Laboratory Form PH Critical Values

Transcription

1 Laboratory Form PH Critical Values Associated Policy: Laboratory General Policy Effective Date: Review Date: RESPONSIBLE POSITIONS: 1. Laboratory Workforce 2. Palmetto Health Providers LABORATORY ADDRESSES: Palmetto Health Richland 5 Richland Medical Park Drive Columbia, SC Palmetto Health Baptist Parkridge 400 Palmetto Health Parkway Columbia, SC Palmetto Health Baptist Taylor at Marion Street Columbia, SC Palmetto Health Tuomey 129 North Washington Stress Sumter, SC Chemistry and Immunoassay Less Than/Equal To Greater Than/Equal To Ammonia: 0-17 Yrs. NA 109 umol/l >/= 18 Yrs. NA 200 umol/l Bilirubin, Total: 0-1 Day: NA 6.0 mg/dl 1-3 Days: NA 15.0 mg/dl 3-30 Days: NA 18.0 mg/dl >=1 Mos: NA 15.1 mg/dl Calcium, Total 6.0 mg/dl 13.0 mg/dl Calcium, Ionized 0.78 mmol/l 1.58 mmol/l CO2 >/= 1 mos. 10 mmol/l 40 mmol/l <1 month 10 mmol/l NA Creatinine >/=19 Yr. NA 15.0 mg/dl 0-18 Yr. NA 4.0 mg/dl Bilirubin, Direct NA 9.0 mg/dl Glucose 0-60 days 40 mg/dl 201 mg/dl 61 days- 17 Yr. 40 mg/dl 400 mg/dl >/=18 Yr. 40 mg/dl 501 mg/dl Glucose, Post Prandial 0-60 days 40 mg/dl 201 mg/dl 61 days- 17 Yr. 40 mg/dl 400 mg/dl >/=18 Yr. 40 mg/dl 501 mg/dl Page 1 of 51

2 Laboratory Form PH Critical Values Chemistry and Immunoassay Less Than/Equal To Greater Than/Equal To Lactic Acid NA 5.0 mmol/l Magnesium Male >/= 18 Yr. 1.0 mg/dl 6.0 mg/dl Male 0-17 Yr. 1.0 mg/dl 5.0 mg/dl Female >/= 18 Yr. 1.0 mg/dl 7.0 mg/dl Female 0-17 Yr. 1.0 mg/dl 5.0 mg/dl Osmolality (Serum) 240 mosm/kg 350 mosm/kg Phosphorus: 1.2 mg/dl 8.9 mg/dl Potassium: 0-5 mos. 2.5 mmol/l 7.0 mmol/l >/= 6 mos. 2.5 mmol/l 6.5 mmol/l Procalcitonin 0 ng/ml 2 ng/ml Sodium: 0-30 Days 125 mmol/l 150 mmol/l 31 Days - 12 years 125 mmol/l 160 mmol/l >/=13 years 120 mmol/l 160 mmol/l Troponin 0.30 ng/ml Uric Acid 12.1 mg/dl Chemistry Therapeutic Drugs Greater Than/Equal To Acetaminophen 151 ug/ml Alcohol 300 mg/dl Amikacin Peak 40.1 ug/ml Amikacin Trough >/=3 months 10.1 ug.ml 0-2months 7.00 ug/ml Carbamazepine(Tegretol) 15.1 ug/ml Cyclosporine 500 ng/ml Dilantin, Total 30.1 ug/ml Dilantin, Free 4.1 ug/ml Digoxin 2.01 ng/ml Gentamicin Peak 12.1 ug/ml Gentamicin Trough >18 years 2.1 ug/ml 3m-18yrs 2.5 ug/ml 0-2 months 1.2 ug/ml Lithium 1.6 mmol/l Phenobarbital 41 ug/ml Salicylate 41 mg/ml Tacrolimus 25.0 ng/ml Theophylline 25.1 ug/ml Tobramycin Peak 15.1 ug/ml Page 2 of 51

3 Laboratory Form PH Critical Values Chemistry Therapeutic Drugs Greater Than/Equal To Tobramycin Trough 0-2 Mos. 1.2 ug/ml 3 Mos.-17 Yrs. 2.5 ug/ml Valproic Acid 201 ug/ml Vancomycin Trough 0-18 years 25.0 ug/ml >18 years 40.1 ug/ml Vancomycin Peak 70.1 ug/ml Coagulation Less Than/Equal To Greater Than/Equal To Antithrombin III 50% NA Fibrinogen 100 mg/dl NA INR NA 4 PT NA 200 PTT NA seconds Flow Cytometry Fetal Hgb Flow Marker 0.30% Hematology Less Than/Equal To Greater Than/Equal To Hemoglobin (0-1 mos) 9.6 g/dl NA (>1 mos) 5.5 g/dl NA Hematocrit (0-3 mos) 25% 65% (> 3 mos) 18% 60.00% WBC (0-3 mos) 2.0 K/uL 50.1 K/uL (> 3 mos) 1.0 K/uL 75.0 K/uL Platelet Count (0-2 mos) 50 K/uL 1,000 K/uL (> 2 mos) 20 K/uL 1,000 K/uL Page 3 of 51

