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Critical Values for Adults and Pediatrics (≥ 12 Month)

Laboratory values in the critical range will be reported by telephone immediately. On inpatients, the laboratory will attempt to phone the physician first; however, if the physician listed as the ordering physician is incorrect or does not respond within 10 minutes, the patient’s nurse will be notified. 

Results will be reported only to a physician or nurse unless the location of the patient is in the recovery room, operating room, or labor & delivery and a physician or nurse cannot come to the phone. 

Critical value laboratory test results will be phoned immediately to non-UC Irvine pathology referral services clients. These results can be released to a clinical laboratory scientist at the referral client location when the ordering physician is unavailable.

The urgency of the contact will be emphasized to the individual accepting the phoned report, as well as the importance of contacting the appropriate physician.

Inability to contact the requesting physician, clinic, or office after two attempts will be followed up with an attempt to reach the pathology resident on call, the clinical pathology attending on call, or the director of the specific laboratory section in which the laboratory results occurred.



Critical Low Value

Critical High Value

Acid fast stain

 -----  First positive smear

Amniotic fluid, culture or gram stain

 -----  Positive

Blood culture

 -----  Positive
Calcium  ≤6.0 mg/dL  ≥13.0 mg/dL
Carbon dioxide (CO2)  -----  ≥50 mEq/L
CSF, cryptococcal antigen  -----  Positive
CSF, culture or gram stain  -----  Positive
Fibrinogen  <100mg/dL  -----
Glucose (blood)  ≤50 mg/dL  ≥400 mg/dL
Glucose, OB patients, 1 hour post glucola  -----  >200 mg/dL
Glucose (CSF)  ≤40 mg/dL  ≥300 mg/dL
Hematocrit  <21 %  ≥62 %
Hemoglobin  <7.0 gm/dL  ≥21 gm/dL

Lead (blood) : children <18 years old
adults >18 years old

 ≥10 mcg/dL
 ≥25 mcg/dL
Magnesium (blood) : For OBER:  ≤1.0 mg/dL  -----  ≥5.0 mg/dL   ≥8.0 mg/dL
Malaria Smear  -----  Any Plasmodium species
Nucleated cells (CSF)  -----  >5 cells present
pH   ≤7.2  ≥7.6
Platelet count   ≤20,000 /mm3  >1,000,000 /mm3
Prothrombin time (PT)  -----  >4.0 INR
Partial thromboplastin time (PTT)  -----  ≥80.0 sec
Potassium  ≤2.8 mEq/L  ≥6.0 mEq/L
Sodium  ≤120 mEq/dL  ≥160 mEq/dL
Urea nitrogen (BUN) : for dialysis patients:  -----  -----  ≥80 mg/dL   ≥100 mg/dL
WBC (blood)   ≤1,000 /mm3  ≥50,000 /mm3

Therapeutic Drug Levels

Acetaminophen  -----  >150 mcg/mL
Amikacin  -----

 Peak:  >35.0 mcg/mL

 Trough: >8.0 mcg/mL

Carbamazepine  -----  >15.0 mcg/mL
Cyclosporin  -----  >400 ng/mL
Digoxin  -----  >2.1 ng/mL
Dilantin  -----  >20.0 mcg/mL
Everolimus  >15 ng/mL
Gentamicin  -----  Peak:  >12.0 mcg/mL

 Trough:  >2.0 mcg/mL

Lithium  -----  >1.5 mEq/L
Pentobarbital  >5 mcg/dL
Phenobarbital  -----  >50 mcg/mL
Salicylate  -----  >30 mg/dL
Sirolimus  -----  >25 ng/mL: Liver Transplantation

 >15 ng/mL: Renal Transplantation

Tacrolimus (FK506)  -----  >20 ng/mL
Theophylline  -----  >20.0 mcg/mL
Tobramycin  -----  Peak:  >12.0 mcg/mL

 Trough: >2.0 mcg/mL

Valproic acid  -----  >120 mcg/mL
Vancomycin  -----  Peak: >60.0 mcg/mL

 Trough: >20.0 mcg/mL


Critical Values for Transfusion Medicine

Notification of the following outcomes are documented according to Blood Bank policy and held on file in the Blood Bank.

  1. Incompatible crossmatch on issued unit (emergency release)
  2. Positive Transfusion Reaction work-up results

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