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Mohammad A. Alfuhaily, PhD د. محمد عبدالمحسن الفحيلي

Associate Professor

College of Applied Medical Sciences, Department of Clinical Laboratory Sciences

كلية العلوم الطبية التطبيقية
Building 24, Office 2299
مدونة

Critical Values: What Are They and Why Do They Exist?

Also known as "panic" values, these are laboratory results that require prompt response by alert lab professionals as they reflect possible life-threateneing conditions, or may progress to irreversible ailments to vital organs. If you get one of these, don't even wait for the lab director to authorize it. Just look up the requesting physician (available on the test requisition form), pick up the phone, and call them ASAP.

It is important to note that cut-off values may differ from one lab to another, and even select tests as well. Here are the essential ones:

Test

Critical Value(s)

Rationale

Glucose

< 40 mg/dl

Hypoglycemic cerebral coma

> 500 mg/dl

Diabetic dehydration and hyperosmolar coma; Diabetic cerebral coma

Bilirubin (Total)

> 15 mg/dl (1st week of life)

Hepatic impairment

Excessive hemolysis

> 20 mg/dl (1st month of life)

Calcium

< 5 mg/dl

Rickets and seizures

> 13 mg/dl

Renal stones and failure

Failure to thrive

Muscle weakness

Potassium

< 2.5 mg/dl

Heart failure

Muscle weakness

> 6.5 mg/dl

Heart failure

Respiratory failure

Paralysis

Muscle weakness

Sodium

< 120 mmol/L

Cerebral edema and death

> 160 mmol/L

Seizures and comatose

Magnesium

> 2.2 mmol/L

Paralysis

Comatose

Hypotension

Cardiac arrhythmias Cardiorespiratory arrest

< 1.3 mmol/L

Paralysis

Seizures

Cardiac arrhythmia

Bicarbonate

< 10 mmol/L

 Coma and death

Troponin

> 0.1 ng/ml

Myocardial infarction (heart attack)

pH

< 7.2

Coma and death

> 7.6

Seizures

Paralysis

Cardiac arrhythmia

Coma