Use regular critical ranges for all other patients, including peritoneal dialysis home dialysis patients. Pdf the critical values are the values of laboratory testing results which required attention or action by the physicians. There are numerous laboratory tests that can be done. Call first positive result within previous 96 hours. When laboratory results fall into the range outlined below, the technologist will promptly call the triage nurse or nurse oncall for the following life threatening laboratory findings. Academy of acute care physical therapy apta task force on. Critical results or values are those that fall outside high and low critical limits. Refer to the laboratory critical value list document for the list of tests and values requiring communicationas per this policy. A critical laboratory test is distinguished from a critical value or critical result, which is defined as a test result that exceeds reference limits to an extreme degree that may indicate a lifethreatening condition. Laboratory critical values callback updated may 20 chemistry assay lower limit upper limit acetaminophen greater than 50 gml alanine aminotransferase alt greater than ul aspartate aminotransferase ast greater than ul amylase greater than 355 iul. Then call anyall 170 troponin t hs 22 ngl for male 14 ngl for female all patients inpatient and outpatient. Panic critical values labcorp defines critical panic results as laboratory test results that exceed established limits high or low as defined by the laboratory for certain analytes as listed in the critical panic limits. In order to strengthen the policy and procedure this study aims to obtain consensus.
Urgent clinician notification of critical results is the lab s responsibility. Department of state health servicessouth texas laboratory. Critical values results table lab section test critical value result call frequency other notes blood gases, cooximetry ph 7. Critical values also known as panic or alarm values highlight a laboratory test result associated with a serious risk for the patients health, requiring immediate communication to the physician.
A new call is made every 7 days if the value for the test continues to be critical. The critical values in use are based on national published standards and. Find, read and cite all the research you need on researchgate. This course will take a closer look at these components. Information from procedural tests assists clinicians in making decisions concerning contrast media and preventing situations that increase patient risk. See below critical values, for a complete list of defined critical values that. Laboratory critical values call back updated march 2010 chemistry assay lower limit upper limit acetaminophen greater than 50 gml alanine aminotransferase alt greater than ul aspartate aminotransferase ast greater than ul amylase greater than 355 iul. Chemistry test value comments bicarbonate total co2 40 mmoll bilirubin, total 15 mgdl. The most common tests include chemistry panels, hematology such as the complete blood count, and blood gases. For inpatients, the laboratory calls critical values the first time the limit is exceeded. Whenever a value falls outside the critical range and then becomes critical again, a new call is made. Based on more than 000 critical values, participants data showed that most critical values reports 92. Pdf laboratory critical values policies and procedures. Table of critical limits c ritical limits define boundaries of lifethreatening values of labora tory test results.
Clinical laboratory critical value immediate notification test list chemistryhematology tests assay lower limit upper limit call if similar result within 2 days. Critical lab value one that represents a pathophysiological state at such variance with normal as to be life threatening unless something is done promptly and for which some corrective action could be taken. When a critical result is obtained, martha jefferson laboratory adheres to the following protocol. When critical values critical results are communicated by phone, there is a readback of unique at least 2 patient identifiers name, date of birth, medical record. Critical results or values are those that fall out side high and low critical limits. A critical result or a critical panic value is an unexpectedunpredictable result in a particular clinical setting and has the potential for serious adverse outcome to the patient or others if not dealt with promptly. Laboratory critical values policies and procedures. Sep 01, 2014 briefly, in the policy of the department of laboratory medicine in padua, a clear definition is given of critical values and critical tests are specified. Critical limits of laboratory results for urgent clinician notification ifcc.
Critical lab results are defined by the medical director as values that indicate the need for immediate interven tion by the patients physician or responsible healthcare provider. Critical values laboratory test interpretations for. Effective practices for the timely and accurate reporting. Ambulatory care pharmacy selfassessment program reference values for common laboratory tests1 reference values for common laboratory tests1 serum chemistries reference range alanine aminotransferase alt 1040 ul. Critical value notification policy policy vi14 clinical laboratory critical value immediate notification policy subject immediate notification of critical values scope all lab sections version 11. Critical values are flagged on patients chart with letter c for. V alues are reference values from texas children s hospital clinical laboratory, current as of august 2011.
The following test results are considered critical lab values and will be called immediately. In addition, all critical values communicated verbally or by phone will be read back to technologist and technologist will. Critical values may imply a lifethreatening situation for the patient and must be brought to the. He defined critical laboratory values as values which reflect pathophysiological derangements at such variance with normal as to be lifethreatening if therapy is not instituted immediately. Critical results are communicated to the physician, the physicians representative, the ordering entity, or other clinical personnel responsible for patient care once the result has been verified and the patients result has been entered into the laboratory computer system. Intermountain laboratory services cp0008a1 817 salt lake city, utah page 1 of 2 laboratory critical values newborn defined as critical value exception applies only applies when not reported in conjunction with a hematocrit blood gases clinical lab cvs carboxyhemoglobin 7%. The responsible physician or a licensed caregiver is contacted within 30 minutes of obtaining the lab test values which are. Critical values are any laboratory result which represents a pa thophysiologic state at such variance with normal as to be life threatening unless some action is taken in a very short time and in which the state may not be readily detectable or highly sus pected by clinical physician lundberg, mlo, 877, p. The laboratory may report a critical value only to the fcp, to the licensed ordering ucmc specified professional, or to a physician or registered nurse responsible for care of the patient. The purpose of this list is to identify the laboratory tests and their respective critical high and critical low valuesresults. Platelet counts of 10 x 109l or less will be communicated as critical values even when recurrent, unless written instructions to the contrary have been received from the specialist and approved by the laboratory director. All critical lab results are to be communicated to or. In order to assist the ordering physician in responding to certain potentially lifethreatening.
