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Medical Laboratory Observer CLR 2026

Page 14

POINT-OF-CARE TESTING CRITICAL LIMITS

Point-of-Care Testing (POCT) Critical Limits By Kami Osher and Gerald J. Kost MD, PhD, MS, FADLM

T

he urgent communication of life-threatening test results is vital for patient safety, enabling rapid, potentially life-saving interventions. Unlike traditional laboratory testing, point-of-care testing (POCT) delivers rapid diagnostic results directly at or near the patient’s site. Healthcare institutions set thresholds for dangerously abnormal results

to guide immediate treatment. These tables display large-scale research by Kami Osher and Gerald J. Kost, MD, PhD, MS, FADLM, published in 2026 in Diagnostics (Basel), involving 417 hospitals across all 50 states and Washington, D.C., including university hospitals and affiliates, heart centers, and trauma centers.1

Table 1. Critical limits for point-of-care clinical chemistry tests.1 Measurand

Number of Hospitals (%)

Units

Low Mean (SD)

Low Median (Range)

High Mean (SD)

High Median (Range)

1.A. Adults Glucose

73 (17.5)

mg/dL

50.3 (4.9)

50 (40–70)

467.7 (60.5)

450 (200–600)

mmol/L

2.8 (0.3)

2.8 (2.2–3.9)

26 (3.4)

25 (11.1–33.3)

Ionized calcium

21 (5)

mmol/L

0.66 (0.17)

0.75 (0.50–1.00)

1.65 (0.10)

1.60 (1.40–1.75)

Potassium

20 (4.8)

mmol/L

2.9 (0.2)

3 (2.5–3)

6.1 (0.2)

6 (6–6.5)

Sodium

18 (4.3)

mmol/L

123.6 (3)

126 (120–126)

156.7 (2.4)

155 (155–160)

CO2 content

17 (4.1)

mmol/L

10.7 (0.6)

11 (10–12)

40 (1.9)

39 (39-45)

Lactic Acid

14 (3.4)

mmol/L

3.6 (0.6)

3.9 (2–4)

11 (2.6)

mg/dL

Calcium

6.5 (0.2)

6.6 (6–6.6)

13 (0.3)

12.9 (12.9–14)

mmol/L

1.64 (0.05)

1.65 (1.5–1.65)

3.25 (0.08)

3.23 (3.23–3.5)

3.9 (0)

3.9 (3.9–3.9)

Venous Lactic Acid

10 (2.4)

mmol/L

1.B. Newborns

Glucose

62 (14.9)

mg/dL

44.7 (5)

45 (40–54)

227.7 (87)

200 (125–500)

mmol/L

2.5 (0.3)

2.5 (2.2–3)

12.6 (4.8)

11.1 (6.9–27.8)

Ionized calcium

18 (4.3)

mmol/L

0.86 (0.05)

0.90 (0.80–0.90)

1.41 (0.14)

1.30 (1.30–1.60)

Potassium

15 (3.6)

mmol/L

3 (0.1)

3 (2.8–3)

6.8 (0.5)

7.1 (6–7.1)

Sodium

14 (3.4)

mmol/L

127.5 (4.3)

130 (120–130)

151.1 (2.9)

150 (150–160)

CO2 content

12 (2.9)

mmol/L

11 (0.4)

11 (10–12)

39.2 (0.4)

39 (39–40)

11 (2.6)

mg/dL

Calcium

6.9 (0.3)

7 (6–7)

13 (0.3)

12.9 (12.9–14)

mmol/L

1.73 (0.08)

1.75 (1.5–1.75)

3.25 (0.08)

3.23 (3.23–3.5)

10

mg/dL

17.9 (0)

17.9 (17.9–17.9)

(2.4)

µmol/L

306.1 (0)

306.1 (306.1–306.1)

Bilirubin Abbreviation: SD, standard deviation.

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