4 Laboratory Form PH Critical Values Immunology Bacterial Antigen Detection, Rapid Test for: Legionella urinary antigen Streptococcus pneumonia antigen Cryptococcal Antigen (CSF or Serum) Heparin Induced Platelet Antibody HIV, Rapid test Microbiology Carbapenemase Isolates C difficile toxin A/B Cultures from: Tissue Samples from OR to include bone and cornea samples Blood Cultures Stool for Parasites Cultures for : Acid Fast Bacteria (AFB) Bordetella Haemophilus influenzae (Invasive) Listeria Neisseria gonorrheae Neisseria meningitidis Streptococcus pneumoniae (Invasive) Salmonella Shigella Campylobacter E coli 0157:H7 India Ink Prep Smears for: Acid Fast Bacteria (AFB) Smears from: CSF Blood Body Cavity Tissue Samples from OR (to include bone and cornea samples Page 4 of 51

5 Laboratory Form PH Critical Values Molecular Pathology Bordetella pertussis DNA Parasitology Malaria Smears Pathologic parasites from O&P exam Present Reference Lab Western Blot Other Reference Lab Critical value results as determined by the reference lab will be called by the reference lab to the Palmetto Richland Lab. Palmetto Richland Lab will then call the panic value result per lab policy. Page 5 of 51

6 Associated PGR: RESPONSIBLE POSITIONS: Laboratory Workforce Palmetto Health Providers Laboratory Form PH Reference and Therapeutic Range Summary Associated Policy: Laboratory General Policy Effective Date: Review Date: LABORATORY ADDRESSES: Palmetto Health Richland Central Laboratory 14 Richland Medical Park Drive Columbia, SC Palmetto Health Baptist Laboratory Taylor at Marion Street Columbia, SC Palmetto Health Richland Rapid Laboratory 5 Richland Medical Park Drive Columbia, SC Palmetto Health Baptist Parkridge Laboratory 400 Palmetto Health Parkway Columbia, SC Palmetto Health Tuomey 129 North Washington Stress Sumter, SC Acetaminophen (Therapeutic) ug/ml Acetone Activated Protein C Resistance >1.84 Adenovirus Rapid Albumin g/dl 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years Years - 61 Years >=61 Years Page 6 of 51

7 Albumin Body Fluid The separation of ascitic fluids into transudates or exudates has been superseded by the division of ascitic fluids into high-gradient or low-gradient fluids as determined by the serum-ascities albumin gradient "calculated as (serum albumin) - (ascitic fluid albumin). The gradient is a reflection of the hydrostatic pressure in the portal circulation. Gradients >/=1.1 are considered high. Specimens of serum and fluid should be drawn the same day. High Values may be seen in: Cirrhosis, Fulminant hepatic failure, Fatty liver, Alcoholic hepatitis, Portal vein thrombosis, Ven-occlusice disease; Low Values may be seen in Peritoneal arcinomatosis, Tuberculosis, Pancreatic, Connective tissue disease, Nephrotic syndrome, Biliary (without cirrhosis). Pleural Fluid: Serum Albumin Level - Pleural Fluid Albumin Level </=1.2 is predictive of an exudate. Alcohol (ETOH) mg/dl <30 Alcohol (ETOH) g%: 0-21 Years SC Legal limit <0.019 >21 Years SC Legal limit <0.079 Alkaline Phosphatase U/L 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/= 21 Years Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/= 21 Years Page 7 of 51

8 Alpha 1 Antitrypsin mg/dl Alpha Fetoprotein Tumor Marker ng/ml <8.79 ALT (SGPT) U/L 0 Days - 1 Year Year - 6 Years Years - 11 Years 9-69 >/= 11 Years <55 0 Days - 1 Year Year - 6 Years Years - 11 Years <37 >/= 11 Years <55 Amikacin Level ug/ml Therapeutic Trough 0 Minutes - 3 Months </= Months - 18 Years </= 10.0 >/= 18 Years </=8.0 Therapeutic Peak 0 Minutes - 18 Years >/=18 Years Random Apply to nomogram. Please contact pharmacy with questions. Ammonia, Plasma umol/l Amylase U/L 0 Minutes - 28 Days Days - 71 Years >/= 71 Years Urine Random </=650 Urine Timed U/24 Hours Page 8 of 51

9 Body Fluid Peritoneal: Elevated at very high concentrations in pancreatitis. At least several-fold times higher in fluid of pancreatic origin compared to simultaneous values in serum, even in cases of acute pancreatitis. Elevated in pancreatic injury. Pleural Fluid: May be high due to contamination with salivary secretions and food in suspected esophageal rupture. Anion Gap 5-15 Anti-Nuclear (ANA) Antibody Anti-Nuclear (ANA) Antibody Profile: Sjogrens (SSA) Antibody AU/mL <99 Sjogrens (SSB) Antibody AU/mL <99 Smith Antibody AU/mL <99 Ribonucleic Protein (RNP) Antibody <99 AU/mL Scleroderma (Scl-70) Antibody AU/mL <99 Jo-1 Antibody AU/mL <99 Double-Stranded DNA (dsdna) Antibody <99 IU/mL Centromere Antibody AU/mL <99 Histone Antibody AU/mL <99 < Equivocal >120 Anti-Streptolysin O (ASO) U/mL: 0 Minutes - 4 Days </=99 4 Days - 18 Years </=250 >/= 18 Years </=199 Anti-Thrombin III Assay (ATIII) % APT Fetal Hemoglobin Absent AST (SGOT) U/L 5-34 Barbiturates, Urine Qualitative Beta-Hydroxybutyric Acid mmol/l Bilirubin, Total mg/dl Page 9 of 51

