Visitor info COVID-19 test info COVID-19 vaccine info

Hospital  >  Departments  >  Laboratory Medicine  >  Clinical Pathology  >  Critical Results  >  Biochemistry Critical Results List: CPI-5.5.1.1.0.1
Share:  
|
PAGE
MENU

Biochemistry Critical Results List: CPI-5.5.1.1.0.1

Department of LMMD
Division of Clinical Chemistry

CPI-5.5.1.1.0.1
Version: 2.24
Effective: 2020/09/09

E-Authorized by: Biochemist

Appendix 1: Table of Adult Critical Limits

Tests Critical limits Units
Acetaminophen 600 (4 hr. post ingestion)
400 (8 hr. post ingestion)
200 (12 hr. post ingestion & if ingestion time not available)
mmol/L
Ammonia ≥ 99 mmol/L
Bicarbonate ≤ 10 or ≥ 40
  • call the first critical result ≥40
  • call any critical result obtained 7 days or more from the first (a critical result on day 7 or more becomes the first critical result again)
mmol/L

Blood Gases


Arterial
pH
pCO2
pO2
Bicarbonate


Venous
pH
PCO2




≤ 7.20 or ≥ 7.60
≤ 30 or ≥ 60
≤ 60
≤ 10 or ≥ 40

  • all results ≤ 10 are called
  • call the first critical result ≥ 40
  • call any critical result obtained 7 days or more from the first (a critical result on day 7 or more becomes the first critical result again)

≤ 7.20 or ≥ 7.60
≤ 25 or ≥ 60

mm Hg
mm Hg
mmol/L

mm Hg

Calcium ≤ 1.50 or ≥ 3.00 mmol/L
Carbamazepine ≥ 63 mmol/L
COHb ≥ 0.150 F.T.Hb
Creatine Kinase > 10,000
Out patient first result
IU/L
Creatinine
(SB patients)
≥ 500
  • Call the first critical result
    ≥ 500
  • Do not call if within previous 2 months Creatinine has been
    ≥ 500
  • Do not call Dialysis patients
mmol/L
Creatinine
(HC patients)
≥ 350 mmol/L
CSF Glucose ≤ 2.0 mmol/L
CSF Protein ≥ 1000 mg/L
Digoxin ≥ 3.0 nmol/L
Ethanol ≥ 30 mmol/L
Gentamicin Peak ≥ 10.00; Trough ≥ 2.00 mg/L
Glucose ≤ 2.5 or ≥ 25.0 mmol/L
Ionized Calcium ≤ 0.85 or ≥ 1.55 mmol/L
Lactate
Venous - Grey top
Arterial - Syringe

≥ 4.0
≥ 3.4

mmol/L
Lithium ≥ 2.0 mmol/L
Magnesium ≤ 0.40 or ≥ 2.00 mmol/L
MetHb ≥ 0.100 F. T. Hb
Osmolality ≤ 250 or ≥ 350 mmol/Kg
Phenytoin ≥ 100 mmol/L
Phosphate < 0.40 or ≥ 3.00 mmol/L
Potassium ≤ 2.7 or ≥ 6.0 (≤ 2.5 for Dialysis patients only) mmol/L
Salicylate ≥ 2.2 mmol/L
Sodium ≤ 120 or ≥ 160 mmol/L
Thiocyanate > 2.0 mmol/L
Tobramycin Peak ≥ 10.00; Trough ≥ 2.00 mg/L
Total Calcium /Systemic Ionized Calcium ratio ≥ 2.5 
Troponin T
High Sensitivity
  • call the first critical result
    ≥ 100
  • call the second critical result if it doubles the first
  • call anytime the result returns to below 100ng/L and then goes above > 100ng/L is to be treated as a first time critical
  • call on 30th day if above 100, treat as day 1 (call)
    • independent of location
ng/L
Urate ≥ 1000 (Dialysis or Nephrology patients: need NOT call) mmol/L
Valproic Acid ≥ 700 mmol/L

 

Appendix 2: Table of Paediatric (< 1 yr.) Critical Limits

Tests Critical limits Units

Blood Gases

pH
pCO2
pO2
Bicarbonate

< 7.23 or > 7.45
< 30 or > 70 Call whenever pCO2
≤ 35
Do not call any pO2 results
≤ 10 or ≥ 40

mm Hg
mm Hg
mmol/L

Cord Blood Gases

pH

≤ 7.00

  • phone critical result to NICU Fellow on-call through locating
Ammonia ≥ 99 µmol/L
Bilirubin, total > 300 µmol/L
Glucose < 2.6 or > 10.0
Provide a preliminary report if the glucose is < 2.0 or > 25.0 prior to repeating test result.
mmol/L
Ionized Calcium ≤ 0.85 or ≥ 1.55 mmol/L
Lactate  ≥ 4.0 mmol/L
Na < 120 or > 155 mmol/L
Triglyceride > 3.0 mmol/L
Vancomycin Peak > 40; Trough < 5 mg/L
Note: Critical Limits for the Neonatal Intensive Care Unit (NICU) may differ on the basis of the gestational age of the infant. There may be NICU-specific action protocols for these and other analytes, and such SOPs take precedence over the general action protocols listed in the main body of this SOP.