Critical Values and Ref Ranges

Obtained from Weber State Canvas

Chemistry Critical Values

Must be personally reported to the patient’s health care provider

Serum or plasma glucose (children and adults)

>40 mg dL brain damage <450 mg/dL diabetic coma

Plasma glucose (newborn to 6 weeks)

>30 mg/dL brain damage <300 mg/dL diabetic coma

Serum total bilirubin (newborn to 6 months) (know this one)

<20 mg/dL may require emergency exchange transfusion

serum or plasma potassium (children and adults)

>3 mMol/L tetany, cardiac fibrillation <6.1 mMol/L arrhythmia, cardiac failure, evaluate for hemolysis

serum or plasma potassium (newborn)

>3 mMol/L tetany, cardiac fibrillation <6.6 mMol/L arrhythmias, cardiac failure, evaluate for hemolysis

serum or plasma sodium

> 120 mMol/L vascular collapse, heart failure <170 mMol/L severe hypretenstion, stroke, heart failure

serum bicarbonate or total CO2

>10mMol/L severe metabolic acidosis <55mMol/L severe metabolic alkalosis

blood pH

>7.20 severe acidosis <7.60 severe alkalosis

serum or plasma calcium (total)

>6.0 mg/dL tetany convulsions (check for wrong anticoagulants) <13.0mg/dL coma

serum or plasma inorganic phosphorus

>1.0 mg/dL acidosis, seizures

serum or plasma magnesium

>1.0 mg/dL tetany, convulsions (check for wrong anticoags) <9.0 mg/dL coma (evaluate for hemolysis)

gloves and plasma magnesium

contamination from powdered gloves (talcum powder is Mg++ and/or Ca++ stearate) will cause drastic elevations in Ca and/or Mg

serum or plasma lithium

<1.5mMol/L coma

fasting blood glucose (FBS)

serum 70-110mg/dL CSF 40-70 mg/dL or 2/3 of the blood level

High A1-C

4.0-7%

OGTT (adult 75g load)

Fasting 70-110 1/2-1 hr >170, 2 hr >110 3-5 hr fasting level mg/dL

serum osmolality

289-308 mOsm/Kg

24 hr urine osmolality

300-900 mOsm/Kg

urine/serum osmolality ratio

random 1-3, 12 hr fluid restriction >3.0

bilirubin (adults)

total 0.2 to 1.0 mg/dL directL 0.0 to 0.4 mg/dL

bilirubin (newborn) (Nbili= all indirect bilirubin)

cord blood below 4.5 mg/dL, 3 day below 7 mg/dL, 5 day below 12 mg/dL, 7 day below 7 mg/dL

plasma sodium (mEq/L = mMol/L)

adult 136-146 mMol/L

potassium (mEq/L = mMol/L)

adult 3.5 - 5.1 mMol/L, newborn 3.7-5,9 mMol/L

chloride (mEq/L = mMol/L)

serum 98-106 mMol/L sweat up to 35 mMol/L

Total CO2 (mEq/L = mMol/L)

venous 23-30, arterial 22-29, capillary 22-29 mMol/L

Bicarbonate (mEq/L = mMol/L)

venous 22-29, arterial 21-28, capillary 21-28 mMol/L

plasma lactic acid (lactate)

0.5-1.9 mMol/L

Blood pH

venous 7.32-7.42, arterial 7.35-7.45, capillary 7.35-7.45

Anion Gap

7-16 mMol/L, method Na-(Cl+Bicarb)

Serum Ca2+ (adults)

total 8.4-10.2 mg/dL (2.1-2.6 mMol/L), ionized 1.11-1.3 mMol/L

serum inorganic phosphorus

adults 1.6-2.3 mg/dL, children 4.5-6.5 mg/dL

sreum magnesium

1.6-2.3 mg/dL (0.65-1.05 mMol/L)

serum Fe

males 50-170 ug/dL, females 30-160 ug/dL