Critical / Panic Value Policy

Critical/Panic values are defined as values that are outside the normal range to a degree
that may constitute an immediate health risk to the individual or require immediate action
on the part of the ordering physician. It is the policy of the clinical laboratory to call the
critical values listed to a licensed provider as soon as completed and verified in
compliance with hospital policies approved by the Lucile Packard Children's Hospital
and Stanford Health Care hospital boards of directors. Read back of the critical values by
the person receiving them to the person making the notification call is required.

Chemistry
ANALYTE

AGE RANGE

CRITICAL VALUE UNITS

Anion Gap

Any age

>30

mmol/L

Bicarbonate (Whole Blood)

Any age

<10
>40

mEq/L

Calcium *

Any age

<6.5
>13

mg/dL

Chloride

Any age

<80
>120

mmol/L

CO2

Any age

<10
>40

mmol/L

CO Hemoglobin

Any age

>20

Free (ionized) Calcium *

Any age

<0.8
>1.6

mmol/L

Glucose

0-2 days
>2 days & <1 year
>1 year

<35
<40
<55

mg/dL

Glucose

<30 days
>30 days & <17 yrs
>17 yrs

>200
>300
>450

mg/dL

Any age

<40
>300

mg/dL

Glucose;
PXP Glucose meter (POCT)

ANALYTE

AGE RANGE

CRITICAL VALUE UNITS

Iron, Serum

Any age

350

ug/dL

Magnesium

Any age

<1.0
>3.5

mg/dL

pCO2

Any age

>65

mmHg

pH

Any age

<7.20
>7.60

pH units

<3 years of age

3-12 years of age
>12 years of age

2.5
2.0
1.5

mg/dL

Any age

<50

mmHg

Less than 1 week

Older than 1 week
Any age

<2.5
<3.0
>6.0

mmol/L

Potassium;
ISTAT (POCT)

Any age

<3.0
>6.0

mmol/L

Sodium

Any age
Any age

<125
>160

mmol/L

TCO (Whole Blood)

Any age

<10
>40

mEq/L

<1 day
>1 day <2 days
>2 days <30 days

8
13
15

mg/dL

Troponin I

Any age

0.3

ng/mL

Troponin I:
ISTAT (POCT)

Any age

0.1

ng/mL

Phosphorus
pO2 (arterial)
Potassium

Total Bilirubin

* Calcium: mmol/L (SI unit) = 0.25 (conversion factor) x mg/dL (conventional unit).

COAGULATION

ANALYTE

AGE RANGE CRITICAL VALUE UNITS

Fibrinogen

Any age

<100

mg/dL

Heparin, unfractionated

Any age

<0.1
>0.7

IU/mL
IU/mL

PTT

Any age

100

sec

PT INR

Any age

>5.0 INR

PT INR;
ISTAT (POCT)

Any age

>4.5

HEMATOLOGY
ANALYTE AGE RANGE

CRITICAL VALUE

UNITS

Any age

0.5 (Outpatient only)

K/L

Cell Count,
Any body fluid

Any age

Intracellular organisms. (Non CSF- Blasts and

Tumor cells to be called as soon as a provider is
available, which for inpatients is immediate, for
others called next business day.)

Cell Count,
CSF only

Any age

WBC Count >30

(excluding peripheral blood contamination)

Cell Count,
CSF only

Any age

Blasts or Tumor Cells

Gram Stain

Any age

Positive

N/A

Hematocrit
(PCV)

Any age

21.0
65.0

Hemoglobin

Any age

7.0

g/dL

Malaria
Screening

Any age

Positive

N/A

Absolute
Neutrophil
Count

/L

ANALYTE AGE RANGE

CRITICAL VALUE

UNITS

/L

Platelet Count

Any age

10,000
50,000 (L&D, OB outpatient clinics, and
Perinatal Diagnostic Center only)
100,000 with 2+microangiopathic changes

Slide
Review/Diff

Any age

Presence of intracellular organisms.

Blasts on peripheral smear (1st time or relapse
only).

Sperm

N/A

Sperm or Trichomonas
Trichomonas

N/A

0.5 (Outpatient only)

50

K/L

Male/Female
<18 Years
Female <18
Years

Stool

Urinalysis

WBC

Male <18
Years
Any age

MICROBIOLOGY

ANALYTE

AGE
RANGE

CRITICAL VALUE

UNITS

Presence of potential B. anthracis or

any BT agent.
Bacillus anthracis
(Category A)
Any assay: Potential
Bioterrorism Agent

Any age

Francisella tularensis
(Category A)

N/A

Yersinia pestis
(Category A)
Brucella species
(Category B)
Blood Culture

Any age

Any clinically important positive

result per protocol

N/A

ANALYTE
Mycobacterium Tuberculosis
PCR Test

AGE
RANGE

CRITICAL VALUE

UNITS

Any age

Positive on Tissue or Culture

N/A

Positive Shiga toxin producing E.

Coli
Stool culture

<18 years

N/A

VIROLOGY
AGE
RANGE

CRITICAL VALUE

UNITS

Antigen test, culture,

serology, or molecular
test

Any age

Positive or suspicious for any Pandemic

(Influenza or SARS) or Bioterrorism Agents
(Smallpox, Viral hemorrhagic fever agents

N/A

Any CSF Assay

Any age

Positive (including virus growth or molecular

test)

ANALYTE