10 0 Minutes - 24 Hours </= Hours - 2 Days </= Days - 5 Days </= Days - 8 Days </= Days - 6 Years Years - 15 Years Years - 21 Years >/=21 Years Minutes - 24 Hours </= Hours - 2 Days </= Days - 5 Days </= Days - 8 Days </= Days - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/=21 Years Body Fluid Peritoneal: Leakage from biliary ducts should result in fluid levels of bilirubin several -fold higher in the fluid than in serum from the patient. High Bilirubin concentration is presumptive evidence for bile leakage Cord Blood <2.0 Bilirubin, Direct mg/dl 0 Day - 1 Month </= Month - 1 Year </= Year - 11 Years </= Years - 15 Years </= Years - 21 Years </= 0.7 >/=21 Years </= Day - 1 Month </= Month - 1 Year </= Year - 11 Years </= 0.4 >/= 11 Years </= 0.5 Bilirubin Indirect: </= 0.7 Blood Culture ID by PCR Not Detected Page 10 of 51

11 BNP (Natriuretic Peptide) pg/ml: 0 Days - 11 Months <24 1 Year - 5 Years <30 6 Years - 10 Years <15 11 Years - 14 Years <21 15 Years - 20 Years <20 >/=21 Years <100 Bordetella pertussis DNA Borrelia burgdorferi Ab (Lyme) < 0.90 Buprenorphine, Urine Qualitative BUN (Blood Urea Nitrogen) mg/dl 0 Minutes - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years Years - 50 Years 9-21 >/= 50 Years Minutes - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years Years - 50 Years 7-19 >/= 50 Years CA 15-3 Level U/mL < 31.4 CA 125 Level U/mL < 35.1 Calcium mg/dl 0 Days - 1 Year Year - 11 Years Years - 21 Years Years - 60 Years >/= 60 Years Page 11 of 51

12 0 Days - 1 Year Year - 11 Years Years - 21 Years >/21 Years Urine Random No Reference Ranges Established Urine Timed mg/24 Hour: CA Free Diet 5-40 Low to Average Intake Average (800 mg/day) Intake Calcium/Creatinine Ratio, Urine No Reference Ranges Established Calcium, Ionized mmol/l (includes pre and post filter) 0-1 Months Months-6 Months >/=7 Months Carbamazepine (Tegretol) Therapeutic ug/ml Carcinoembryonic Antigen (CEA) ng/ml </= 5.0 Cardiolipin Antibody IgG GPL Cardiolipin Antibody IgM MPL CD4 Level/ T&B Cell Enumeration Panel (CD3, CD4, CD8, CD19, CD16/56) / T Helper/Suppressor, Whole Blood(CD3, CD4, CD8) CD3 WB %: 0-3 Months Months Months - 1 Yr Years Years Years Years >/= 18 Years CD3 WB Cells/uL: 0-3 Months Months Page 12 of 51

13 6 Months - 1 Yr Years Years Years Years >/= 18 Years CD4 T Helper WB %: 0-3 Months Months Months - 1 Yr Years Years Years Years >/= 18 Years CD4 WB Cells/uL: 0-3 Months Months Months - 1 Yr Years Years Years Years >/= 18 Years CD8 TSuppr WB %: 0-3 Months Months Months - 1 Yr Years Years Years >/= 18 Years CD8 WB Cells/uL: 0-3 Months Months Months - 1 Yr Years Years Years Years >/= 18 Years CD16/56 NK Cells WB %: 0-3 Months 4-18 Page 13 of 51

14 3-6 Months Months - 2 Yr Years Years 3-22 >/= 18 Years CD16/56 WB Cells/uL: 0-3 Months Months Months - 1 Yr Years Years Years Years >/= 18 Years CD19 TSuppr WB %: 0-3 Months Months Months - 1 Yr Years Years Years Years 6-23 >/= 18 Years CD19 WB Cells/uL: 0-3 Months Months Months - 1 Yr Years Years Years Years >/= 18 Years Cell Count, CSF: Nucleated Cells /ul 0-12 Months Years Years 0-10 >/= 12 Years 0-8 RBC /ul 0-1 Chloride mmol/l: 0 Minutes - 30 Days Page 14 of 51

15 >/= 30 Days Urine Random No Reference Ranges Established Urine Timed mmol/24 Hours: 0 Days - 28 Days No Reference Ranges Established 28 Days - 2 Years Years - 18 Years Varies greatly with intake >/= 18 Years Chloride, Sweat mmol/l 0-6 Months Months-150 Years 0-40 Infants up to and including 6 months of age: >/=60 Indicative of CF Individuals older than 6 months of age: >/=60 Indicative of CF Note: Sweat chloride values <30 have been documented in genetically proven CF patients. Clinical correlation is necessary. Cholesterol mg/dl 0 Days - 12 Months Year - 2 Years Years - 22 Years <170 >/=22 Years <200 0 Days - 12 Months Year - 2 Years Years - 22 Years <170 >/=22 Years <200 Non-HDL Cholesterol, Calculated mg/dl Ages 2 Years - 22 Years Acceptable <120 Borderline High >/=145 Ages >/= 22 Years The goal for Non-HDL Cholesterol in persons with high serum triglycerides can be set at 30 higher than that for LDL Cholesterol. For example, if the LDL Cholesterol target goal is less than 100, the corresponding Non-HDL Cholesterol target goal would be less than 130. Page 15 of 51

16 HDL mg/dl 0 Days - 1 Year Year - 2 Years Years - 22 Years Acceptable >45 Borderline >/= 22 Years >/=60 0 Days - 1 Year Year - 2 Years Years - 22 Years Acceptable >45 Borderline >/= 22 Years >/=60 LDL mg/dl: 0 Days - 1 Year Year - 2 Years Years - 22 Years < 109 >/=22 Years < 99 Acceptable <110 Optimal <100 Near or Above optimal VLDL mg/dl 0-40 Cancer Antigen 125 (CA125) U/mL </= 35.0 Cancer Antigen 15-3 (CA 15-3) </= 31.3 CKMB ng/ml: Female </= 3.4 Male </= 7.2 Clostridium Difficile Toxin B gene by PCR CO2 mmol/l: 0 Days - 12 Months Year - 6 Years Years - 11 Years Years - 14 Years Years - 20 Years Years - 61 Years >/= 61 Years Complement, C-3 mg/dl 0 Days - 2 Months Page 16 of 51

