JOB AID CRITICAL VALUES AND TESTS W/O MICRO CRITICAL TESTS. Always call results for the following test(s):

Transcription

1 Facilities: NoCo Laboratories JOB AID CRITICAL VALUES AND TESTS W/O MICRO CRITICAL TESTS Always call results for the following test(s): CONSTITUENT Ethylene Glycol (Performed at CU) Time Interval (from receipt in Lab to notification) 6 hours

2 CHEMISTRY Units Low High Result Comment Acetaminophen µg/ml >99 Alcohol mg/dl >500 ALT (SGPT) Labor Deck Only IU/L > 100 Labor Deck only AST (SGOT) Labor Deck Only IU/L > 100 Labor Deck only Bilirubin, Neonate (0-31 mg/dl >17.9 days) Bilirubin, Total Labor Deck mg/dl > 3.0 Labor Deck only Only Calcium mg/dl <6.0 >13.0 CO % >5.0% CO2 content mmol/l <10 Digoxin ng/ml >2.3 Dilantin µg/ml >29 Fetal Fibronectin - Call Positives Only Gentamycin, Peak µg/ml >11.9 Gentamycin, Valley µg/ml >3.9 Glucose mg/dl <50 >490 Ionized Calcium mg/dl Lactic Acid mmol/l 4.0 LD - Labor Deck only IU/L > 400 Labor Deck Only Lithium mmol/l >1.5 Magnesium mg/dl <1.0 Magnesium Labor Deck Only mg/dl >10.0 Labor Deck Only pco2 mmhg <20 >70 ph <7.2 >7.6 Phenobarb µg/ml >45 Phosphorus mg/dl <1.2 po2 mmhg <40 Potassium mmol/l <2.5 >5.9 Salicylate mg/dl >30 Sodium mmol/l <120 >155 Tegratol µg/ml >14 Theophylline µg/ml >24 Tobramycin, Peak µg/ml >11.9 Tobramycin, Valley µg/ml >3.9 Troponin ng/ml Valproic Acid 12 yrs & older µg/ml >120 Valproic Acid - under 12 yrs µg/ml >150 Vancomycin, Peak µg/ml >39.9 Vancomycin, Valley µg/ml >25.0

3 HEMATOLOGY Units Low High Result Comment Hct % <18 >70 Hgb g/dl <6.0 >23.0 Platelets Thousand/ <30 >1,000 Platelets Labor Deck only Platelets - Oncology WBC WBC Oncology mm3 Thousand/mm3 Thousand/mm3 Thousand/ mm3 Thousand/ mm3 < 100 Labor Deck only >1,000 <1.5 >50.0 CRNC Critical result not called per department policy CRNC Critical result not called per department policy COAGULATION Units Low High Result Comment AT3 % <50 D-Dimer ug/ml FEU 0.50 Fibrinogen mg/dl <100 PT - INR seconds >5.0 INR PTT seconds >150.0

4 CONSTITUENT Reference Tests RESULTS ACTION Newborn Screen Any abnormal result If still an IP --Call the nursing unit with results. --Result test in the LIS as: REF-;xx/xx/xxxx. Also include the call to/read back information listed in the first section of this procedure. --Make a copy and send to the physician --Scan the results into Quick Chart --File a copy with the send out results in the Customer Service file. --Send the original copy of the results to the nursing unit via the pneumo tube system If discharged --Call the physician on the next business day for their office. --Result test in the LIS as: REF-;xx/xx/xxxx. Also include the call to/read back information listed in the first section of this procedure. --Make a copy of the results and send to the physician --Scan the results into Quick Chart --File a copy with the send out results in the Customer Service file. --Send the original copy of the results to Medical Records

5 CONSTITUENT Transfusion Services Positive antibody screens Antibody problems, which may delay transfusion of compatible blood Blood type correction Corrected result, when the correction is clinically significant ACTION Exception: Outpatient Oncology patients ONLY require positive antibody screen results called for newly identified antibodies. A positive antibody screen due to a known antibody for Outpatient Oncology patients ONLY is not a critical result. Errors that can adversely affect the patient. Technologist informs Medical Director or Pathologist On Call as soon as possible Pathologist calls Physician Incompatible crossmatch, OK to transfuse Technologist informs Medical Director or Pathologist On Call as soon as possible Pathologist calls Physician Positive antibody screen in an Emergency or Type Specific Release Positive Direct Antiglobulin Test on cord blood Positive fetal screens Technologist calls the physician/medical Director or Pathologist on call as soon as possible Technologist calls Nurse in charge of as soon as possible Technologist calls and informs Nurse in charge of patient as soon as possible about a positive FMH and that a Kleihauer Betke will be performed. Transfusion reactions that indicate a clerical error, ABO/Rh discrepancy, positive DAT, hemolysis, or a positive gram stain on blood container. Technologist informs Medical Director or Pathologist On Call as soon as possible Pathologist calls Physician

6 REFERENCES: Terri Yablonsky Stat. Understanding National Safety Goal 2C: Clarity Brings Compliance. Critical Values, Volume 2, Issue 2, January 2009