Critical Values/Critical Results List Summary [CL 041647.

001]

Effective Date: 08/27/2009

DLMP Critical Values / Critical Results List

PURPOSE The purpose of this list is to identify the laboratory tests and their respective critical high and critical low values/results. This list pertains to testing that is performed in Rochester and MML performing sites. A Critical Value / Critical Result is defined as A value/result that represents a pathophysiological state at such variance with normal (expected values) as to be life-threatening unless something is done promptly and for which some corrective action could be taken. NOTE: The critical values/results do not necessarily correspond with normal reference ranges, toxic ranges, or therapeutic ranges. Test Report Name HEMATOLOGY Activated Partial Thromboplastin Time, Plasma Fibrinogen Hemoglobin Hemoglobin INR (International Normalizing Ratio) Leukocytes Manual Absolute Neutrophil Count Neutrophils Platelets, Blood CHEMISTRY Ammonia Ammonia Arsenic, Serum Bilirubin Total, Serum Calcium, Total Calcium, Ionized, Blood Carbon Monoxide Creatinine, Blood/Plasma/Serum Creatinine, Blood/Plasma/Serum Creatinine, Blood/Plasma/Serum Creatinine, Blood/Plasma/Serum Creatinine, Blood/Plasma/Serum
Parent Document: Critical Value Policy [POL 006271]

Age

Critical Low 60

Critical High 150 24.0 20.0 6.0 100.0 1000 Critical High 500 150 0.15 15.0 12.0 6.0 20 1.5 2.0 2.5 3.0 10.0

Units sec mg/dL g/dL g/dL x10(9)/L x10(9)/L x10(9)/L 10(9)/L Units ug/dL ug/dL ug/mL mg/dL mg/dL mg/dL % mg/dL mg/dL mg/dL mg/dL mg/dL
08/27/2009 7:21 am

0-7 weeks >7 weeks

6.0 6.0 0.5 0.5 40

Age <1 yr <1 yr

Critical Low 7.0 2.0 -

1 day-30 days 1 mo - 23 mos 2 yrs - 11 yrs 12 yrs -15 yrs 16 yrs

Printed copies are considered current only on the date printed.

Critical Values/Critical Results List Summary [CL 041647.001]

Effective Date: 08/27/2009

CHEMISTRY Creatine Kinase, Total FT4 (Free Thyroxine) FT4 (Free Thyroxine) Glucose, Plasma/Serum Glucose, Plasma/Serum Magnesium, Serum Osmolality Phosphorus Potassium Sodium TOXICOLOGY/TDM Acetaminophen, Plasma Amitriptyline + Nortriptyline Butabarbital Butalbital Caffeine Carbamazepine Carbamazepine, Free Cyanide, Blood Desipramine Digoxin, Serum Disopyramide Ethanol, Blood Ethosuximide Ethylene Glycol, Serum Imipramine + Desipramine Lidocaine, Plasma Lead, Blood Lead, Blood Lithium, Serum Methanol (Volatile Screen) Nortriptyline Phenobarbital
Parent Document: Critical Value Policy [POL 006271]

Age <50 yrs 50 yrs < 1 week > 1 week

Critical Low 25 40 1.0 190 1.0 2.5 120

Critical High 10, 000

9.0 6.0

Units U/L ng/dL ng/dL mg/dL mg/dL mg/dL Mosm/Kg mg/dL mM/L mM/L Units ug/mL ng/mL ug/mL ug/mL ug/mL ug/mL ug/mL ug/mL ng/mL ng/mL ug/mL mg/mL ug/mL mEq/L ng/mL ug/mL ug/dL ug/dL mEq/L mg/mL ng/mL ug/mL

> 400 > 400 9.0 390 6.0 160 Critical High 120 1000 40 10

Age

Critical Low -

0 - 15 yrs
16 yrs

30 12 4 2.0 500 4.0 8 400 100 any value detected 1000 6.0 20 70

> 1.5 any value detected 500 > 60

Printed copies are considered current only on the date printed.

08/27/2009 7:21 am

Critical Values/Critical Results List Summary [CL 041647.001]

Effective Date: 08/27/2009

Phenytoin, Total Phenytoin, free Primidone Procainamide + NAPA Procainamide, Plasma Quinidine Salicylates, Serum Theophylline, Plasma Valproic Acid Valproic Acid, free MICROBIOLOGY Gram Stain Bacterial Culture, Aerobic Bacterial Antigen Test

> 30 > 2.5 > 15 > 30.0 > 16.0 > 7.0 > 50.0 > 30 > 120 > 15

ug/mL ug/mL ug/mL ug/mL ug/mL ug/mL mg/dL ug/mL ug/mL ug/mL

Critical Value / Critical Result Positive result from a sterile body fluid, normally sterile tissue, or corneal scraping. Positive result from blood, sterile body fluid, normally sterile tissue, or corneal scrapings. Positive result from CSF

Bacterial Culture, Aerobic (also includes Identification of Bacillus anthracis, Brucella spp., Clostridium Enteric Pathogen Culture and botulinum, Corynebacterium diphtheriae, Francisella tularensis, Bacteria/Candida Culture, Blood) or Vibrio cholerae, or Yersinia pestis. Bacterial Culture, Anaerobic Cryptococcal antigen Fungal smear or Fungal culture or PCR Positive result from CSF Identification of a Zygomycete, dimorphic pathogen, Cryptococcus neoformans/C. gattii or Pneumocystis jiroveci. Herpes simples virus from CSF, amniotic fluid, or ocular Positive result from CSF on infant <12 months

Fungal Culture or Mycobacterial Culture Positive result from CSF or blood. Viral Culture or PCR Viral Culture or PCR

Acanthamoeba/Naegleria Direct exam or Identification of Acanthamoeba spp. from CNS or ocular Culture Identification of Naegleria spp. from CNS Babesia PCR or Smear Malaria/Filaria/Trypanosome PCR or Smear Toxoplasma gondii PCR Parasitic Exam Positive result from blood Positive result from blood Positive result from CSF or amniotic fluid Strongyloides stercoralis larvae from non-intestinal sites

Parent Document: Critical Value Policy [POL 006271]

Printed copies are considered current only on the date printed.

08/27/2009 7:21 am