AVERA SACRED HEART HOSPITAL LABORATORY
YANKTON, SOUTH DAKOTA
Policy/Procedure/Test Name
Physician alert values
veloped/Revised By:
Terri Mingo
Distribution:
Laboratory
Approved by:
Richard Strom MD
Page 1 of 1
Previous Reviews/Revisions 3/02, 10/04, 11/04,
Date
6/05, 9/05, 8/06, 10/06, 8/07, 9/07, 2/08, 11/08;
12/11
3/09;7/09, 1/10, 6/10, 8/10, 10/11;1/11,
Current Review/Revision Date
8/11;12/11;1/12;3/12
6/11/2012
Review/Revised
Review/Revised Review/Revised Review/Revised
Patient location:
In House Patient
Out Reach (during office hours)
Out Reach (after office hours)
SHH Health Screen
Primary Contact
Nursing Unit
Out Reach Center
Ordering Clinician
Clinician (if listed)
Secondary contact
Physician
Ordering Clinician
Medical Director
Medical Director
Tertiary contact
Medical Director
Medical Director
The tech performing the test will immediately notify a licensed staff member if any of the following values are obtained. The
technologist will document on the LIS report that such a call was made including time, date and name of staff the verbal report was made.
(Exception: The HUC in the ICU and ED at SHH may receive the critical value notification.)
Hematology
Hematocrit
---------------------------Adult
Under 2 months
Hemoglobin --------------------------Adult:
Under 6 years
Leukocyte Count ---------------------New results
Platelet Count -------------------------New results
< 20%
or
< 6.0 gm/dl
< 9.0 gm/dl
< 1,000/mm3
< 50,000/mm3
or
> 55%
> 70%
> 18.0 gm/dl
or
or
> 50,000/mm3
> 1,000,000/mm3
Coagulation
Prothrombin – INR ----------------------------------------Partial Thromboplastin Time ----------------------------HEP Anti Xa -----------------------------------------------
Chemistry
Glucose -----------------------------------------< 50 mg/dl
or
Calcium -----------------------------------------< 6.0 mg/dl
or
Magnesium -------------------------------------< 1.0 mg/dl
or
Sodium ---------------------------------Adult
< 120 mmol/L or
0-18 years
< 130 mmol/L or
Potassium ------------------------------Adult
< 3.0 mmol/L
or
0-1 year
< 3.0 mmol/L
or
Osmolality---------------------------------------< 250 mOsml/kg or
Bilirubin (total) --------------------------------------------> 12 mg/dl
Carbon Monoxide-----------------------------------------> 14 %
ETOH-------------------------------------------------------> 250mg/dl
TNT (Troponin)--------------------------------delta flag
or
Drug screens------------------------------------any positive result
> 5.0
> 90 seconds
>1.0 IU/ml
> 500 mg/dl
> 13.0 mg/dl
> 3.8 mg/dl
> 160 mmol/L
> 150 mmol/L
> 6.0 mmol/L
> 7.5 mmol/L
> 323 mOsml/kg
> 0.100 ng/mL (1st/series)
TDM:
Aceto
Salic
Li
Dig
Carb
Phno
Phny
Theo
Valp A
Gent
Tobra
Vanc
Amik
ug/mL
mg/dL
mmol/L
ng/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
ug/mL
> 150
> 30
> 2.0
> 3.0
> 18.0
> 55.0
> 25.0
> 20.0
> 140
Tr: > 4.0
Tr: >4.0
Tr: > 20.0
Tr: > 10
Peak: > 35
Microbiology: Blood Cultures ------------ Presence of organism(s) on culture and/or gram stain
Serology:
Urinalysis:
Blood Bank:
Corrected
Reports:
Cerebrospinal Fluid------- Presence of organism(s) on culture and/or gram stain
Joint Fluid ----------------- Presence of organism(s) on culture and/or gram stain
Stool culture --------------- Isolation of Salmonella, Shigella, Campylobacter or E. coli 0157:H7 organisms
Methicillin resistant Staph aureus (MRSA) from a hospital or nursing home location
Vancomycin Resistant Enterococcus (VRE)
Acid Fast Bacillus or malaria positive smears
Influenzae A or B, HIV, E. coli 0157 -any positive results
Ketosis and/or sugars in urine of the newborn
Any abnormal antibody identification or problem type and screen or cross match. If compatible red cells cannot be
obtained for a bleeding patient.
Change in blood type, organism or any clinically significant anatomic pathology diagnosis. Any numerical value
that has changed from a normal to abnormal result or from an abnormal to a normal result.