DLMP Critical Values/Critical Results List [CL 041647.009]
Effective Date: 12/01/2015
Mayo Clinic Laboratories
FLA, MMLNE, RST
Department of Laboratory Medicine & Pathology
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, Arizona, Florida, Mayo Clinic Health
System (MCHS) 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 directly with normal reference ranges,
toxic ranges, or therapeutic ranges.
NOTE: In addition to the critical values identified on this list, critical alerts from testing referred to
outside laboratories (non-Mayo) will be communicated to clients in accordance with notification
standards once those performing laboratories notify Mayo.
HEMATOLOGY
Test Report Name
Activated Partial Thromboplastin Time,
Plasma
Fibrinogen
Hemoglobin
Hemoglobin
INR (International Normalizing Ratio)
Leukocytes
Absolute Neutrophil Count
Neutrophils
Platelets, Blood
CSF White Blood Cell Count
Parent Document: Critical Value Policy [POL 046402]
Age
0-7 weeks
>7 weeks
Critical Low
-
Critical High
≥ 150
Units
sec
≤ 60
≤ 6.0
≤ 6.0
≤ 0.5
≤ 0.5
≤ 40
≥ 24.0
≥ 20.0
≥ 5.0
≥ 100.0
≥ 1000
≥ 100.0
mg/dL
g/dL
g/dL
x10(9)/L
x10(9)/L
x10(9)/L
x10(9)/L
Cells/mcL
Printed copies are considered current only on the date printed.
DLMP Critical Values/Critical Results List [CL 041647.009]
CHEMISTRY
Test Report Name
Ammonia – (Florida units are µmol/L,
MCHS&RST units are mcmol/L)
*Ammonia – Arizona (Deviation in units)
Ammonia – (Florida units are µmol/L,
Effective Date: 12/01/2015
Age
≥1 yr
≥1 yr
< 1 yr
Critical Low
-
Critical High
≥ 200
Units
mcmol/L
-
≥500
≥ 100
mcg/dL
mcmol/L
≤ 6.5
≤ 2.0
≤ 3.0
≤ 3.0
≥ 150
≥ 15.0
≥ 13.0
≥ 6.0
≥ 6.5
≥ 5.5
mcg/dL
mg/dL
mg/dL
mg/dL
mg/dL
mg/dL
≤ 3.0
≥ 6.0
mg/dL
-
≥ 20
%
-
≥ 1.5
≥ 2.0
mg/dL
mg/dL
-
≥ 2.5
≥ 3.0
≥ 10.0
≥ 10,000
mg/dL
mg/dL
mg/dL
U/L
ng/dL
MCHS&RST units are mcmol/L)
*Ammonia – Arizona (Deviation in units)
< 1 yr
Bilirubin Total, Serum
< 1 yr
Calcium, Total
Calcium, Ionized, Blood
< 1 yr
Calcium, Ionized, Blood
≥ 1 yr
*Calcium, Ionized, Blood - Florida (Deviation
< 1yr
due to methodology difference)
*Calcium, Ionized, Blood - Florida (Deviation
≥ 1 yr
due to methodology difference)
Carbon Monoxide (Carboxyhemoglobin
Level)
Creatinine, Blood/Plasma/Serum
1 day-4 weeks
Creatinine, Blood/Plasma/Serum
5 weeks - 23
mos
Creatinine, Blood/Plasma/Serum
2 yrs - 11 yrs
Creatinine, Blood/Plasma/Serum
12 yrs -15 yrs
Creatinine, Blood/Plasma/Serum
≥ 16 yrs
Creatine Kinase, Total
FT4 (Free Thyroxine)
< 50 yrs
FT4 (Free Thyroxine)
FT4 (Free Thyroxine) – Florida
Glucose, Plasma/Serum
Glucose, Plasma/Serum
Magnesium, Serum
Osmolality
*pH (MCHS and AZ only)
*pC02, arterial (MCHS and AZ only)
*pO2 (MCHS)
*pO2 (AZ)
Phosphorus
Potassium
Sodium
Parent Document: Critical Value Policy [POL 046402]
-
-
≥ 7.8
≥ 50 yrs
All ages
-
≥
< 4 weeks
≥ 4 weeks
≤ 40
≤ 50
≤ 1.0
≤ 190
< 7.200
< 20.0
< 40.0
≤ 45.0
≤ 1.0
≤ 2.5
≤120
≥ 7.8
6.0
ng/dL
ng/dL
> 400
≥ 400
≥ 9.0
≥ 390
>7.600
>70.0
≥ 6.0
≥ 160
mg/dL
mg/dL
mg/dL
mOsm/Kg
pH
mmHg
mmHg
mmHg
mg/dL
mmol/L
mmol/L
Printed copies are considered current only on the date printed.
