APPENDIX A. Duke University Reference Laboratory Values

Chemistry
Magnesium…..1.6-2.2 mg/dl                        Bun….7-21 mg/dl
Total Protein….6.0-8.0 mg/dl                       Sodium…135-145 mmol/L
Albumin…………3.9-5.0 mg/dl                    Potassium…3.2-4.8 mmol/L
Calcium……… 8.7-10.2 mg/dl                     Chloride….98-108 mmol/L
Phosphorus….2.3- 4.3 mg/dl                       CO2……..21-30 mmol/L
Uric Acid………..2.5-8.0 mg/dl                    Glucose…..75-110 mg/dl
Total Bilirubin…0.2-1.2 mg/dl                       Creatinine…..0.7-1.4 mg/dl
Cholesterol……. <200 mg/dl
Triglyceride……. <250 mg/dl
AST (SGOT)…….10-60 U/L
ALT (SGPT)……..10-60 U/L
Alkaline Phosphatase……30-135 U/L
Amylase………30-110 U/L
LDH…….260-600 U/L
CPK……. 20-200 U/L

Hematology Automated Counts
WBC…3.2-9.8 x 10^9/L                                                                    
RBC (male) ….4.3-5.9 x 10^12/L       (female)….3.5-5.0 x 10^12/L
Hemoglobin (male)…13.6-17.2- g/dl    (female)…12.0-15.0 g/dl
Hematocrit (male)….39-49%    (female)…..33-43%
MCV…80-98 μm3
ESR... males: [Age (in years) / 2]; females [(Age + 10) / 2]
Platelet…..150-450 x 10^9/L   
Lymphocytes…..0.6-4.2 x 10^9/L                   
Monocytes…0-0.9 x 10^9/L   
Neutrophils…2.0-8.6 x10^9/L   
Basophils….0-0.2 X 10^9/L 
Eosinophils….0-0.7 X 10^9/L  

 MANUAL DIFFERENTIAL
Neutrophil…37-80% (varies with age)
Band…0-6%
Lymph….10-50% (varies with age)
Mono….0.12%
Eosinophil…0-7%
Basophil….0-2%
Variant Lymph…0-6%

CSF
CSF opening pressure: 50–180 mmH2O
Glucose: 40–85 mg/dL.
Protein (total): 15–45 mg/dL.
Lactate dehyrogenase: 1/10 of serum level.
Lactate: less than 35 mg/dL.
Leukocytes (WBC): 0–5/µL (adults / children); up to 30/µL (newborns). 
Gram stain: negative.
Culture: sterile.
Specific gravity: 1.006–1.009.
Syphilis serology: negative.
Gross appearance: Normal CSF is clear and colorless.
Differential: 60–70% lymphocytes; up to 30% monocytes 
    and macrophages; other cells 2% or less.

ROUTINE URINALYSIS
Ph….5-9
Specific Gravity….1.005-1.030
Protein, glucose, hemoglobin, ketone, bilirubin NEGATIVE

ALERT VALUES DUKE UNIVERSITY
HEALTH SYSTEM CLINICAL
LABORATORIES

The following alert values are for the general, adult patient population and apply to all DUHS Clinical Laboratories performing these tests. Patient subsets, for example pediatric patients, may require unique alert values which are determined by each individual laboratory. Alert values are laboratory results which, when identified in the laboratory, are confirmed according to accepted guidelines and then immediately telephoned to the ordering physician, appropriate nurse, or unit designee.

Hematology Alert Values
Activated Partial Thromboplastin Time (aPTT), Plasma………. >150.0 seconds
Bleeding Time, IVY………… >9 minutes (pre-op and biopsy patients)
Fibrinogen, Plasma…………… <100 milligrams/dL
Hematocrit, Blood…………….. <0.15 v/v
Hemoglobin, Blood……………. <5.0 grams/dL
Platelet aggregation in the presence of heparin is Abnormal.
Platelet Count, Blood………… <30 or > 800 x 10^9/L
Prothrombin Time (PT), Plasma…………… >40 seconds
……………………………………………….>4.0 (PT 1NR)
White Blood Cell (WBC) Count………………. <1.0 x 10^9/L (adult)
…………………………………………………<1.5 x 10^9/L (pediatric)
………………………………………………….>15.0x10^9/L (all)

Arterial Blood Gas Alert Values
Carboxyhemoglobin (COHb)……………….. >10%
02 Saturated……………………………………. <85%
pCO2……………………………………………………………………<25 or >60 mmHg
pH……………………………………………….. <7.25 or>7.60
P02………………………………………………………………………... <SOmmHg

Capillary Blood Gas Alert Values
pCO2 ……………………………………………… <25 or >60 mmHg
pH………………………………………………….. <7.25 or>7.60

Venous Blood Gas Alert Values
Carboxyhemoglobin (COHb)…………………………. >10%
pC0 2 ………………………………………..<28 or >65 mmHg
pH…………………………………………...<7.23 or >7.58
Chemistry Alert Values
Acetaminophen, Plasma……………………….>100 mcg/mL
Amikacin, Plasma ……………………………..>5.0 mcg/mL
Caffeine, Serum …………………………………>50 mcg/mL
Calcium, Plasma or Serum ………………………<7.0 or >12.0 mg/dL
Carbamazepine, Plasma ……………………………>12 mcg/mL
Cyclosporine A, Whole Blood ……………………..>500 ngms/mL
Digoxin, Plasma …………………………………….>2.0 ngms/mL
Ethanol, Plasma ……………………………………...>250 mgms/dL
Gentamicin, Plasma…………………………………..>2.5 mgms/mL
Glucose, Plasma………………………………….<50 or >350mgs/dL          
Calcium……………………………………………………<0.87 or >1.41 mmol/L
Lactate (Lactic Acid), Plasma …………………………………….>5.0 mmols/L
Lead, Blood ……………………………………………………….>10.0 mcgs/dL
Potassium, Plasma or Serum…………… <2.8 or >6.0 millimoles/L
Sodium, plasma or Serum…………………<120 or >155 millimoles/L
Magnesium, Plasma or Serum…..<1.2 or >3.8 milligrams/dL

ALERT VALUES DUKE UNIVERSITY
HEALTH SYSTEM CLINICAL
LABORATORIES
Therapy related, drugs and IV fluids

Lidocaine Plasma :……………> 6.0 micrograms/mL
Lithium, Serum……………….>1.5 millimoles/L
Magnesium, Plasma or Serum…..<1.2 or >3.8 milligrams/dL
N-Acetyloprocainamide, Plasma…>30 micrograms/mL
Phenobarbital, Plasma…………….>55 micrograms/mL
Phenytoin, Free, Plasma…………..>2.0 micrograms/mL
Phenytoin, Total, Plasma…………. <1 or >7.5 milligrams/dL
(pediatric, excluding patients <1 month of age)
(8.5 milligrams/dL for newborns)………<1.0 milligrams/dL (adults)
Potassium, Plasma or Serum…………… <2.8 or >6.0 millimoles/L
Procainamide, Plasma……………………>16 micrograms/mL
Quinidine, Plasma………………………..>6.0 micrograms/mL
Salicylate, Plasma………………………...>300 milligrams/L
Sodium, plasma or Serum…………………<120 or >155 millimoles/L
Theophylline, Plasma………………………>30 micrograms/mL
Tobramycin, (Spot, Pre or Post), Plasma…….>2.5 micrograms/mL
Valproic Acid, Plasma………………………..>120 micrograms/mL
Vancomycin, Plasma………………………….>15 micrograms/ml
Pre……………………………………………..>15 micrograms/mL
Post…………………………………………….>40 micrograms/mL