AVERA SACRED HEART HOSPITAL LABORATORY

YANKTON, SOUTH DAKOTA

Policy/Procedure/Test Name
Physician alert values / Page 1 of 1
veloped/Revised By:
Terri Mingo / Date
12/11 / Previous Reviews/Revisions 3/02, 10/04, 11/04, 6/05, 9/05, 8/06, 10/06, 8/07, 9/07, 2/08, 11/08; 3/09;7/09, 1/10, 6/10, 8/10, 10/11;1/11, 8/11;12/11;1/12;3/12
Distribution:
Laboratory / Current Review/Revision Date
6/11/2012
Approved by:
Richard Strom MD / Review/Revised / Review/Revised / Review/Revised / Review/Revised

Patient location:Primary ContactSecondary contactTertiary contact

In House Patient Nursing UnitPhysicianMedical Director

Out Reach (during office hours)Out Reach CenterOrdering ClinicianMedical Director

Out Reach (after office hours)Ordering ClinicianMedical Director

SHH Health ScreenClinician (if listed)Medical Director

The tech performing the test will immediately notify a licensed staff member if any of the following values are obtained. The technologist will document on the LIS report that such a call was made including time, date and name of staff the verbal report was made. (Exception: The HUC in the ICU and ED at SHH may receive the critical value notification.)

HematologyHematocrit ------Adult< 20% or > 55%

Under 2 months> 70%

Hemoglobin ------Adult:< 6.0 gm/dl or > 18.0 gm/dl

Under 6 years< 9.0 gm/dl

Leukocyte Count ------New results< 1,000/mm3 or50,000/mm3

Platelet Count ------New results< 50,000/mm3or 1,000,000/mm3

CoagulationProthrombin – INR ------> 5.0

Partial Thromboplastin Time ------90 seconds

HEP Anti Xa ------>1.0 IU/ml

ChemistryGlucose ------< 50 mg/dl or500 mg/dl

Calcium ------< 6.0 mg/dl or13.0 mg/dl

Magnesium ------< 1.0 mg/dl or3.8 mg/dl

Sodium ------Adult< 120 mmol/L or160 mmol/L

0-18 years< 130 mmol/L or150 mmol/L

Potassium ------Adult< 3.0 mmol/L or6.0 mmol/L

0-1 year< 3.0 mmol/L or> 7.5 mmol/L

Osmolality------< 250 mOsml/kg or 323 mOsml/kg

Bilirubin (total) ------> 12 mg/dl

Carbon Monoxide------> 14 %

ETOH------250mg/dl

TNT (Troponin)------delta flagor> 0.100 ng/mL (1st/series)

Drug screens------any positive result

TDM:

Acetoug/mL / Salic
mg/dL / Limmol/L / Digng/mL / Carbug/mL / Phnoug/mL / Phnyug/mL / Theo
ug/mL / Valp A ug/mL / Gent ug/mL / Tobraug/mL / Vanc
ug/mL / Amik
ug/mL
150 / > 30 / 2.0 / 3.0 / 18.0 / 55.0 / 25.0 / 20.0 / 140 / Tr: 4.0 / Tr: 4.0 / Tr: > 20.0 / Tr: > 10
Peak: > 35

Microbiology:Blood Cultures ------Presence of organism(s) on culture and/or gram stain

Cerebrospinal Fluid------Presence of organism(s) on culture and/or gram stain

Joint Fluid ------Presence of organism(s) on culture and/or gram stain

Stool culture ------Isolation of Salmonella, Shigella, Campylobacter or E. coli 0157:H7 organisms

Methicillin resistant Staph aureus (MRSA) from a hospital or nursing home location

Vancomycin Resistant Enterococcus (VRE)

Acid Fast Bacillus or malaria positive smears

Serology:Influenzae A or B, HIV, E. coli 0157 -any positive results

Urinalysis:Ketosis and/or sugars in urine of the newborn

Blood Bank:Any abnormal antibody identification or problem type and screen or cross match. If compatible red cells cannot be obtained for a bleeding patient.

Corrected Change in blood type, organism or any clinically significant anatomic pathology diagnosis. Any numerical value

Reports: that has changed from a normal to abnormal result or from an abnormal to a normal result.