DLMP Critical Values/Critical Results List [CL 041647.009]
TOXICOLOGY/TDM
Test Report Name
Acetaminophen, S
Acetone (Volatile Screen), applies to all
specimen types
Amitriptyline and Nortriptyline, S
Butalbital, S
Caffeine, S
Carbamazepine, Total, S
Carbamazepine, Free, S
Cyanide, B
Desipramine, S
Digoxin, S
Disopyramide, S
Doxepin and Nordoxepin, S
Ethanol, Blood
Ethanol, Serum
Ethosuximide, S
Ethylene Glycol, S
Imipramine and Desipramine, S
Isopropanol (Volatile Screen), applies to all
specimen types
Lidocaine, S
Lead, Blood
Lead, Blood
Lithium, S
Methanol (Volatile Screen), applies to all
specimen types
Nortriptyline, S
Phenobarbital, S
Phenytoin, Total, S
Phenytoin, Free, S
Primidone and Phenobarbital, S
Primidone
Phenobarbital
Procainamide, S
Procainamide
N-Acetylprocainamide
Quinidine, S
Salicylates, S
Theophylline, S
Valproic Acid, Free and Total, S
Free Valproic Acid
Total Valproic Acid
Valproic Acid, Total, S
Parent Document: Critical Value Policy [POL 046402]
Effective Date: 12/01/2015
Age
Critical Low
-
Critical High
> 150
4 hours after dose
Units
mcg/mL
-
Any value detected
mg/dL
-
≥ 300
≥ 10
≥ 30
≥ 15.0
≥ 4.0
≥ 2.0
≥ 300
≥ 4.0
≥ 7.0
≥ 300
≥ 400
≥ 400
>150
≥ 20
≥ 300
ng/mL
mcg/mL
mcg/mL
mcg/mL
mcg/mL
mcg/mL
ng/mL
ng/mL
mcg/mL
ng/mL
mg/dL
mg/dL
mcg/mL
mg/dL
ng/mL
mg/dL
-
Any value detected
0 – 15 yrs
≥ 16 yrs
-
> 6.0
≥ 20
≥ 70
> 1.6
Any value detected
mcg/mL
mcg/dL
mcg/dL
mmol/L
mg/dL
≥ 300
≥ 60.0
≥ 30.0
≥ 2.5
ng/mL
mcg/mL
mcg/mL
mcg/mL
≥ 15.0
≥ 60.0
mcg/mL
mcg/mL
>12
≥ 40
≥ 6.0
≥ 50.0
>20
mcg/mL
mcg/mL
mcg/mL
mg/dL
mcg/mL
>30
≥ 151
≥ 151
mcg/mL
mcg/mL
mcg/mL
-
-
-
Printed copies are considered current only on the date printed.
DLMP Critical Values/Critical Results List [CL 041647.009]
Effective Date: 12/01/2015
MICROBIOLOGY
Result
Detection (e.g., stain, culture, PCR, antigen detection) of a
clinically significant bacterium, fungus, parasite, or virus
(except HIV and hepatitis A through E virus)
Identification/detection of a select agent (or other highly
pathogenic organism) including, but not limited to Bacillus
anthracis, Brucella species, Burkholderia mallei, Burkholderia
pseudomallei, Clostridium botulinum, Corynebacterium
diphtheriae, Coxiella burnetii, Francisella tularensis,
monkeypox virus, variola virus, Vibrio cholerae, or Yersinia
pestis. In the event of an outbreak of a novel contagious
microorganism, detection of such an organism may fall into
this category.
Detection of clinically significant fungi including, but not
limited to members of the Zygomycetes class, dimorphic
fungal pathogens (Histoplasma capsulatum, Blastomyces
dermatitidis, or Coccidioides species), Cryptococcus
neoformans, Cryptococcus gattii, or Pneumocystis jiroveci
Detection of Strongyloides stercoralis larvae
Detection of herpes simplex virus or Bordetella pertussis
Specimen source and patient details
Blood, cerebrospinal fluid, brain tissue,
amniotic fluid, ocular fluid/corneal scrapings
Any specimen tested
Any specimen tested
Non-intestinal specimen
Any specimen tested from a neonate (< 1
month)
REVISION/DOCUMENT HISTORY
Effective Date
Version
Synopsis of Change
10/25/2012
001
Created Mayo Enterprise Critical Value List and assigned document number 046404. This
document replaces Mayo Clinic Rochester DLMP document number 027509 and replaces Arizona
document DOCMAN-0000116209.
04/13/2015
002
Updated Ammonia and Valproic Acid. Approved by DLMP CPC 9/2014
08/24/2015
003
Updated Ammonia to reflect FLA unit of measure. Updated Free T4 (note: or ≥ upper limit of
AMR if upper limit is <9.0 ng/dL) – approved by DLMP CPC 6/23/2015. Updated
Acetaminophen, Ethosuximide, Procainamide, Theophylline, Free Valproic Acid - approved by
DLMP CPC 3/23/2015.
12/01/2015
004
Changes to the Clinical Microbiology tests. Approved by CLMP CPC 4/9/2014, DLMP CPC
4/14/2014. Clarified note on Ammonia reporting units.
Parent Document: Critical Value Policy [POL 046402]
Printed copies are considered current only on the date printed.