Critical Values

List of critical values

1-Chemistry

ANALYTE

AGE RANGE

CRITICAL VALUE

UNITS

Anion Gap

Any age

>30

mmol/L

Bicarbonate (Whole Blood)

Any age

<10
>40

mEq/L

Calcium *

Any age

<6.5
>13

mg/dL

Chloride

Any age

<80
>120

mmol/L

CO2

Any age

<10
>40

mmol/L

CO Hemoglobin

Any age

>20

%

Free (ionized) Calcium *

Any age

<0.8
>1.6

mmol/L

Creatinine

1-28 days

5weeks-23mo

2y-11y

12y-15y

Adults

≥1.5

≥2

≥2.5

≥3

≥10

mg/dl

Digoxin

Any age

≥4

ng/ml

Glucose

0-2 days
>2 days &<1 year
>1 year

<35
<40
<55

mg/dL

Glucose

<30 days
>30 days &<17 yrs
>17 yrs

>200
>300
>450

mg/dL

Glucose (GDM)
GDM Glucose Tolerance
GMD Glucose Tolerance 1hr
GMD Glucose Tolerance 2hrs
GMD Glucose Tolerance 3hrs

Any age

<50
>300

mg/dL

Glucose

PXP Glucose meter (POCT)

Any age

<40
>300

mg/dL

Iron, Serum

Any age

≥350

ug/dL

Magnesium

Any age

<1.0
>3.5

mg/dL

pCO2

Any age

>65

mmHg

pH

Any age

<7.20
>7.60 

pH units

pH – Arterial & Venous Blood Gases, Cord Blood

Any age

<= 7.00

N/A

Base Excess – Arterial & Venous
Blood Gases, cord blood

Any age

<= -10.0
= >10.0

mmol/L

Phosphorus

<3 years of age
3-12 years of age
>12 years of age

≤2.5
≤2.0
≤1.5

mg/dL

pO2 (arterial)

Any age

<50

mg/dL

Potassium

Less than 1 week
Older than 1 week
Any age

<2.5
<3.0
>6.0

mmol/L

Potassium;
ISTAT (POCT)

Any age

<3.0
>6.0

mmol/L

Sodium

Any age
Any age

<125
>160

mmol/L

TCO₂ (Whole Blood)

Any age

<10
>40

mEq/L

Total Bilirubin

<1 day
>1 day <2 days
>2 days <30 days

≥7
≥11
≥15 

mg/dL

Troponin I

Any age

≥0.3 

ng/mL

Troponin I:
ISTAT (POCT)

Any age

≥0.1

ng/mL

* Calcium: mmol/L (SI unit) = 0.25 (conversion factor) x mg/dL (conventional unit)

2- HEMATOLOGY

Critical value

Hb

Critical value: ≤ 6.0 g/dl, ≥ 20 g/dl

 

Hct

Critical value: ≤ 18%, > 60%



 

WBC

Critical value: ≤ 2.0, ≥ 49.9X10/ul



 

Platelets

Critical value: ≤ 20,000,≥ 999,000/ ul



 

Absolute neutrophil count

Critical value: <500/ cmor ,≥ 999,000/ ul



 

3- COAGULATION

ANALYTE

AGE RANGE

CRITICAL VALUE

UNITS

Fibrinogen

Any age

<100

mg/dL



Heparin, unfractionated



Any age



<0.1
>0.7



IU/mL
IU/mL



PTT



 



Any age

 

≥100



sec

PT INR

Any age



>5.0 INR

 

N/A

PT INR;
ISTAT (POCT)

Any age

>4.5

N/A

4-MICROBIOLOGY

ANALYTE

AGE RANGE

CRITICAL VALUE

UNITS

Any assay: Potential Bioterrorism Agent

Any age

Presence of potential B. anthracis or any BT agent.

Bacillus anthracis
(Category A)

Francisella tularensis
(Category A)

Yersinia pestis
(Category A)

Brucella species
(Category B) 

N/A



Blood Culture



Any age



Any clinically important positive result per protocol



N/A





Mycobacterium Tuberculosis: Ziehl neelsen stain, Culture or PCR Test



Any age

 

Positive



N/A

Stool culture

<18 years



Positive Shiga toxin producing E. Coli

 

N/A

CSF culture

Any age

Organism seen in CSF direct film or culture

N/A

5- VIROLOGY

ANALYTE

AGE RANGE

CRITICAL VALUE

UNITS

Antigen test, culture, serology, or molecular test

Any age

Positive or suspicious for any Pandemic (Influenza or SARS) or Bioterrorism Agents (Smallpox, Viral hemorrhagic fever agents

N/A

Any CSF Assay

Any age

Positive (including virus growth or molecular test)

N/A

References

J Aldrige 05/2008 mod 09/2009