Panic & Critical Result Reporting

Panic Definition

Panic values include test results considered life-threatening and may require immediate intervention by the healthcare provider. CLIA §493.1291(g) regulation requires laboratories to “immediately alert the individual or entity requesting the test and, if applicable, the individual responsible for using the test results when any test result indicates an imminently life-threatening condition, or panic or alert values.”

 

Panic Results Notification

    • Panic results are called to the ordering provider or designee, day or night, as soon as they are available and are viewable immediately in LabCheck under the Message Center Criticals and Panics or under Reports then select Critical.
    • During regular daytime hours, panic results are phoned directly to your dialysis facility.
    • After hours, results are phoned to the managing physician or designee.
    • Both require reliable 24-hour contact information from your facility.

 

Default Panic Values (See Table A)

Unless you instruct us otherwise, Ascend Clinical uses the panic values listed in the table that follows titled Ascend Clinical Default Panic Values.

 

Making Changes – Panic Notification Form (PNF)

You may request additional tests, individualized exception values, change default values or update contact information using the Panic Notification Form available in the forms section of the Reference Manual. All changes or additions must be approved by your Medical Director or designee and our Quality Assurance department. We will notify you when the PNF has been denied, approved and/or implemented.

 

Critical Definition

Critical values include medically important abnormal test results not regarded as imminently life-threatening but that may require possible intervention prior to your routine laboratory report review.

 

Critical Results Notification

    • Critical results are not called to your facility.
    • They are posted in LabCheck under the Message Center Criticals and Panics or under Reports then select Critical.

 

ASCEND CLINICAL DEFAULT PANIC VALUES (TABLE A)

Test

Unit of Measure

Low ≤

High ≥

Aluminum

(ug/L)

60

Calcium, Total

(mg/dL)

14.1

Calcium, Adjusted Total

(mg/dL)

14.1

Carbamazepine, Total

(mg/L)

20.0

Culture, Blood

Positive

Culture, Effluent

Positive

Culture, Fungal

Positive

Cyclosporin, as Trough

(ng/mL)

600

Digoxin

(ng/mL)

2.6

Glucose

(mg/dL)

39

601

Hemoglobin

(g/dL)

6.0

Lithium

(mEq/L)

2.0

Phenobarbital

(mg/L)

60.0

Phenytoin (Dilantin), Free

(mg/L)

3.1

Phenytoin (Dilantin), Total

(ug/mL)

40.1

Phosphorus

(mg/dL)

0.9

Platelet Count

(K/uL)

20

1000

Potassium

(mEq/L)

2.4

7.1

Potassium, Post

(mEq/L)

2.4

5.5

PT INR

 ratio

7

Sirolimus (Rapamycin)

(ug/L)

2.9

Sodium

(mEq/L)

119

161

Tacrolimus (FK506)

(ng/mL)

2.9

Theophylline

(mg/L )

40.0

Valproic Acid

(mg/L)

150

WBC

(K/uL)

1.9

20.1