17 2 Months - 3 Months Months - 4 Months Months - 5 Months Months - 6 Months Months - 7 Months Months - 10 Months Months - 1 Year Year - 15 Years Years - 80 Years >/= 80 Years Days - 2 Months Months - 3 Months Months - 4 Months Months - 5 Months Months - 6 Months Months - 7 Months Months - 10 Months Months - 1 Year Year - 15 Years Years - 80 Years >/= 80 Years Complement, C-4: 0 Days - 2 Months Months - 3 Months Months - 4 Months Months - 5 Months Months - 6 Months Months - 7 Months Months - 10 Months Months - 1 Year Year - 15 Years Years - 80 Years >/= 80 Years Complete Blood Count (CBC): WBC K/uL 0-15 Days Days Months Page 17 of 51

18 2-3 Months Months Months Years Years Years >18 Years Female 0-15 Days Days Months Months Months Months Years Years Years >18 Years RBC M/uL 0-15 Days Days Months Months Months Years Years Years >18 Years Female 0-15 Days Days Months Months Months Years Years Years >18 Years HGB 0-15 Days Days Page 18 of 51

19 1-2 Months Months Months Years Years Years >18 Years Days Days Months Months Months-6 Years Years Years >18 Years HCT % 0-15 Days Days Months Months Months Months Years Years Years >18 Years Days Days Months Months Months Months Years Years Years >18 Years MCV fl 0-15 Days Days Page 19 of 51

20 1-2 Months Months Months Years Years Years >18 Years Days Days Months Months Months Years Years Years >18 Years MCH pg 0-15 Days Days Months Months Months Years Years Years >18 Years Days Days Months Months Months Years Years Years >18 Years MCHC g/dl 0-15 Days Days Months Page 20 of 51

21 2-6 Months Months Years Years Years >18 Years Days Days Months Months Months Years Years >18 Years RDW-CV % 0-15 Days Days Months Months Months Years Years Years >18 Years Days Days Months Months Months Years Years Years >18 Years MPV fl 0-15 Days Days Months Months Months Page 21 of 51

22 2-6 Years Years Years >18 Years Days Days Months Months Months Years Years Years >18 Years Platelet Count K/uL Differential White Count (Manual): Polys %: 0-1 Months Months Years Years >17 Years Lymphocytes %: 0-1 Months Months Years Years >17 Years Monocytes %: 0-1 Months 0-20 >1 Months 0-10 Bands %: 0-1 Months Months 0-13 >2 Years 0-10 Eosinophils %: 0-6 Basophils %: 0-2 Differential White Count (Automated): Neutrophils %: 0-1 Months Months Page 22 of 51

23 2-9 Years Years >18Years Lymphocytes %: 0-1 Months Months Years Years >18Years Monocytes %: 0-1 Months Months 4-13 Differential White Count (Absolutes): K/uL Absolute Neutrophils Absolute Lymphocytes Absolute Monocytes Absolute Eosinophils Absolute Basophils Immature Granulocytes Absolute Neutrophils Absolute Lymphocytes Absolute Monocytes Absolute Eosinophils Absolute Basophils Immature Granulocytes Cortisol ug/dl 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/=21 Years AM (Before 10 am) >/=21 Years PM (After 10 am) Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Page 23 of 51

24 15 Years - 21 Years >/=21 Years AM (Before 10 am) >/=21 Years PM (After 10 am) C-Peptide ng/ml Creatine Phosphokinase (CPK) U/L Male Female Creatinine mg/dl 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/= 21 Years Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/= 21 Years Body Fluid Urine, Random Urine, Timed (based on a daily urine output of 1.5 L) Male Female Pleural and Peritoneal: Urine extravasation will usually present as a transudate with a high concentration of creatinine and urea and a low concentration of glucose and ph. Peritoneal Fluid creatinine concentration will be markedly elevated ( ), with the creatinine to serum creatinine greater than 1.0. In the situation in which fluid aspiration inadvertently consists of urine from the bladder, the urea to creatinine ratio should be much higher than for peritoneal fluid from which urea is more readily absorbed than creatinine. Leakage of urine should be suspected when the fluid has a high creatinine concentration relative to that in serum from a simultaneously collected blood specimen. No established Reference Range Page 24 of 51

25 Urine,Timed mg/24 Hours: Male Female Creatinine Clearance ml/min per 1.73 m2: Male Female C-Reactive Protein, Inflammation mg/l: 0 Days - 12 Months Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/= 21 Years </= 5.0 C-Reactive Protein, High Sensitivity mg/l Low Risk <1.0 Average Risk High Risk >3.0 Cryptococcal Antigen, Blood/CSF Cryptosporidium Stain Cyclic Citrullinated Peptide (CCP) Ab EliA U/mL Absent < 7.0 Cyclosporine ng/ml Therapeutic ranges are poorly defined. They are related to clinical protocol, the organ transplanted, time following transplantation, organ function, and coadministration of other drugs. Ranges are also method and specimen dependent. Cytomegalovirus (CMV) IgG U/mL < 0.60 Cytomegalovirus (CMV) IgM AU/mL < D-Dimer ug/ml (FEU) < 0.5 DHEA Sulfate ug/dl 0 Days - 12 Months </= Page 25 of 51

