Laboratory Test Critical values, Which need immediate action

There are values of various tests that need immediate action or immediate communication of the result to the hospital or referring doctors.
- These values should be conveyed to the concerned person without any delay.
The tests and their critical values:
Test | Critical value > (more than) | Critical value < (less than) |
Biochemical tests | ||
Amylase | Three times the normal value | |
Bilirubin level |
adult= > 12 mg/dL newborn= >15 mg/dL |
|
Blood glucose level |
Adult male = > 400 mg/dL Adult female = >400 mg/dL Newborn = >300 mg/dL |
Adult male =<50 mg/dL Adult female = <40 mg/dL Infants = <40 mg/dL Newborn = <30 mg/dL |
Serum sodium (Na+) | > 160 meq/L | < 120 meq/L |
Serum potassium (K+) |
Adult = > 6.5 meq/L Newborn = >8 meq/L |
Adult = < 2.5 meq/L Newborn = <2.5 meq/L |
Serum calcium (Ca++) | > 13 mg/dL (3.25 mmol/L) | < 6 mg/dL (1.5 mmol/L) |
Ionized calcium | >7 mg/dL (1.58 mmol/L) | <2.2 (0.78 mmol/L) |
Serum phosphate (PO4)3- | < 1 mg/dL | |
Magnesium (Mg++) | >3 meq/L | <0.5 meq/L |
Serum bicarbonate (HCO3–) | > 40 meq/L | < 10 meq/L |
Chloride (Cl–) | >115 meq/L | <80 meq/L |
Creatinine | >4 mg/dL | |
Blood urea nitrogen (BUN) | >100 mg/dL | |
Uric acid | >12 mg/dL | |
Triglyceride | >400 mg/dL | |
HDL |
Male = < 35 mg/dl. Female = < 40 mg/dl. |
|
Ethanol | >300 mg/dL (>65 mmol/L) | |
Haptoglobin | <40 mg/dL | |
Insulin assay | >30 µU/mL | |
Arterial pH | > 7.6 | < 7.2 |
pCO2 | >60 | <20 |
HCO3 | >40 | <15 |
pO2 (arterial) | <40 | |
O saturation | 75% or lower | |
CO2 content | <6 meq/L | |
Osmolality | >320 mOsm /Kg H2O | <265 mOsm /Kg H2O |
Haptoglobin | <40 mg/dL | |
Prealbumin | <10.7 mg/dL = Severe nutritional deficiency | |
Hematology | ||
Hemoglobin | >20 g/dL | <5 g/dL |
Methemoglobin | >40% of the total Hb | |
Hematocrit (Hct) | > 60% | < 14% |
Reticulocytes | > 20 % | |
Platelets | > one million/cmm | < 20,000/cmm |
Total leucocyte count (TLC) | > 50,000 /cmm | < 2000 /cmm |
Carboxyhemoglobin (COHb) | >20% | |
Prothrombin time | > 20 seconds | |
Partial thromboplastin time (PTT) | >100 seconds | |
Activated partial thromboplastin (APTT) | >70 seconds | |
INR | >5.5 | |
Fibrinogen | <100 mg/dL | |
Fibrinogen degradation factor (FDP) | >40 mcg/mL | |
Microbiology | ||
CSF gram stain | Positive | |
Pleural fluid gram stain |
Positive | |
Synovial fluid gram stain |
Positive | |
Peritoneal fluid gram stain |
Positive | |
Blood culture | Positive | |
Hormones | ||
TSH | > 7 mIU/L (hypothyroidism) | < 0.5 mIU/L (hyperthyroidism) |
Thyroxin (T4) |
|
Adult <2 mcg/dL if myxedema comma Newborn = <7 mcg/dL |
Estriol | <40% below the average of two previous values, demand immediate evaluation of fetal well-being during pregnancy | |
Growth hormone | ||
Surgical pathology | ||
Fine needle aspiration | Positive for malignant cells | |
Cervical biopsy or PAP smear | Positive for malignant cells |
Very informatve
Thanks.
Very informatve
Thanks.