RESULT VALUES HANDLED AS CRITICAL
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Absolute Neutrophil Count
See table below for BMTU and AIOC Inpatient exceptions.
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<1.0 x 109/L
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Acetaminophen
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>40 ug/mL
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AFB Culture or Smear, Cerebrospinal Fluid
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Positive
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Amikacin trough
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>10 ug/mL
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Antibody, red blood cell, unexpected and clinically significant, STAT and surgical blood transfusions
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Positive
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Antithrombin III Activity
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<20 U/dL
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APTT
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>119.9 seconds
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Bleeding Time
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>15 minutes
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Blood Culture
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Positive
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Blood culture, blood product associated with transfusion reaction
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Positive
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Blood parasites (Malaria, Babesia, Microfilaria, Trypanosomes, etc.)
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Positive
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Caffeine
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>50 ug/mL
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Calcium
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<6.0 mg/dL
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>12.0 mg/dL
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Carbamazepine
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>15 ug/mL
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Carboxyhemoglobin
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>12
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CO2
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<10 mmol/L
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>39 mmol/L
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Coagulation Factor Activities ( II, V, VII, VIII, IX, X, XI, XII and vWF)
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<20 U/dL
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Cryptococcal Antigen
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Positive
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Culture, following sources:
- Any source (Acanthamoeba, Naegleria, Balamuthia, Nocardia, partial acid fast organisms only)
- Blood
- CSF
- Eye (Gram negative rod only)
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Positive
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Cyclosporine
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>500 ng/mL
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Digoxin
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>3.0 ng/mL
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Ethanol
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>400 mg/dL
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Ethylene glycol
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>3 mg/dL
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Factor Inhibitors
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>0.5 U/mL
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Fibrinogen
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<100 mg/dL
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Gentamicin trough
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>2.0 ug/mL
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Glucose
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<41 mg/dL
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>499 mg/dL
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Gram Stain, following sources:
- Body fluids (ascites, CSF, paracentesis, peritoneal)
- Tissues (brain, epidural, eye, heart)
- Specimens submitted from Surgery
- Blood products associated with transfusion reaction
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Positive
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Hematocrit
See table below for BMTU and AIOC Inpatient exceptions.
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<24 %
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>60%
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Hemoglobin
See table below for BMTU and AIOC Inpatient exceptions.
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<8 gm/dL
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>20 gm/dL
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Hemoglobin, plasma
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>9.9 mg/dL
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Heparin Associated Platelet Antibodies
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Positive
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Heparin Level
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>1.2 U/mL
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INR
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>6
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Ionized Calcium
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<0.76 mmol/L
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>1.65 mmol/L
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Isopropanol
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Any
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Ketones (infants under 6 months old)
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3+
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Lidocaine
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>7.0 ug/mL
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Lithium
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> 1.5 mmol/dL
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Low Molecular Weight (LMW) Heparin Level
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>1.5 U/mL
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Magnesium
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<1.1 mEq/L
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>4.9 mEq/L
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Methanol
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Any
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Methemoglobin
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>3
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Methotrexate
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24 Hour: >5 μmol/L
48 hour: >1 μmol/L
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pCO2
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<21 mmHg
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>69 mmHg
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Pentobarbital
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>30 ug/mL
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PH, Arterial
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<7.201
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>7.599
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Phenobarbital
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>50 ug/mL
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Phenytoin
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>30 ug/mL
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Phenytoin, Free
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>4.0%
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Phosphorus
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<1.1 mg/dL
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Plasminogen
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<20 U/dL (>6 months)
<10 U/dL (0-6 months)
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Platelets
See table below for BMTU and AIOC Inpatient exceptions.
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<50 x 109/L
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>1,000 x 109/L
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PO2, Arterial
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<40
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Potassium
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<2.6 mmol/L
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>6.3 mmol/L
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Protein C Activity
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<20 ug/dL (>4 years)
<10 ug/dL (0-4 years)
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Protein C Clot
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<20 ug/dL (>4 years)
<10 ug/dL (0-4 years)
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Protein S Clot
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<20 ug/dL (>6 months)
<10 ug/dL (0-6 months)
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Protein S Free
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<20 ug/dL (>6 months)
<10 ug/dL (0-6 months)
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Protein S Total
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<20 ug/dL (>6 months)
<10 ug/dL (0-6 months)
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Reducing Substances (infants under 6 months old)
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Positive
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Salicylate
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>40 mg/dL
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Sodium
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<121 mmol/L
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>159 mmol/L
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Tacrolimus
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>25 ng/mL
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Theophylline
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>30 ug/mL
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Thiocyanate
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>100 ug/mL
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Tobramycin trough
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>2.0 ug/mL
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Transfusion reaction investigation, hemolytic
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Positive
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Triglycerides
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>1499 mg/dL
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Valproic Acid
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>150 ug/mL
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Vancomycin peak
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>80 ug/mL
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Viral culture, source: CSF, brain
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Positive
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Viral culture for HSV, source: Blood, BAL, tissue other than skin
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Positive
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Viral culture for HSV, CMV or VZV, source: Eye
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Positive
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WBC
See table below for BMTU and AIOC Inpatient exceptions.
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<1.5 x 109/L
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>30 x 109/L
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Hematology Alert Values - AIOC and BMTU Inpatient Units
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If value is…
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CHECK BEFORE CALLING
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ALWAYS CALL
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WBC
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Absolute Neutrophil Count (ANC)
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Platelets (PLT)
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Hemoglobin (Hgb)
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Hematocrit (Hct)
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less than
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1.5 x 109/L
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1.0 x 109/L
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25 x 109/L
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7 gm/dL
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21%
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greater than
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30 x 109/L
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600 x109/L
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20 gm/dL
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60%
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►WBC and ANC results are called when:
1. It is the first time the alert value is detected on the patient.
2. The patient has not had a similar alert value within the previous 24 hours.
3. The test was not ordered in the previous 24 hours.
4. Previous result within 24 hours was not an alert value. (The patient's result has changed from an alert value to a non‑alert value, then back to an alert value.)
►PLT, Hgb, HCT are ALWAYS CALLED regardless if there was a previous critical result.
- D-dimer (Outpatients only; excludes patients in Emergency Department) ≥ 500 ng FEU/mL
- INR 4.0 - 5.9
- Positive AFB smears
- Positive AFB cultures other than M. gordonae
- Positive Coccidioides immitis, Blastomyces dermatidis, or Histoplasma capsulatum DNA probes
- Positive cultures for bacteria and fungus from body fluids and tissues (normally sterile sites)
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