26 1 Year - 6 Years </= Years - 11 Years </= Years - 15 Years Years - 21 Years Years - 25 Years Years - 35 Years Years - 45 Years Years - 55 Years Years - 65 Years Years - 70 Years >/=70 Years Days - 12 Months </= Year - 6 Years </= Years - 11 Years </= Years - 15 Years Years - 21 Years Years - 25 Years Years - 35 Years Years - 45 Years Years - 55 Years Years - 65 Years Years - 70 Years >/=70 Years Digoxin Therapeutic Range ng/ml Dilantin (Phenytoin) Therapeutic Range: Total ug/ml Free ug/ml Free % Drugs of Abuse Screen, Urine Amphetamines, Qual Benzodiazepines, Qual Cannabinoids, Qual Cocaine Metabolites, Qual Opiates, Qual Methadone, Qual Oxycodone, Qual Ecstasy (MDMA), Qual Drug Scr Creatinine Urine Male Page 26 of 51

27 Female DRVV (Dilute Russell Viper Venom) No evidence of phospholipid inhibitor EBV VCA (Epstein Barr Virus) IgG U/mL <18.00 Absence of detectable EBV-VCA IgG antibodies Equivocal Repeat testing in days may be helpful. >/=22.00 Presence of detectable EBV-VCA IgG antibodies. A positive result indicates current or past exposure to Epstein- Barr virus. EBV VCA (Epstein Barr Virus) IgM U/mL < Absence of detectable EBV-VCA IgM antibodies. Equivocal Repeat testing in days may be helpful >/=44.00 Presence of detectable EBV-VCA IgM antibodies. Specific IgM antibodies are usually detected in patients with recent primary infection and may be found in patients with reactivated infections. Electrophoresis, Hemoglobin: % Hgb A Hgb A Hgb F by age: % Hgb F 0-1 Month Months Months Months-1 Year Years >/= 18 Years <0.5 Page 27 of 51

28 Electrophoresis, Protein Urine: Albumin Alpha 1 Alpha 2 Beta Gamma Not Detected Not Detected Not Detected Not Detected Not Detected Electrophoresis, Protein Serum : Albumin Alpha Alpha Beta Gamma Albumin/Globulin Estradiol pg/ml: Males: 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/= 21 Years Females: 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/= 21 Years: Follicular Phase Mid-Cycle Luteal Post Menopausal not on HRT < Post Menopausal on HRT < Factor II,V,VII,VIII, IX, X, XI,XII %: Factor V Leiden Mutation Page 28 of 51

29 Factor XIII clot present Normal clot stable for >24 hours. Dissolution of clot in 24 hours indicates marked deficiency of Factor XIII (<5% activity). Fat, Fecal (Qualitative) Fecal Lactoferrin Small amount of neutral fat is normal Ferritin ng/ml: Male and 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years Male >/=21 Years Female >/=21 Years Fetal Fibronectin Fetal Hgb Flow Marker % < 0 Fibrinogen mg/dl Fibrin Split Products (FSP) ug/ml < 4 Folate ng/ml FSH miu/ml: Males: 0 Days - 1 Year </= Year - 6 Years </= Years - 11 Years </= Years - 15 Years Years - 21 Years >/= 21 Years Females: 0 Days - 1 Year Year - 6 Years Years - 11 Years </= 4.62 Page 29 of 51

30 11 Years - 15 Years Years - 21 Years Normally Menstruating Females: Follicular Phase Mid-Cycle Luteal Post Menopausal GC and Chlamydia DNA by PCR GC DNA by PCR Chlamydia DNA by PCR Gentamicin ug/ml: Therapeutic Trough: 0-3 Months <1.1 3 Months - 18 Years <2.1 >/= 18 Years <2.0 Therapeutic Peak: 0-18 Years >/=18 Years >5.0 Random Apply to nomogram. Please contact pharmacy with questions. GFR/ GFRA (African American) ml/min/1.73 sq meter >60 GGT (Gamma Glutamyltransferase) U/L Male Female 9-36 GI Panel by PCR Cryptosporidium Ag/ Giardia Ag Not Detected Gliadin Ab, IgA u/ml < Equivocal >10.0 Gliadin Ab, IgG u/ml < Equivocal >10.0 Page 30 of 51

31 Glomerular Basement Membrane Antibody (GBM) 0-99 AU/mL < Equivocal >120 Glucose mg/dl 0-30 day >31 day Impaired Fasting Random CSF Body Fluid Pleural Fluid: <60 is suggestive of an empyema or parapneumonic effusion. Synovial Fluid Reference Range: Plasma-synovial fluid difference </= Abnormal: Serum-synovial fluid difference or more. NOTE: Postprandial equilibrium between plasma and synovial fluid may require several hours. At equilibrium, the synovial fluid glucose level is normally 10 or less than the plasma level. In general, noninflammatory and hemorrhagic joint disorders have synovial fluid glucose levels or less, respectively, than the simultaneously measured plasma levels. Inflammatory disorders are 0-40 below the plasma level, while infectious and crystal-induced are and 0-80 less than the plasma level, respectively. Gestational Screen 1 Hour >/=140 Post Prandial: Non-Pregnant Adults with Diabetes <180 More or less stringent glycemic goals may be appropriate for individual patients. Gestational Diabetes Screen For values >/= 140 the American Diabetes Association (ADA) recommends a 100g Oral Glucose Tolerance Test. Page 31 of 51

