Critical / Panic Value Policy
Critical/Panic values are defined as values that are outside the normal range to a degree that may constitute an immediate health risk to the individual or require immediate action on the part of the ordering physician. It is the policy of the clinical laboratory to call the critical values listed to a licensed provider as soon as completed and verified in compliance with hospital policies approved by the Lucile Packard Children's Hospital and Stanford Health Care hospital boards of directors. Read back of the critical values by the person receiving them to the person making the notification call is required.
Chemistry
|
1
ANALYTE |
1
AGE RANGE |
1
CRITICAL VALUE |
1
UNITS |
|---|---|---|---|
|
1
Anion Gap |
1
Any age |
1
>30 |
1
mmol/L |
|
1
Bicarbonate (Whole Blood) |
1
Any age |
1
<10 |
1
mEq/L |
|
1
Calcium * |
1
Any age |
1
<6.5 |
1
mg/dL |
|
1
Chloride |
1
Any age |
1
<80 |
1
mmol/L |
|
1
CO2 |
1
Any age |
1
<10 |
1
mmol/L |
|
1
CO Hemoglobin |
1
Any age |
1
>20 |
1
% |
|
1
Free (ionized) Calcium * |
1
Any age |
1
<0.8 |
1
mmol/L |
|
1
Glucose |
1
0-2 days |
1
<35 |
1
mg/dL |
|
1
Glucose |
1
<30 days |
1
>200 |
1
mg/dL |
|
1
Glucose (GDM) |
1
Any age |
1
<50 |
1
mg/dL |
|
1
Glucose; PXP Glucose meter (POCT) |
1
Any age |
1
<40 |
1
mg/dL |
|
1
Iron, Serum |
1
Any age |
1
≥350 |
1
ug/dL |
|
1
Magnesium |
1
Any age |
1
<1.0 |
1
mg/dL |
|
1
pCO2 |
1
Any age |
1
>65 |
1
mmHg |
|
1
pH |
1
Any age |
1
<7.20 |
1
pH units |
|
1
pH - Arterial & Venous Blood Gases, Cord Blood |
1
Any age |
1
<= 7.00 |
1
N/A |
|
1
Base Excess - Arterial & Venous |
1
Any age |
1
<= -10.0 |
1
mmol/L |
|
1
Phosphorus |
1
<3 years of age |
1
≤2.5 |
1
mg/dL |
|
1
pO2 (arterial) |
1
Any age |
1
<50 |
1
mg/dL |
|
1
Potassium |
1
Less than 1 week |
1
<2.5 |
1
mmol/L |
|
1
Potassium; |
1
Any age |
1
<3.0 |
1
mmol/L |
|
1
Sodium |
1
Any age |
1
<125 |
1
mmol/L |
|
1
TCO₂ (Whole Blood) |
1
Any age |
1
<10 |
1
mEq/L |
|
1
Total Bilirubin |
1
<1 day |
1
≥7 |
1
mg/dL |
|
1
Troponin I |
1
Any age |
1
≥0.3 |
1
ng/mL |
|
1
Troponin I: |
1
Any age |
1
≥0.1 |
1
ng/mL |
* Calcium: mmol/L (SI unit) = 0.25 (conversion factor) x mg/dL (conventional unit).
COAGULATION
|
1
ANALYTE |
1
AGE RANGE |
1
CRITICAL VALUE |
1
UNITS |
|---|---|---|---|
|
1
Fibrinogen |
1
Any age |
1
<100 |
1
mg/dL |
|
1
Heparin, unfractionated |
1
Any age |
1
<0.1 |
1
IU/mL |
|
1
PTT |
1
Any age |
1
≥100 |
1
sec |
|
1
PT INR |
1
Any age |
1
>5.0 INR |
1
N/A |
|
1
PT INR; |
1
Any age |
1
>4.5 |
1
N/A |
HEMATOLOGY
|
1
ANALYTE |
1
AGE RANGE |
1
CRITICAL VALUE |
1
UNITS |
|---|---|---|---|
|
1
Absolute Neutrophil Count |
1
Any age |
1
≤0.5 (Outpatient only) |
1
K/µL |
|
1
Cell Count, Any body fluid |
1
Any age |
1
Intracellular organisms. (Non CSF- Blasts and Tumor cells to be called as soon as a provider is available, which for inpatients is immediate, for others called next business day.) |
1
|
|
1
Cell Count, CSF only |
1
Any age |
1
WBC Count >30 |
1
/µL |
|
1
Cell Count, CSF only |
1
Any age |
1
Blasts or Tumor Cells |
1
|
|
1
Gram Stain |
1
Any age |
1
Positive |
1
N/A |
|
1
Hematocrit (PCV) |
1
Any age |
1
≤21.0 |
1
% |
|
1
Hemoglobin |
1
Any age |
1
≤7.0 |
1
g/dL |
|
1
Malaria Screening |
1
Any age |
1
Positive |
1
N/A |
|
1
Platelet Count |
1
Any age |
1
≤10,000 |
1
/µL |
|
1
Slide Review/Diff |
1
Any age |
1
Presence of intracellular organisms. |
1
% |
|
1
Stool |
1
Male/Female <18 Years |
1
Sperm |
1
N/A |
|
1
Urinalysis |
1
Female <18 Years Male <18 Years |
1
Sperm or Trichomonas
|
1
N/A |
|
1
WBC |
1
Any age |
1
≤0.5 (Outpatient only) |
1
K/µL |
MICROBIOLOGY
|
1
ANALYTE |
1
AGE RANGE |
1
CRITICAL VALUE |
1
UNITS |
|---|---|---|---|
|
1
Any assay: Potential Bioterrorism Agent |
1
Any age |
1
Presence of potential B. anthracis or any BT agent. Bacillus anthracis Francisella tularensis Yersinia pestis Brucella species |
1
N/A |
|
1
Blood Culture |
1
Any age |
1
Any clinically important positive result per protocol |
1
N/A |
|
1
Mycobacterium Tuberculosis PCR Test |
1
Any age |
1
Positive on Tissue or Culture |
1
N/A |
|
1
Stool culture |
1
<18 years |
1
Positive Shiga toxin producing E. Coli
|
1
N/A |
VIROLOGY
|
1
ANALYTE |
1
AGE RANGE |
1
CRITICAL VALUE |
1
UNITS |
|---|---|---|---|
|
1
Antigen test, culture, serology, or molecular test |
1
Any age |
1
Positive or suspicious for any Pandemic (Influenza or SARS) or Bioterrorism Agents (Smallpox, Viral hemorrhagic fever agents |
1
N/A |
|
1
Any CSF Assay |
1
Any age |
1
Positive (including virus growth or molecular test) |
1
N/A |