The purpose of this list is to identify the laboratory tests and their respective critical high and critical low values results. The value of the statistic is calculated and compared to critical values to test the assumption. Critical panic values are defined as values that are outside the normal range to a degree that may constitute an immediate health risk to the individual or require immediate action on the part of the ordering physician. The content of publications of laboratory medicine best practices is in the public domain. The system of critical value reporting was first implemented in a hospital by george d. Academy of acute care physical therapy apta task force. Check mtuitive document manager to ensure this is the latest version. Critical values will be reported only for tests that are ordered. It is the policy of the clinical laboratory to call the critical values listed to a licensed provider as soon as completed and verified in compliance with hospital policies approved by the lucile. Laboratory data should be produced under a quality system. Laboratory personnel will initiate notification of an appropriate caregiver physician, house staff, or nurse of any defined critical value s detected within 20 minutes of detection of the result in the lab.
For tests and results listed below, laboratory personnel will automatically telephone a report to primary nurse or physician promptly upon completion of test, regardless of test priority. The laboratory test value should be ascertained by a competent member of the laboratory laboratory doctor, clinical chemist, senior medical laboratory tech nician who should discuss the result with the treating physician. Critical values in laboratory medicine acute care testing. 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. Table of critical limits adults c clinical laboratory reference. Effective practices for the timely and accurate reporting of.
Critical values 24 hrsday sodium less than 120 mmoll greater than 160 mmoll total bilirubin 3 days 02 days greater than 260 moll greater than 310 moll 4 28 days greater than 340 moll urea greater than 35. The system of critical value reporting was first implemented in. Table of critical limits c clinical laboratory reference. They are also advised to continually check for updated normal ranges. Critical results may also be referred to as panic values. Upon verbal notification from the referral laboratory of a critical value, import the template critref as an order comment on the appropriate order. Laboratory critical values list critical lab results are defined by the medical director as values that indicate the need for immediate intervention by the patients physician or responsible healthcare provider.
The laboratory will ask for a verification readback of the. Critical lab results are defined by the medical director as values that indicate the need for immediate interven tion by the. Pathology consultation on reporting of critical values. Effective practices for the timely and accurate reporting of critical values.
In practice, a control chart is designed so that a nonstatistician can perform these tests easily by. Laboratory criticalpanic value list stanford health care. The concept of critical values for laboratory results was first introduced by lundberg in 1972. Because of their critical nature, critical values require urgent notification of the appropriate healthcare professional. Critical values, also known as alert or panic values, are laboratory results that indicate a possible lifethreatening situation for the patient. Mar 30, 2012 using laboratory values can be a key piece of assessment to determine what is occurring within the body of a patient. This is the newest step in a critical value notification process that had been working wellbut not quite well enough. Test low high commentsfrequency if not each time hematologycoagulationserology cont.
The laboratory test value should be ascertained by a competent member of the laboratory laboratory doctor, clinical chemist, senior medical laboratory technician. Pdf the critical value is a laboratory result representing a pathophysiological state that offers risk to a patients life. Microbiology critical values print new copies from intranet last approved date. Clinical laboratory critical value immediate notification policy. Personal norms just like temperature, all have individual normals high normal may be extreme high in some patients example.
Lundberg 1972 defined a critical value as a physiological state at such variance with normal as to be life threatening unless something is done promptly and for which some corrective action can be taken. Laboratory values see inside back cover for continuation. Hematology absolute neutrophil count male 17805380l 1. Any positive gram stain or culture result from a blood culture. Pathologists and laboratory professionals are often confronted with many obstacles in the reporting of such critical values, including establishing clinically relevant criteria for critical values, resolving difficulties in locating an ordering provider when a critical value is obtained, and ensuring that the provider understands the severity. Pdf the critical value concept in clinical laboratory researchgate. Policy the medical director of the laboratory shall establish a list of critical laboratory values. Critical values list national reference laboratory. All critical values should be successfully reported to a responsible physician or registered. Pediatric values are different than adult values variations among labs use norms listed by lab, keep in mind that there are three blood test normal ranges. Receiving and reporting critical lab results from the laboratory a. Clinical laboratory critical value immediate notification. For outpatients, the ordering physicians office or number provided on requisition is contacted. It is the policy of the clinical laboratory to call the critical values listed to a licensed provider as soon as completed and verified in compliance with hospital policies approved by the lucile packard childrens hospital and stanford health care hospital boards of directors.
These analytes, critical values and the reporting procedure have been approved by the ucmc medical staff organization. Cheat sheet retrieved from lab values cheatsheet8734 red blood cells rbc. Clinical laboratory critical result notification i. Mayo clinic laboratories critical values critical results list. The results of tests with critical values will be communicated to the responsible licensed caregiver in a timely and reliable manner according to the established procedure. Labcorp defines critical panic results as laboratory test results that exceed established limit s high or low as defined by the laboratory for certain analytes as listed in the critical panic limits. Ucsf clinical laboratories critical and subcritical values. Critical results are considered life threatening and require immediate notification of the physician, the physicians representative, the ordering entity, or other clinical personnel responsible for.
Pdf critical value of the clinical laboratory test in thailand. All practitioners are urged to consult the normal laboratory values for their local laboratory, as these may differ from those listed below. Critical values are posted in the online laboratory handbook. A hypercritical value notification policy at northwell health in new york state authorizes the laboratory alone to activate a hospitals rapid response team when necessary.
766 489 588 1601 430 761 1377 128 643 1168 448 1249 625 1324 513 537 1737 319 235 269 1047 934 497 1531 1220 857