32 Glucose Tolerance, Gestational: Fasting Glucose: 95 1 Hour Glucose: Hour Glucose Hour Glucose 140 The diagnosis of Gestational Diabetes Mellitus is made if at least two of the following four plasma glucose levels are met or exceeded: Glucose Tolerance: Fasting Normal Impaired >/=126 Provisional Diagnosis of Diabetes 2 Hour Glucose Normal Impaired 3 Hour Glucose 4 Hour Glucose 5 Hour Glucose >/= 200 Provisional Diagnosis of Diabetes No Reference Ranges per ADA guidelines No Reference Ranges per ADA guidelines No Reference Ranges per ADA guidelines Group B Strep by Rapid PCR H Pylori biopsy screen Haptoglobin mg/dl 0 Days - 12 Months <223 1 Year - 5 Years <244 6 Years - 10 Years < Years - 14 Years < Years - 20 Years < Years - 60 Years Male Years - 60 Years Female >/=61 Years Male >/=61 Years Female HCGQ (Beta HCG) Quantitative miu/ml: Non-pregnant Female <5 Weeks Post Last Menstrual Period: 1-10 < , , , ,860-50, ,583-49,413 Hemoglobin A1C % Page 32 of 51

33 0-18 years >/=19 years Estimated Glucose Average: Refer to Glucose Hepatitis A IgG Antibody Hepatitis A Antibody IgM Hepatitis B Surface Antigen Hepatitis B Antibody IgG Hepatitis Core IgM Hepatitis Core Total Ab Hepatitis C RNA by PCR, Quant HIV, Rapid Exposure w/reflex HIV 1/2 Ab Confirm May be Reactive with Past Infection or Vaccination Non Reactive Non Reactive May be Reactive with Past Infection or Vaccination Non Reactive Non Reactive Not Detected Non Reactive HIV, Ag w/hiv1 & 2 Antibodies Non Reactive Homocysteine umol/l Male Female HSV DNA by PCR Not Detected Herpes Simplex Type 1 IgG < 1.0 Herpes Simplex Type 2 IgG < 0.90 Immunoglobulin A (IgA): 0 Minutes - 2 Months Months - 12 Months Year - 11 Years Years - 59 Years >/= 60 Years Minutes - 2 Months Months - 12 Months 8-91 Page 33 of 51

34 1 Year - 11 Years Years - 59 Years >/= 60 Years Immunoglobulin E Total ku/l: 0 Months - 6 Months < 14 6 Months - 1 Year < 35 1 Year - 3 Years < 98 3 Years - 4 Years < Years - 7 Years < Years - 9 Years < Years - 13 Years < Years - 16 Years < Years - 18 Years < 538 >/= 18 Years < 215 Individual Allergy Levels ku/l: Normal For Specialists use only Low Moderate High Very High Peanut Components Allergy Levels ku/l: (Ara h1, Ara h2, Ara h3, Ara h8, Ara h9) < 0.10: No significant level : Clinical relevance undetermined : Indicative of ongoing sensitization : Indicative of stronger ongoing : Indicative of high level sensitization >17.50: Indicative of very high level sensitization Any detectable level (>/= 0.1) of Specific IgE for Peanut Components may be significant. Ara h 1, 2, 3, and 9 are the peanut proteins most linked to systemic allergic reactions, including anaphylaxis. If any one of these four components is positive, the patient has a high risk of systemic allergic reaction when exposed to peanuts, regardless of the whole peanut allergen result. Reactivity to Ara h 8 and non-reactivity to Ara h 1,2,3, and 9 indicates a lower risk of a systemic allergic reaction. Consider additional testing. Immunoglobulin G (IgG) mg/dl: 0 Minutes - 30 Days Month - 11 Months Months - 23 Months >/= 2 Years Minutes - 30 Days Page 34 of 51

35 1 Month - 11 Months Months - 23 Months >/= 2 Years Immunoglobulin M (IgM) mg/dl: 0 Days - 3 Months Months - 23 Months Year - 11 Years >/= 12 Years Days - 3 Months Months - 23 Months Year - 11 Years >/= 12 Years India Ink Prep Insulin, Fasting uu/ml Iron ug/dl: Male and 0 Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >/=21 Years >/=21 Years Iron Binding Capacity (TIBC) ug/dl LAP (Leukocyte Alkaline Phosphatase) Lactic Acid, Plasma mmol/l: Plasma CSF Lactate Dehydrogenase (LDH) U/L: Serum Page 35 of 51

36 Body Fluid Ratio of Pleural Fluid LDH to a simultaneously collected Serum Protein >0.6 is predictive of an exudate. Synovial Fluid: Studies indicate that LDH levels correspond to moderate disease activity. Levels 750 indicate high inflammatory activity. Lamellar Bodies: K/uL Mature Lung >/= 60 Transitional Lung Immature Lung 0-14 Legionella Antigen, Urine Luteinizing Hormone (LH) miu/ml: 0 Days - 12 Months < Year - 5 Years < Years - 10 Years < Years - 14 Years < Years - 20 Years < Normally Menstruating Females: Follicular Phase Mid-Cycle Peak Luteal Cycle Postmenopausal without Hormone Therapy 0 Days - 12 Months < Year - 5 Years < Years - 10 Years < Years - 14 Years < Years - 20 Years <4.94 >/= 21 Years Lipase U/L: 0 Days - 11 Months < 42 1 Year - 5 Years Years - 10 Years Years - 20 Years < 44 >/= 21 Years 8-78 Lipid Laden Macrophage Page 36 of 51

