Hunter Area Pathology Service

Haemoglobin

<80g/L – with the exception of Renal patients

White Cell count

< 4.0 x 10⁹ /L or >20.0 x 10⁹ /L on first presentation.

Platelets

< 50 x 10⁹ /L on first presentation

Blood film

All Neutropenia’s on first presentation

Abnormal differentials and films with

• Marked toxic changes
• Neutropenia
• Marked Left Shift
• Platelet Clumps

Coagulation Screen

Prothrombin Time >= 20 seconds

Activated Partial Thromboplastin Time >= 45 seconds

Patient on I.V. Heparin Therapy

APTT result of > 80 seconds

INR result of >= 4.5

Fibrinogen

< 1.0 g/L

Sodium

< 126 mmol /L or > 154 mmol /L

Potassium

< 2.5 mmol /L or > 6.0 mmol /L

(> 6.4 mmol /L for NEW BORN, or PRE-DIALYSIS)

Bicarbonate

< 15 mmol /L or > 40 mmol /L

Creatinine

Serum - increase of 70 umol /L with in 24 hours

Glucose

< 2.5 mmol /L or > 27.5 mmol /L

(< 1.7 mmol /L NEW BORN)

Urate

> 0.40 mmol /L for PREGNANCIES

Ionised Calcium

< 0.90 mmol /L or > 1.34 mmol /L

(> 1.36 mmol /L for Renal Failure)

Calcium

< 1.5 mmol /L or > 3.00 mmol /L

(in the absence of IONISED CALCIUM)

Phospate

<0.50 mmol /L

Neonatal Bilirubin

>300 mmol /L

Lithium

> 1.2 mmol /L

Digoxin

> 3.0 nmol /L

Gentamicin

Where TOXIC

Vancomycin

Where TOXIC

Tobramycin

Where TOXIC

Anticonvulsants

(Phenytoin, Phenobarbitone,

Carbamazepine, Valproate, Primidone)

> Upper Therapeutic Limit

Amikacin

> Upper Therapeutic Limit

Positive sample from a usually sterile site [eg blood cultures, CSF etc], either Gram stain and /or culture

influenza A positive

pertussis [PCR] positive

Acid-fast stain positive [Mycobacteria] and/or TB positive culture

Cryptococcal antigen, Legionella antigen, pneumococcal antigen, etc positive

Any notifiable disease [eg meningococcal meningitis, measles, HIV, gonorrhoeae, syphilis, etc]

Any rare disease requiring prompt treatment [eg Q Fever, leptospirosis, etc]