CRITICAL VALUES LIST
CRITICAL TESTS
Critical tests are called to the caregiver regardless of the result obtained. The Clinical Laboratory does not currently define any tests as “critical.”
CRITICAL VALUES
Click here to review the University of Colorado Hospital “Critical Results/Values Notification and Documentation” policy.
| TEST | LOW Less than: <Less than or equal to: ≤ | HIGH Greater than: >Greater than or equal to: ≥ |
| Absolute Neutrophil Count See table below for Oncology exceptions. | <1.0 x 109/L | |
| Acetaminophen | ≥40.0 ug/mL | |
| AFB Culture or Smear, Cerebrospinal Fluid | Positive | |
| Amikacin trough | >10 ug/mL | |
| Antibody, red blood cell, unexpected and clinically significant, STAT and surgical blood transfusions | Positive | |
| Antithrombin III Activity | <20 U/dL | |
| APTT | >159 seconds | |
| Bicarbonate (HCO3), arterial blood gas | ≤12 mmol/L | ≥40 mmol/L |
| Bilirubin, total (newborns 0-1 month) | ≥20.0 mg/dL | |
| Blood Culture | Positive | |
| Blood culture, blood product associated with transfusion reaction | Positive | |
| Blood parasites (Malaria, Babesia, Microfilaria, Trypanosomes, etc.) | Positive | |
| Calcium | <6.0 mg/dL | >12.0 mg/dL |
| Carbamazepine | ≥15.0 ug/mL | |
| Carboxyhemoglobin | ≥12% | |
| CO2 | ≤9 mmol/L | ≥40 mmol/L |
| CO2, total (tCO2), arterial blood gas | ≤12 mmol/L | ≥40 mmol/L |
| Coagulation Factor Activities ( II, V, VII, VIII, IX, X, XI, XII and vWF) | <20 U/dL | |
| Cryptococcal Antigen | Positive | |
| Culture, following sources:
| Positive | |
| Cyclosporine | >400 ng/mL | |
| Digoxin | ≥3.0 ng/mL | |
| Ethanol | ≥400 mg/dL | |
| Ethylene glycol | ≥3 mg/dL | |
| Factor Inhibitors | >0.5 U/mL | |
| Fibrinogen | <100 mg/dL | |
| Gentamicin trough | ≥2.00 ug/mL | |
| Gentamycin peak | ≥12.0 ug/mL | |
| Gentamycin random | ≥12.0 ug/mL | |
| Glucose | ≤40 mg/dL | ≥500 mg/dL |
| Gram Stain, following sources:
| Positive | |
| Hematocrit See table below for Oncology exceptions. | <24 % | >60% |
| Hemoglobin See table below for Oncology exceptions. | <8 gm/dL | >20 gm/dL |
| Heparin Associated Platelet Antibodies | Positive | |
| Heparin Level | >1.2 U/mL | |
| INR | ≥6.0 | |
| Ionized Calcium | ≤0.75 mmol/L | ≥1.66 mmol/L |
| Isopropanol | ≥5 mg/dL | |
| Ketones (infants under 6 months old) | 3+ | |
| Lidocaine | >9 ug/mL | |
| Lithium | > 1.5 mmol/dL | |
| Low Molecular Weight (LMW) Heparin Level | ≥1.7 U/mL | |
| Magnesium | ≤1.2 mg/dL | ≥6.0 mg/dL |
| Methanol | >5 mg/dL | |
| Methemoglobin | ≥3.0% | |
| Methotrexate | 24 Hour: >5 µmol/L
48 hour: >0.5 µmol/L | |
| pCO2 | ≤20 mmHg | ≥70 mmHg |
| PCR, following sources (viruses):
| Positive | |
| Pentobarbital | >50 ug/mL | |
| PH, Arterial | ≤7.200 | ≥7.600 |
| Phenobarbital | ≥50.0 ug/mL | |
| Phenytoin | ≥30.0 ug/mL | |
| Phenytoin, Free | ≥4.0 ug/mL | |
| Phosphorus | ≤1.0 mg/dL | |
| Plasminogen | <20 U/dL (>6 months)
<10 U/dL (0-6 months) | |
| Platelets See table below for Oncology exceptions. | <50 x 109/L | >600 x 109/L |
|
PO2, Arterial | ≤39 mmHg | |
| Potassium | ≤2.5 mmol/L | ≥6.4 mmol/L |
| Propylene glycol | ≥5 mg/dL | |
| Protein C Activity | <20 ug/dL (>4 years)
<10 ug/dL (0-4 years) | |
| Protein C Clot | <20 ug/dL | |
| Protein S Clot | <20 ug/dL | |
| Protein S Free | <20 ug/dL | |
| Protein S Total | <20 ug/dL | |
| Reducing Substances (infants under 6 months old) | Positive | |
| Salicylate | ≥40.0 mg/dL | |
| Sirolimus | >30 ng/mL | |
| Sodium | ≤120 mmol/L | ≥160 mmol/L |
| Tacrolimus | >25 ng/mL | |
| Theophylline | ≥30.0 ug/mL | |
| Thiocyanate | >50 ug/mL | |
| Tobramycin trough | ≥2.0 ug/mL | |
| Transfusion reaction investigation, hemolytic | Positive | |
| Triglycerides | ≥1500 mg/dL | |
| Triglycerides (Dermatology Clinic only) | ≥800 mg/dL | |
| Valproic Acid | ≥150.0 ug/mL | |
| Vancomycin, random and peak | ≥80.0 ug/mL | |
| Vancomycin, trough | ≥35.0 ug/mL | |
| Viral culture, following sources:
| Positive for CMV, HSV, VZV, or Enterovirus | |
| Viral culture, source BAL | Positive for CMV, HSV, or VZV | |
| WBC See table below for Oncology exceptions. | <1.5 x 109/L | >30 x 109/L |
Critical Values – Oncology Patients Only
| Results called when criteria met | Results are always called | |||
|---|---|---|---|---|
| WBC | ANC | Platelets | Hemoglobin | Hematocrit |
| <1.5 x 109/L | <1.0 x 109/L | <25 x 109/L | <7 gm/dL | <21% |
| >30 x 109/L | >600 x 109/L | >20 gm/dL | >60% |
WBC and ANC (Absolute Neutrophil Count) are called to Oncology healthcare providers when:
- It is the first time the critical value is detected on the patient.
- The patient has not had a similar critical value within the previous 24 hours.
- The test was not ordered in the previous 24 hours.
- The previous result within 24 hours was not a critical value. (The patient’s result has changed from a critical value to a non-critical value, then back to a critical value.)
Positive test results considered significant, but not defined as critical will be called to the care provider on the same day that the results are available. These results are:
- D-dimer (Outpatients only; excludes patients in Emergency Department) ≥ 500 ng FEU/mL
- Positive AFB smears
- Positive AFB cultures other than M. gordonae
- Positive Coccidioides immitis, Blastomyces dermatidis, or Histoplasma capsulatum DNA probes
- Positive cultures for bacteria and fungus from body fluids and tissues (normally sterile sites)