37 Lithium Therapeutic Range mmol/l Acute Mania: Maintenance: Low Molecular Weight Heparin IU/mL Low therapeutic High therapeutic Magnesium mg/dl: 0 Days - 11 Months Year - 5 Years Years - 10 Years Years - 20 Years >/= 21 Years Urine, Random No Reference Range Urine, Timed mg/24 hr Meningitis/Encephalitis Panel by PCR, CSF Not Detected Microalbumin,Urine mg/dl: Random <1.9 Timed mg/min <20 Timed mg/24hr <30 Microalbumin/Urine Creatinine Ratio mg/g <30 Monotest MPO/PR-3 (ANCA) Antibodies AU/mL Myeloperoxidase Antibody 0-99 Serine Protease 3 Antibody 0-99 Mumps IgG <9.00 No current or previous infection. Such individuals are presumed to be susceptible to primary infection. Page 37 of 51

38 Equivocal Should be tested by an alternate serologic procedure. Additionally, specimen which remain equivocal after repeat testing should be reevaluated by drawing another sample one to three weeks later. >/=11.00 A positive test result indicates a current or previous infection and is consistent with immunity. Mycobacterium Tuberculosis by PCR Mycoplasma Pneumoniae Not Detected Myeloperoxidase Antibody AU/mL 0-99 Neisseria Gonorrhea Nitrites, Urine Occult Blood, Fecal Fecal Gastric/Vomitus Osmolality: mosm/kgh20 Blood Urine Depending on fluid intake Average fluid intake: After 12 Hr fluid restriction: > 850 P2Y12 Platelet Function Parasitemia % 0 Parathyroid Hormone, Intact pg/ml PCR, Rapid MRSA Phencyclidine (PCP), Urine Qualitative Page 38 of 51

39 Phenobarbital Therapeutic Range ug/ml ph: Urine Gastric <4.0 Phosphorus mg/dl 0 Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >/= 21 Years Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >/= 21 Years Pinworm Prep/Exam Platelet Function Screen: Col/Epi Col/ADP Not Present <194 sec <103 sec Potassium (K+) mmol/l: Serum: 0 Days - 27 Days Days - 23 Months Years - 17 Years >/= 18 Years Plasma: Male Female Urine, Random Urine, Timed mmol/24 hrs No Reference Ranges Established Prealbumin mg/dl Page 39 of 51

40 0 Days - 1 Year < Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years < Years - 60 Years > 60 Years Days - 1 Year < Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years < Years - 60 Years > 60 Years Procalcitonin mg/ml </= 0.1 Progesterone ng/ml: Male < 0.3 Normal Menstruating Females: Follicular Phase: < 0.4 Luteal Phase: Postmenopausal Females: < 0.3 Pregnant Females: First Trimester: Second Trimester: Third Trimester: Prolactin ng/ml: 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 20 Years > 20 Years Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 20 Years Page 40 of 51

41 > 20 Years Protein C Activity % Protein S Activity % Protein, Total g/dl: Serum: 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years Years - 60 Years > 60 Years Body Fluid Pleural and Pericardial: Transudate effusions have a low concentration of Total Protein. Exudate effusions have a high concentration of Total Protein. Serous fluid Total Protein values >/=3.0 separate exudates from transudates. A ratio of serous fluid total protein to a simultaneously collected serum protein of >/=0.5 is predictive of an exudate. CSF: 0 Days - 30 Days >/= 1 Month Urine, Random < 15 Urine, Timed mg/24hr < 300 At rest Protein/Creatinine Ratio, Urine mg/g < 200 Prothrombin Time (PTINR) Seconds PT Mixing Study No Inhibitor Detected PTT Seconds PTT Mixing Study No Inhibitor Detected PSA (Prostate Specific Antigen): Total ng/ml </= 4.00 Free ng/ml > 2.50 PSA, Free % </= 26.0 Page 41 of 51

42 Rapid Influenzae A & B Antigen Screen Rapid Strep Grp A Screen Respiratory Panel by PCR Not Detected Reticulocyte Count (Automated) Retic % Male and 0-4 Days Days Days Days-6 Months Months-2 Years Years Years Years >/=18Years Retic Absolute M/uL Male and 0-4 Days Days Days Days-6 Months Months-2 Years Years Years Years >/=18Years >/=18Years Immature Retic Fraction (IRF) % Minutes-6 Months Months-2 Years Years-6 Years Years-12 Years Years-18 Years >/=18 Years Minutes-6 Months Months-2 Years Years-6 Years Years-12 Years Page 42 of 51

43 12 Years-18 Years >/=18 Years Rheumatoid Factor IU/mL <30 RPR Serological Test for Syphilis RSV antigen Nonreactive Rubeola IgG < 25 No current or previous infection. Such individuals are presumed to be susceptible to primary infection. Equivocal Should be tested by an alternate serologic procedure. Additionally specimens which remain equivocal after repeat testing should be reevaluated by drawing another sample one to three weeks later. > 30 A positive test result indicates a current or previous infection and is consistent with immunity. Salicylate, Therapeutic Range Sedimentation Rate (ESR) mm/hr: (Palmetto Health Richland Rapid Care, Palmetto Health Baptist and Palmetto Health Baptist Parkridge) Male 0-50 Years Years Years 0-30 Female 0-50 Years Years Years 0-42 Page 43 of 51

44 Sedimentation Rate (ESR) mm/hr: (Palmetto Health Central Laboratory): 0-1 Years Years Years 0-15 >/=50 Years Years Years Years 0-20 >/=50 Years 0-30 Semen Analysis: ph > 7.2 Volume ml Count million/ml Viscosity Normal-High Normal Liquefaction Motility Complete 50% or more motile with forward progression within 60 minutes of ejaculation. Sex Hormone Binding nmol/l: Male Female Sodium mmol/l; 0 Days - 27 Days Days - 23 Months Years - 17 Years >/=18 Years Urine, Random No Reference Ranges Urine, Timed mmol/24 Hours: 6 Years - 9 Years Years - 13 Years >/=14 Years Years - 9 Years Years - 13 Years >/=14 Years Special Fungal/ Pneumocystis Stain Page 44 of 51

