Critical results
For critical results being sent internally within the Hospital, we provide a telephone service, 24 hours a day, seven days a week.
All results will be telephoned 24 hours a day if they meet the criteria stated below.
Haematology
Inpatients
All haematology results meeting the criteria below will be phoned to the requesting clinician, except where the results are persistently abnormal. In these cases, only a change to results, that may affect patient management, will be phoned over.
Analyte
Hb
Platelet count
Suspected leukaemia
Neutrophils
Glandular fever screen
Malaria screen
Emergency Sickle Screen
INR
APTT Ratio
Fibrinogen
DDimer
Critical limit(s)
<70g/l or >200g/l
<50 x 109/l or >1000 x 109/l
Blasts, high WBC, etc
<1.0 x 109/l or >30 x 109/l
Positive
Positive
Positive or negative
>5.0
>4.5
<1.5g/l or >11g/l
>20.0ug/ml
GP results
All GP results meeting the critical criteria will be telephoned during the "normal working" day. Please refer to the discipline-specific sections for detailed information.
Results phoned to the out-of-hours service should also be phoned to the GP surgery the following morning to verify that action has been taken. All haematology results meeting the criteria in the table below will be phoned to the requesting clinician, or the out-of-hours service, except where the results are persistently abnormal. In these cases, only a change to results that may affect patient management will be phoned over.
If there is concern that the patient’s condition may result in the patient being contacted by an on-call clinician, this should be made clear to the patient during their appointment.
Analyte
Hb
Platelet count
Suspected leukaemia
Neutrophils
Malaria screen
Emergency Sickle Screen
INR
APTT Ratio
Fibrinogen
DDimer
Critical Limit(s)
<80g/l or >200g/l
<50 x 109/l or >1000 x 109/l
Blasts, high WBC, etc
<1.0 x 109/l or >30 x 109/l
Positive
Positive or negative
>5.0
>4.5
<1.5g/l or >11g/l
Any result >=0.5ug/ml
Additional considerations
In addition to contacting the requesting clinician, the following cases will be promptly referred to a Consultant Haematologist for direct clinical liaison and advice:
- newly presented leukaemia
- newly presented malaria infection
- positive sickle haemoglobin screen in patients about to undergo anaesthesia
- any low factor assay result for patients undergoing an emergency procedure
- persistently prolonged isolated APTT or PT result where there is an acute bleeding risk to the patient (when the patient is not on anticoagulant therapy)
Chemical Pathology
Inpatients
For critical results being sent internally within the Hospital, we provide a telephone service, 24 hours a day, seven days a week.
All results will be telephoned 24 hours a day if they meet the criteria stated in the table below.
GP Results
The below table identifies the arrangements for telephoning GP results out-of-hours. The table indicates whether the results are telephoned to the GP out-of-hours service, or whether they are telephoned to the GP practise the following working day.
Therapeutic drug monitoring results will be telephoned (as specified below) if they are significantly outside the therapeutic range. It must be stressed, however, that the patient and not the biochemistry result should be treated. This is because therapeutic ranges are only guides and there is wide inter-individual variation.