Collaborative Laboratory Services
 Saint Francis Campus
 Mount Sinai Campus
 Burgdorf Campus
Laboratory Turn-around Times and Critical Values
Document Number:
QAQC.32.Proc
Manual: Quality Assurance Quality Control
1.0
Version:
009
Publish Date: May, 2012
Clinical Purpose:
1.1
All Results which fall into the range of “Call or Panic Values” must be called to
the appropriate Unit/Doctor’s Office/Nursing Home within 30 minutes of
generated result.
1.2
It is the responsibility of the reporting technologist to call the “Call or Panic
Value” result(s). The supervisor should be notified if the report cannot be given.
The person giving the result must provide two patient identifiers. The person
receiving the results must be a licensed caregiver and must verify the report by
repeating back the test name and test results. Documentation of the call is
required in the Laboratory Information System (LIS) by appending the result
with “CRB” the time the result was called and the full name of the person to
whom the result was given (ex. –CRB-;1300-;Jim Smith).
1.3
SFH-Microbiology—If the patient has been discharged from the hospital, call the
ordering physician if a private physician or an attending physician. If a resident
was the ordering physician, call the Chief Resident of the specialty area caring for
the patient (for example Medicine or Surgery). If unsuccessful, call the
Pathologist on call with the information.
1.4
If the responsible licensed caregiver or physician does not take a critical result, a
Confidential Incident Report should be completed and forwarded to Risk
Management.
1.5
Extended delays in patient reporting are communicated electronically via email or
verbally to nurse supervisors and/or managers.
1.6
If the patient has been discharged from the hospital, call the ordering private
physician or an attending physician.
1.7
Draw Times:
1.7.1
1.7.2
1.7.3
1.8
Result Intervals: (Specimen Receipt to Test Completion)
1.8.1
1.8.2
1.8.3
1.8.4
1.8.5
1.9
In-patient STAT requests will be drawn within 30 minutes of request.
Hospital Out-patient STAT requests will be drawn within 2 hours of
request.
CLS Out-Patient Stats available 4-6 hours from request of blood draw.
CLS Out-patient (Nursing Homes, Physician office’s and Draw Stations)
Emergency / STAT specimens
within 1 hour
Blood Gas specimens (STAT)
within 15 minutes
CLS Out-Patient Stats available 4-6 hours from request of blood draw.
Stroke Protocol---PT/INR
within 30 minutes
Routine Specimens
within 4 hours
Refer to chart on the following page for the defined critical ranges.
Collaborative Laboratory Services
Laboratory Turn-around Times and Critical Values
Document Number: QAQC.32-009
Laboratory Call and Panic Values
Attachment 1A: Adult Laboratory Call and Panic Values
The person giving the result must provide two patient identifiers.
The person receiving the results must be a licensed caregiver and must verify
the report by repeating back all results
CHEMISTRY
HEMATOLOGY
Adult
Critical Value
> 100
> 15.0
> 100 First value only
Critical Test
Acetaminophen, µg/mL
Bilirubin, total, mg/dL
BUN, mg/dL
Calcium, mg/dL
< 6.5 or
CO2, mmol/L
Digoxin, ng/mL
Glucose, mg/dL
Ionized Calcium, mmol/L
< 10 or > 40 First value only
> 2.6
< 45 or > 500
< 0.8 or > 1.6
Lithium, mEq/L
> 13.0
>1.5
< 0.8 or > 5.0
> 60.0
> 30.0
< 2.8 or > 6.0
< 120 or > 160
> 0.4
First value only
Magnesium, mg/dL
Phenobarbital, µg/mL
Phenytoin, µg/mL
Potassium, mmol/L
Sodium, mmol/L
Troponin I, ng/mL
Adult
Critical Value
Hematocrit, %
< 20.0
Platelet count, K/µL
< 25
WBC, K/µL
≤ 1.5 or ≥ 40.0
Presence of Plasmodium/Babesia species in
peripheral blood
Critical Test
COAGULATION
INR
PTT, sec
Heparin PF4
Antibody Screen
≥ 5.0
≥ 110
Presumed positive
BLOOD GAS
pH
pCO2, MMHG
pO2, MMHG
< 7.2 or > 7.6
< 20 or > 76
< 40
MICROBIOLOGY
Positive blood cultures
Positive CSF gram stain and cultures
Attachment 1B Neonatal Laboratory and Panic Values
CHEMISTRY
Critical Test
Calcium, mg/dL
Glucose, mg/dL
Potassium, mmol/L
Sodium, mmol/L
Neonatal Bilirubin, mg/dL
HEMATOLOGY
Neonatal
Critical Value
< 7.0 or >13.0
<40 or >200
<2.5 or >6.0
<125 or >160
> 15.0
Critical Test
Hemoglobin, gm/dL
Platelet Count, K/µL
WBC, K/µL
Neonatal
Critical Value
≤ 8.0 or ≥ 24.0
≤ 50
or ≥ 1,000
≤ 2.0
or ≥ 34.0
BLOOD GAS
pCO2, MMHG
pO2, MMHG
pH
<30 or > 50
<40 or >90
< 7.2 or >7.5
2 of 3
Collaborative Laboratory Services
Laboratory Turn-around Times and Critical Values
Document Number: QAQC.32-009
Attachment 1C: Antepartum Laboratory and Panic Values
(The following values will be considered critical results for pregnant women located
in Labor and Delivery, 4-1, and 4-9).
CHEMISTRY
HEMATOLOGY
Pregnancy
Critical Value
> 72
> 66
> 620
> 1.2
> 1.3
Critical Test
AST (SGOT), U/L
ALT (SGPT), U/L
LDH, U/L
Creatinine, mg/dL
Bilirubin, mg/dL
Magnesium, mg/dL (patient on
Magnesium sulfate)
Creatinine Clearance, mL/min
24 hour urine protein, mg/24
hours
Critical Test
Hematocrit, %
Hemoglobin, gm/dL
Platelet Count, K/µL
Pregnancy
Critical Value
< 25.0
< 8.0
<100
COAGULATION
> 8.0
Fibrinogen, mg/dL
< 300
< 100
FSP, µg/mL
> 40
> 300
Attachment 1D: Pulmonary Laboratory and Panic Values
Blood Gas
Critical Test
pCO2, MMHG
pO2, MMHG
pH
2.0
Pulmonary
Critical Value
<30 or > 50
< 60
< 7.25 or >7.60
References:
Laboratory Turn-around Times and Critical Values, CLS Procedure, QAQC.32.1.Chart,
March 2010.
3 of 3