45 Specific Gravity, Urine Strep Pneumoniae Antigen, Urine / CSF Tacrolimus(FK506) ng/ml Whole Blood Trough: Adult Heart Transplant 1 to 3 Months Adult Heart Transplant >/=4 Months 5-15 Adult Kidney Transplant In combination with Azathioprine: Months 1 to Months 4 to In combination with mycophenolate mofetil/il-2 receptor antagonist (e.g. daclizumab) 1 to 12 Months 4-11 Tacrolimus ER (Astagraf XL) with basiliximab induction: Month 1: 7-15 Months 2 to > 6 Months 5-10 Tacrolimus ER (Astagraf XL) without induction: Month Months 2 to Months > Liver Transplant (Pediatric and Adult) Months 1 to T3, Free pg/ml: 0 Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >/=21 Years Days - 11 Months Page 45 of 51

46 1 Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >/=21 Years T3, Total ng/dl: 0 Days - 12 Months Days - 12 Months Male and 1 Year - 6 Years Years - 11 Years Years - 15 Years Years - 21 Years >/=21 Years T4, Total ug/dl T4, Free (Free Thyroxine/FT4) ng/dl 0 Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >=21 Years Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >=21 Years Tegretol (Carbamazepine) Therapeutic Range ug/ml 4-12 Testosterone ng/dl: 21 Years - 49 Years >/= 50 Years T-Helper Lymphocytes Absolute Cells/uL Page 46 of 51

47 0-3 Months Months Months Months Years Years Years >18 Years Theophylline ug/ml Therapeutic Range 5-20 Thrombin Clot Time Seconds 0-21 Thyroglobulin Antibody IU/mL < 4.1 Thyroperoxidase Antibody U/mL < 5.6 Tobramycin ug/ml: Therapeutic Through: 0-2 Months <1.1 3 Months.-17 Years <2.1 >/=18 Years <2.0 Therapeutic Peak: 0-17 Years ug/ml >/=18 Years >5 ug/ml Random Apply to nomogram. Please contact pharmacy with questions. Toxoplasma IgG IU/mL < 7.20 Transferrin mg/dl: 0 Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years Years - 59 Years Years - 80 Years Days - 11 Months Year - 5 Years Years - 10 Years Page 47 of 51

48 11 Years - 14 Years Years - 20 Years Years - 59 Years Years - 80 Years Transferrin Saturation %: Male Female Treponema Ab < 0.90 Triglycerides: 0 Days - 11 Months Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years >/=21 Years Normal < 150 Borderline High High Very High >/= 500 Troponin ng/ml <0.03 TSH (Thyroid Stimulating Hormone) Male 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years > 15 Years Female 0 Days - 1 Year Year - 6 Years Years - 11 Years Years - 15 Years > 15 Years Unfractionated Heparin Anti-Xa IU/mL Therapeutic Range Urea Nitrogen, Blood (BUN) mg/dl: Page 48 of 51

49 Male and 0 Days - 11 Month Year - 5 Years Years - 10 Years Years - 14 Years Years - 20 Years Years - 49 Years 9-21 >/=50 Years Years - 14 Years Years - 20 Years Years - 49 Years 7-19 >/=50 Years Body Fluid Pleural and Peritoneal: Urine extravasation will usually present as a transudate with a high concentration of creatinine and urea and a low concentration of glucose and ph. Urine, Random: Urine, Timed mg/6hrs No Reference Ranges Established mg/6 Hours; ,000 mg/24 Hours Uric Acid mg/dl: 0 Days 29 Days Days - 3 Months Months - 6 Months Months - 11 Months Months - 23 Months Years - 17 Years >/= 18 Years Days 29 Days Days - 3 Months Months - 6 Months Months - 11 Months Months - 23 Months Years - 17 Years >/= 18 Years Urinalysis w/microscopy: Spec Gravity Page 49 of 51

50 Urine Ph 5-9 Urine Glucose Urine Protein Urine Ketone Urine Bilirubin Urine Blood Urine Nitrite Urine Urob Leuk Esterase Urinalysis Microscopic Exam WBC s: 0-5 /hpf RBC s: 0-3 /hpf Epithelial Cells: 0-7 /lpf Bacteria: None seen Hyaline Casts: 0-5 /lpf Vaginitis Panel by PCR Valproic Acid Therapeutic Range ug/ml Vancomycin ug/ml: Therapeutic Trough Therapeutic Peak Varicella Zoster, IgG < 135 No current or previous infection. Such individuals are presumed to be susceptible to primary infection. Equivocal Should be tested by an alternate serologic procedure. Additionally specimens which remain equivocal after repeat testing should be reevaluated by drawing another sample one to three weeks later. > 165 A positive test result indicates a current or previous infection and is consistent with immunity. Page 50 of 51

51 Varicella Zoster, IgM Equivocal </= No detectable IgM antibodies to VZV. A negative result indicates no active infection with VZV. Should be retested. Specimens that remain in the equivocal range after repeat testing are considered equivocal and should be retested by an alternate method if clinically indicated. >/= 1.10 for IgM antibodies to VZV. Such individuals are presumed to be at risk of transmitting VZV infection. Vitamin B12 pg/ml Vitamin D 25-Hydroxy Level ng/ml vwf Antigen (Factor VIII Related Antigen) >50% Wet Prep None Seen/ Not Present Page 51 of 51