Except those on renal wards or under renal consultants.
eGFR
Adults: 15
-
ml/min
AKI
-
3
Not CKD patients
Glucose
2.5
25
mmol/L
Calcium adjusted
1.8
3.5
mmol/L
Magnesium
0.4
-
mmol/L
Phosphate
0.3
-
mmol/L
AST
-
600
U/L
ALT
-
600
U/L
Total CK
-
5000
U/L
Amylase
-
500
U/L
Digoxin
-
2.5
ng/mL
Theophylline
-
25
mg/L
Phenytoin
-
25
mg/L
Lithium
-
1.5
mmol/L
Troponin I
-
16 (female or unknown)
34 (male)
ng/L
GP only
Ammonia
-
100
umol/L
Ethanol
-
Paediatrics only: any detectable
mg/L
Paediatrics only
Paracetamol
-
10
mg/L
Not ED patients
Salicylate
-
300
mg/L
Not ED patients
Conj bilirubin (DBIL)
-
Paediatrics only:
25
umol/L
Paediatrics only
Total bilirubin
-
Paediatrics only: 225
umol/L
Paediatrics only
Carbamazepine
-
25
ug /mL
Iron
-
ED only: 70
umol/L
ED only
Phenobarbitone
-
70
mg/L
CSF Gluc
3.3
-
mmol/L
CSF Prot
-
0.45
g/L
Lactate
-
2.3
CRP
-
300
Total bile acids
-
20
Methotrexate
Phone all
umol/L
Haematology
Haemoglobin
White 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
Platelets
Clotting 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.
Immunology
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)
HPA Microbiology
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
The laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital form part of the services provided by University Hospitals Birmingham and are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/
Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217
United Kingdom Health Security Agency laboratory is a UKAS accredited medical laboratory No.8213
Tests not appearing on the UKAS Schedule of Accreditation 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.
Protection of personal information - Laboratory Medicine comply with the Trust Data Protection policy and have procedures in place to allow the Directorate and its employees to comply with the Data Protection act 1998 and associated best practice and guidance.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235