosporidium Stain
Positive/Present
266
Giardia Antigen
Positive/Present
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Giardia/Cryptosporidia Antigen
Positive/Present
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-Blood Bank
270
Antibody Screen on a patient who has a stat crossmatch ordered
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Post-transfusion Direct Antiglobulin Test (DAT) when the pre-transfusion DAT was negative.
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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.
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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
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-Reference Lab
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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.