Clinical Chemistry

Low

High

Units

General Chemistry

Ammonia, plasma (≤ 1 month old)

> 120

µmol/L

Ammonia, plasma (> 1 month old)

> 100

µmol/L

ß-Hydroxybutyrate, blood

> 1.5

mmol/L

Bilirubin, total, serum

> 300

µmol/L

Calcium, serum

< 1.6

> 3.2

mmol/L

Adjusted Calcium, serum

< 1.6

> 3.2

mmol/L

Calcium, ionized, blood

< 0.8

> 1.6

mmol/L

Glucose, serum and plasma (≤ 1 year old)

< 2.5

> 16.0

mmol/L

Glucose, serum and plasma (> 1 year old)

< 2.5

> 20.0

mmol/L

Glucose, CSF (≤ 6 months)

< 2.0

mmol/L

Glucose, CSF (> 6 months)

< 2.4

mmol/L

pCO2, blood

< 20

> 50

mmHg

pH, blood

< 7.2

> 7.6

pO2, blood

< 40

> 150

mmHg

Potassium, serum (≤ 1 month old)

< 2.5

> 7.0

mmol/L

Potassium, serum (> 1 month old)

< 2.5

> 6.0

mmol/L

Sodium, serum

< 125

> 155

mmol/L

WBC count, CSF (< 1 month)

> 20

/µL

WBC count, CSF (1 to ≤ 2 months)

> 10

/µL

WBC count, CSF (> 2 months)

> 5

/µL

Drugs

Amikacin (trough, peak, random), serum

> 38.0

mg/L

Gentamicin (trough), serum

> 3.0

mg/L

Gentamicin (peak), serum

> 12.0

mg/L

Paracetamol, serum

> 5.0

mg/L

Salicylate

> 30

mg/dL

Valproic acid, serum

> 120

mg/L

Vancomycin (trough, peak), serum

> 80.0

mg/L

Special Chemistry

Free T4, serum (≤ 2 months)

< 5.2

pmol/L

TSH, serum

> 30.00

mlU/L

TSH, cord blood

> 30.00

mlU/L

Reviewed by Chemical Pathologist (May 2025)

Haematology

Parameters

Patient Group

Notification Criteria

Comments

Hb (g/dL)

Chronic Transfusion Cases

≤ 7.0

1. If applicable, confirm results by repeat testing and/or microscopy.
2. Inform patient’s Dr or SN in charge.
   
    
   
   TO NOTE:

• Notification Criteria of WBC, Hb, PLT and/or ANC are not applicable to known Paed Haem / Paed Onco Patients at SOC visit.
• Patient Listing for Chronic Transfusion Cases is provided by Paed Onco Dept. This list is reviewed and updated periodically.
  

All Other Cases

≤ 8.0

HCT (%)

Neonatal Cases Only

≥ 65.0

WBC (x10⁹ /L)

All Cases

≤ 1.0

≥ 50.0

Platelets (x10⁹ /L)

≤ 20

≥ 1000

ANC (x10⁹ /L)

CE Cases Only

≤ 0.1

All Cases (except CE cases)

≤ 1.0

I/T Ratio

Neonatal Cases Only

≥ 0.25

Bone Marrow Aspiration Morphology Examination

All Cases

Indicative of leukaemia/malignancy

1. Inform patient's Dr or SN in charge.

Blast

All Cases

Present

1. If applicable, confirm results by repeat testing and/or microscopy.
2. Results countercheck by HA Lab Day Supervisor / designate and/or Haematologist.
3. Inform patient’s Dr or SN in charge.
4. If HA Lab Day Supervisor / designate and/or Haematologist is not available during AOH, inform preliminary result to Dr or SN in charge. Keep the slide for review on the next working day.

MP (microscopy)

Present

Kleihauer-Betke Test

Present

CSF for Blast

Present

PT (secs)

All Cases

≥ 20.0

1. If applicable, confirm results by repeat testing for new cases only.
2. Inform patient’s Dr or SN in charge.

TO NOTE:

• Notification Criteria of PT is not applicable to patients at Cardiac Center.
  
   

INR

≥ 5.0

APTT (secs)

Neonatal Cases Only

≥ 70.0

APTT (secs)

All Other Cases

≥ 60.0

Fibrinogen (g/L)

All Cases

≤ 0.40

Anti Xa (LMWH) (IU/ml)

≥ 2.0

Anti Xa (UFH) (IU/ml)

≥ 1.1

Factor VIII Assay (%)

New Case Only

≤ 5.00

Factor VIII Assay (%)

Presence of inhibitors

Factor IX Assay (%)

≤ 5.00

Factor IX Assay (%)

Presence of inhibitors

Dengue Serology

All Cases

NS1 Antigen / IgM and/or IgG positive

Inform patient’s Dr or SN in charge.

MP Serology

Malaria Pan and/or plasmodium falciparum Antigen positive

Plasma Hb (g/dL)

≥ 0.10

Reviewed by Head of Service, Haematology (May 2025)

Microbiology

Notification Criteria

Blood

Positive Gram-stain results

Cerebrospinal fluid

Positive Gram-stain results

Note: Care provider will be informed of the identification(s) and antibiotic sensitivities of organism(s) once ready/ available.

Reviewed by Head of Service, Microbiology (May 2025)