Biochemistry Critical Ranges

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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