panic value

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panic value

Alert value, critical value Lab medicine Lab results from a specimen that must be reported immediately to a clinician–ie, of such severity as to mandate urgent therapy. See Decision levels.
Panic values
Chemistry panic values
Analyte SI units US units
Calcium < 1.65 mmol/L  <  6.6 mg/dl
    > 2.22 mmol/L    > 12.9 mg/dl
Glucose  < 2.60 mmol/L  < 46 mg/dl
       > 26.9 mmol/L    > 484 mg/dl
K+  <  2.8 mmol/L  <  2.8 mEq/L
     >  6.2 mmol/L  >  6.2 mEq/L
    >  8.0 mmol/L if hemolyzed
Na+    < 120 mmol/L   < 120 mEq/L
       > 158 mmol/L   > 158 mEq/L
CO2 in plasma <  11 mmol/L  <  11 mMol
   >  40 mmol/L  >  40 mMol
Hematology, eg blasts or sickle cells on a peripheral smear, possibly indicating leukemia or sickle cell anemia
Microbiology, eg positive gram stain or culture from blood, serosal fluids or CSF, acid-fast stain or positive mycobacterial culture results
Transfusion medicine Incompatible cross-match and positive serology for VDRL; the panic values differ in each lab and the route of the communication is at the discretion
of the lab director

panic value

A laboratory test result so far outside the normal range that it requires immediate notification of a health care provider.
References in periodicals archive ?
According to the requirements of the Administrative Department and clinical needs, through detailed research, demonstration and preliminary design, [sup][6] the hospital established the group of panic values management, drafted rules and regulations as well as work programs and the specific implementation measures for panic value management, and carried out training and education program for staffs to ensure the work moving on smoothly.
Today, highly automated labs process hundreds of samples a day, as medical laboratory scientists sort "panic values" from routine results.
Since Lundberg's first description of so-called panic values (1), a variety of other terms have appeared in the literature, for example: urgent, critical, acute, alert, emergent, abnormal, markedly or significantly abnormal, clinically significant, vital, red-orange-yellow zone values, and various combinations thereof.
Procedure for prompt reporting of panic values from lab and radiology
Some mobile devices are able to receive alerts that may be used to automate critical results or panic values. In surgical pathology and cytology, it may be possible to use such systems to notify clinicians of important diagnoses that should not be overlooked.
For example, "calibrate the Acme hematology analyzer," "perform an infant heel capillary puncture for bilirubin," or "explain the importance of medical ethics as it relates to lab testing." Note the lack of ambiguity in these expectations; well-written learning objectives simply describe what is expected of a trainee; they do not describe a trainer's behavior--like "teach capillary puncture," "give out the panic values for electrolytes"--teaching activities should not be part of learning objectives.
Features include remote monitoring of real-time system performance, automated calibration and quality control, continual monitoring of onboard inventory, customizable QC and calibration auto-acceptance parameters, autoverification of results performed according to user-programmable rules, automatic repeat of panic values, and an onboard help system.
In spite of a long history of reporting panic values and the incorporation of critical values into multiple regulations, there is little standardization of procedures.
Readers here in the US may have a problem as all values are in SI units, so we have to use a conversion table and calculate the panic values, which might make the American laboratorian panic!
George Lundberg's 1972 innovative article on panic values (critical values) first appeared in MLO.
The staff must be trained, the procedure(s) must be written, and the information for the new test (e.g., billing, reference ranges, and panic values) usually must be entered into the LIS (laboratory information system).
* Lab panic values (with panic value notification log)