Protocols can be downloaded from here
- Created on .
- Last updated on .
Protocols can be downloaded from here
Pathology Phone Limits
Phoning and Critical Limits
Below Above Units Sodium 120 150 mmol/L Potassium 3 6.5 mmol/L Urea 30 mmol/L Creatinine 500 umol/L Glucose 2.5 20 mmol/L Calcium adjusted 1.8 3.5 mmol/L Magnesium 0.4 mmol/L Phosphate 0.3 mmol/L AST 700 U/L ALT 400 U/L Total CK 500 U/L Amylase 600 U/L TBA 20 umol/L Iron 70 umol/L Total bilirubin 225 umol/L Carbamazepine 25 ug /mL Digoxin 2.5 ng/mL Theophylline 45 mg/L Phenytoin 20 mg/L Phenobarbitone 70 mg/L Lithium <0.2 >1.5 mmol/L Valproate 100 mg/L Cyclosporin A 200 ug/L CRP 300 mg/L Salicylate 50 mg/L Paracetamol 10 mg/L Ammonia All phoned Lactate All phoned
HaemoglobinWhite Blood Cell Count <8.0 g/dl normochromic and normocytic Low result – neutropenia <0.5 x 10 9/L <7.0 g/dl microcytic and hypochromic High result – White cell count >40 x 10 9/L <7.0 g/dl macrocytic or Lymph count > 20 x 10 9/L <5.0 g/dl renal patients Any presence of blast cells PlateletsClotting Studies Lower limit - <70 x 10 9/L INR - >5.0 Upper limit - >1000 x 10 9/L PTT - >180 seconds Fibrinogen < 1.0g/l All Positive Malaria Screens All Anti FXa results >1.20 iu/ml If the patient is known to the department and has had a similar result within the previous 7 days then the urgent contact is not necessary.
CD4 count <200 cells/cumm or <10% on new patients (paediatric levels are different, but agreed with Paed consultants) Lymphocyte subsets in infants <2yo: Any T cell subset below age-related normal range, any other abnormality suggesting SCID (e.g. MHC class II deficiency). (Note this is not exclusive: any abnormality may be discussed with requesting clinician) New positive GBM antibodiest New positive MPO antibodies New positive PR3 antibodies New paraprotein IgG , A or M > 20g/L IgD or IgE (any size) serum monoclonal free light chains (any size, whether or not with intact paraprotein)
Bacteriology Gram stain results of positive blood culture on Day 1 Positive CSF results Positive sterile site results Significant in-patient results from enteric bench Multi resistant gram negative and gram positive isolates including mupirocin resistant MRSA Group B streptococcal isolates from neonates Group A in patient isolates Positive Legionella urinary antigen and Pneumococcal urine antigen results Smear and culture positive Mycobacteria Antibiotic assay results outside normal ranges Any other significant results at the discretion of Medical Microbiologists Virology Serological evidence of acute infection with Hep A, Hep B and in pregnant patients CMV, Parvovirus and Rubella New diagnoses of HIV VZV IgG negative from exposed patients at risk of severe VZV infection New diagnosis of Hep B, Hep C and HIV in haemodialysis patients Evidence of Hep B/Hep C and HIV in needle stick injury source patients Clinically important positive respiratory PCR results i.e.: influenza, RSV in immunocompromised patients Positive PCR results in outbreaks Positive blood PCR for CMV and Adenovirus Negative blood results for CMV PCR Significant blood PCR results for EBV and Polyomavirus All positive PCR results on CSF specimens All positive Chlamydia PCR results on eye swabs All positive PCR results from neonatal unit
To assess prednisolone metabolism in steroid dependent asthmatics
Small group of asthmatics remain symptomatic despite long term treatment with oral corticosteroids “prednisolone”, with major implication in terms of steroid induced side effects. The cause of this lack of effect could be due to poor adherence, malabsorption, rapid metabolism or genetically mediated resistance to steroids. The aim of this test is to assess the cause of the apparent lack of responsiveness to steroids in a patient.
Copyright heftpathology 2013, 2014, 2015, 2016, 2017, 2018
HTA licence number is 12366
Protection of Personal Information – Laboratory Medicine comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.
The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database http://www.heftpathology.com/frontpage/test-database.html.
Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235