Critical Values - Mayo Medical Laboratories

7. If this information is not included in the “readback”, specifically request it.
III. Communication and Documentation of Critical Test Results to the ordering provider or designee
A. Every attempt is made to speak to the ordering provider or designee. If the ordering provider is not available the
result may be given to another Physician/PA/APRN or his/her designee.
1. A phone call is immediately placed to the ordering provider for notification. An RN/LPN must communicate the
result directly to the ordering provider or his/her designee.
2. Document the time and the name of the caregiver to whom the result was reported in the patient record.
3. Any telephone orders that result from the report of a critical test result to the Physician/PA/APRN should use the
“readback” verification process.
B. If there is an existing physician order for a protocol (ex. Insulin, Heparin) that provides direction for nursing or
pharmacist intervention in response to a critical result, or treatment has already been initiated by the
Physician/PA/APRN, that action is taken and/or information documented in the patient’s medical record.
IV. Information to be documented includes the:
A. Test name and test value/result
B. Date and time the test result was received
C. Date and time the test result was reported to the ordering provider or his/her designee.
D. Name of the person receiving the results
V. If the critical result reported is part of series (ex. Cardiac enzymes) but is moving toward the reference range, the results
do not need to be reported to the ordering provider.
VI. When lab staff encounter critical ED or inpatient test results that they believe are likely inaccurate (e.g. results are widely
outside of expected from recent previous results; are incompatible with life; or are consistent with contamination from IV
fluids), lab staff will:
A. Automatically initiate a redraw for those tests
B. Notify the patient’s RN that this is being done and instruct the RN to immediately inform the patient’s practitioner:
1. Of the present critical result
2. That those results are suspect (including rationale as to why the results are suspect); and
3. That a redraw will be completed for those tests
C. An exception report will be filed in Meditech documenting the suspect values, verbal read-back notification of the
nurse or physician, and the follow-up action being taken.
Values
TEST Less than Greater than
Alcohol
400 mg/dl
Calcium 6.0 mg/dl 14.0 mg/dl
CO2 10.0 mmol/L 40.0 mmol/L
Carbon Monoxide 10 %
Fibrinogen
80 mg/dl
Glucose 50 mg/dl 400 mg/dl
Hematocrit 21% 60%
Hemoglobin 7.0 gm/dl 20 gm/dl
HIV
New positive results
INR 5.0
Magnesuim 1.0 mg/dl 4.9 mg/dl
Blood Film for Parasites
Any organism seen
Neonatal bilirubin
VARIES BY AGE
Neonatal urine glucose 3+
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