Biochemistry Critical Ranges

GP Patient critical ranges

TEST		ADULT REFERENCE INTERVAL	FAX/EMAIL	FAX/EMAIL & PHONE
Sodium	3511	135 – 145          mmol/L	<130 or >147	<125 or >150
Potassium	3512	3.5 – 5.2           mmol/L	<3.0 or >5.5	<2.8 or >6.2
Urea	3517	3.2 – 7.7           mmol/L	>30 (>10.0 up to age 18) If not previously known.	>45 even if previously known.
Creatinine	5422	Male:         50 – 110 umol/L Female:       45 – 90 umol/L	>300 (>150 up to age 18) - if not previously known. Fax if increase >50 in one week.	>350 (or x3 baseline) >200 up to age 18 Don’t phone if decreasing, or renal patient, or <200 higher than previously.
Urate	3520	Male:     0.20 - 0.42 mmol/L Female: 0.15 - 0.36 mmol/L	>0.70	Phone >0.36 in pregnancy.
Calcium	3521	2.2 – 2.6           mmol/L	<1.90 or >2.80	<1.80 or >3.00
Phosphate	3522	Adult: 0.8 – 1.5  mmol/L	<0.60 or >1.80	<0.5 or >3.0
Glucose	3516	Fasting: 3.5-6.0 mmol/L Random: 3.5-7.7  mmol/L	<3.0	<2.8 >15.0 if new (>25.0 if known diabetic)
Bilirubin	3525	Adult: 2 – 20      umol/L	>300	All neonates (<1 month old)
GGT	3528	Male:             10 – 50 IU/L Female:         10 – 35 IU/L	>2500
Lipase		10 – 70 IU/L	>80
ALP	3527	Adult: 30 –150   IU/L	>2500
ALT	3530	Male:        0 – 40  IU/L Female:    0 – 30  IU/L	>2000	>30 in pregnancy
AST	3529	10 – 50                IU/L	>2000	>50 in pregnancy
Total protein	3523	64 – 83                g/L	<45 or >100
Albumin	3524	35 –50                 g/L	<21
CK	4100	Male:   60 – 220  IU/L Female:30 - 180 IU/L	>2000	>5000
LD	3135	110 – 220          IU/L	>400
Digoxin	3565	0.6 – 2.0           nmol/L	>2.0 if 12 h or later post dose	>3 at any time post dose
Phenytoin	4760	40 – 80             umol/L	>90 (trough)	>100
Carbamazepine	4648	16 – 40              umol/L	>55 (trough)	>70
Valproate	4810	350 - 700          umol/L	>800 (trough)	>1000
Theophylline	4781	55 – 110           umol/L	>110 (trough)	>120
Lithium	4716	0.4 – 0.8           mmol/L	>0.8 if >12hr post dose >1.6 at any time	>2.0 at any time
CRP	3206	<5                      mg/L	>100
hs TnI	8674	Women <16       ng/L Men       <34	All results (should auto-fax)	Women >16 Men >34
HCG	3552	<5                      IU/L	All results (should auto-fax)
Magnesium	3532	0.6 – 1.2            mmol/L	<0.5 or >1.6	<0.4 or >2.5
Iron	3531	10 – 30              umol/L		All ?toxic ingestions
Triglyceride	4151	<1.7                   mmol/L		>20
Cortisol	8621	170 – 540          nmol/L		<100 if taken before 10am and not dexamethasone suppression test
Prot/Creat ratio	993	<23		>30 in pregnancy

Hospital Patients critical ranges

TEST		LOWER LIMIT	UPPER LIMIT
Blood pH	3501	7.00
Sodium	3511	120	155
Potassium	3512	2.8	6.2      (unless haemolysed, or refrigerated in contact with red cells.)
Chloride	3513	80	125
Urea	3517		40.0  if new.  45.0 if already known.
Creatinine	5422		350 (or x3 baseline)  if new
Glucose	3516	2.8  adults/children	35.0
Calcium	3521	1.7	3.0
Magnesium	3532	0.3	1.9
Phosphate	3522	0.30	3.00     ( 4.00  for dialysis patients)
Lactate	5268		7.0
hs TnI	8674		> 34 (men), >16 (women) if Outpatient, GP patient, Napier, Waipukurau , or Wairoa
Cortisol	8621	<50, if not Dexamethasone test, contact Endocrinologist by phone
SBR	3125		250  newborn (<1 day) 350  (>1 day)
Lithium	4716		>2.0  at any time
Digoxin	3565		3.0  if more than 12hr post dose
HCO3	3504	< 16
Gentamicin			>1.5 Email in Delphic (HPHA)
Vancomycin		<10 Email in Delphic (HPHA)	>25 Email in Delphic (HPHA)

*Also known as Panic Ranges

Critical ranges reviewed September 2023