HFH
and HFMG Critical Value Notification List: May 2006 |
| |
IMMEDIATE
Reporting IPD, ER & OPD* |
NEXT
MORNING** Reporting for OPD ONLY |
| ANALYTE
|
Value
LESS than. |
Value
GREATER than. |
Value
LESS than |
Value
GREATER than |
| Acetaminophen
|
|
30
mcg/ml |
|
|
| Bicarbonate
|
10
mEq/L |
40
mEq/L |
|
|
| Total Bilirubin
(neonates only
for HFH/HFMG) |
|
>
7 mg/dL IF Age <= 24 hrs.
> 13 mg/dL IF Age > 24 but <= 48 hrs.
> 18 mg/dL IF Age > 48 but <= 72 hrs.
|
|
|
Blood Gases |
Values are routinely Called to Responsible Caregiver
(Otherwise call either Venous or Arterial pH < 7.2 or > 7.6;
or Arterial pO2 < 60)
|
|
|
| Blood
Urea Nitrogen *** |
|
100
mg/dl (IPD & ER ONLY) |
|
100
mg/dl*** |
| Calcium
|
7.0
mg/dL**** |
12.9
mg/dl |
|
|
Carbamazipine |
|
|
|
|
Cyclosporine A |
|
|
|
|
Digoxin |
|
2.5 ng/ml |
|
|
FK506 (Tacrolimus) |
|
19.9 ng/mL |
|
|
| Glucose
|
40
mg/dl |
400
mg/dl |
|
|
| Hemoglobin
|
5.0
g/dl |
20.0
g/dl |
|
|
| INR
(International Normalized Ratio) |
|
>
5.0 (IPD only ); > 9.9 (OPD only) |
|
>
5.0 but <= 9.9 |
| Lactate |
|
>3.9 mmol/L |
|
|
| Lidocaine
|
|
5.0
mcg/ml |
|
|
Lipase |
|
>120*** (HFH) (first only)
570*** (FRL, STH, BLM) (first only) |
|
|
| Lithium
|
|
2.0
mEq/L (IPD & ER ONLY) |
|
2.0
mEq/L |
| Magnesium
|
1.0
mg/dl |
4.0
mg/dl (IPD & ER ONLY) |
|
4.0
mg/dl |
| Neutrophils,
Total **** |
0.5
K/mm3 (IPD ONLY) |
|
0.5
K/mm3 **** |
|
| Phenobarbital
|
|
45
mcg/ml (IPD & ER ONLY) |
|
45
mcg/ml |
Phenytoin |
|
25 mcg/mL |
|
|
Phosphorus
(PO4)
|
1.2
mg/dl |
|
|
|
| Platelet
Count |
30
K/mm3 |
1000
K/mm3 |
|
|
| Potassium
|
2.5
mEq/L |
6.0
mEq/L |
|
|
| PT
(SEE INR) |
|
|
|
|
| PTT
|
|
147 sec (IPD & ER ONLY) |
|
|
| Salicylate
|
|
30
mg/dl (IPD & ER ONLY) |
|
30
mg/dl |
| Sodium
|
124
mEq/L |
154
mEq/L |
|
|
| Theophylline
|
|
25
mcg/ml |
|
|
Troponin I (first abnormal only) |
|
>= 0.20 ng/mL (HFH / Main Campus)
>= 0.10 ng/mL (FRL, BLM, STH Labs) |
|
|
| Valproic Acid |
|
150 mcg/mL |
|
|
| White
Blood Cell Count *** |
see Neutrophils above |
35
K/mm3 (IPD & ER ONLY) |
|
35
K/mm3 *** |
| Blood
Culture |
Initial
positive finding |
|
| CSF
Culture |
Initial
positive finding (includes...)
Bacterial
Fungal
India Ink
Gram Stain
Antigen - Cryptococcus
HSV PCR
| |
| N.
gonorrhea
Culture or PCR (newborns only) |
Initial
positive finding |
|
C. trachnomatis Culture or PCR
(newborns only) |
|
|
| Acid
Fast Smear or Culture |
Initial
positive finding |
|
| Primary
Stool Pathogens |
Initial
positive finding |
|
| Malaria
Smear |
Initial
positive finding |
|
| *If
"(IPD ONLY)", then only IPD samples with values in this range
will be called immediately.
**:
OPD Patients with analyte values in this range will be reported the next
morning ( 8 am; 7 days/week) if value initially detected after 5 pm on the preceding day.
***:
All NEW critical WBC and BUN elevations will be called back (IPD/ER immediately;
OPD the next morning beginning at 8 am). In the OPD setting, IF the
current BUN or WBC is the latest of a continuous
string of critical values (and one has already been previously called
back) AND it has not more than doubled
from the most recent previous value,
THEN the current critical value will NOT be called back.
In the IPD setting, IF the current
BUN or WBC is the latest of a continuous string of critical values (and
one has already been previously called back
within the last 24 hours), THEN the current critical value will NOT be
called back.
****:
All NEW neutropenias and hypocalcemias will be called back (Hypocalcemias: immediately; Neuropenias: IPD/ER immediately; OPD the
next morning
beginning at 8 in BOTH the IPD and OPD setting, IF the current neutropenic or hypocalcemic value is the latest of a continuous string of such values
(each
< 24 hours apart from the next, with the first having been called), THEN the current neutropenic or hypocalcemic value will NOT be called back).
|
